Improving ObamaCare – Little by Little


ObamaCare is getting better – little by little. The refusal of Congressional Democrats to cooperate in any way that changes ObamaCare has made wholesale repeal and replacement impossible.

But improvements are happening anyway. The repeal of the Individual Mandate was made possible by the passage of the tax reform legislation. Now people can choose to purchase health insurance without the threat of a government tax if they decide the insurance isn’t worth the money.

Other changes are being made possible through de-regulation. The latest is a change that affects small business owners. It will allow small businesses to band together to provide insurance on equal footing with corporations and unions.

The Wall Street Journal editorial board says the share of workers at small businesses with employer-sponsored health benefits has dropped by 25% since 2010 (when ObamaCare was passed) as insurance costs have ballooned in part due to government mandates. Ironically, ObamaCare tried to increase the number of workers on insurance by mandating businesses cover all full-time workers (over 30 hrs. /week) for businesses with 50 or more such employees.

As a result, about 11 million workers employed by small businesses are uninsured. Others have been dumped by their employers onto state insurance exchanges where premiums are subsidized by taxpayers.

President Trump is trying to fix this problem. He instructed Labor Secretary Alexander Acosta to consider “expanding the conditions that satisfy the commonality-of-interest requirements” for association health plans under the Employee Retirement Income Security Act, or ERISA. Large group plans that are self-insured (funded by unions or employers) are covered by ERISA. These plans were exempted from ObamaCare’s essential benefits requirements, although they must comply with rules regarding life-time spending limits and pre-existing conditions.

President Obama was interested in satisfying the interests of liberal supporters like unions and large corporations. President Trump is trying to level the playing field for small businesses and sole proprietorships.

Currently, small businesses must purchase coverage from insurers in the small group or individual marketplaces, which are subject to ObamaCare’s coverage mandates and controls on premium prices. The Obama Administration precluded small employers from forming association plans that are exempt from ERISA by their narrow interpretation of the “commonality of interests” membership requirements.

Secretary Acosta has now proposed new rules that would more broadly define the “commonality of interest” clause to include geographical area, as well as an industry, trade or profession. This would allow national industry groups to sponsor plans. It would also allow independent contractors, like Uber drivers or free-lance journalists, to form or join association plans.

These changes will lower the cost of health insurance premiums for all those affected.

Naturally, supporters of ObamaCare are howling that President Trump is trying to destroy the ObamaCare exchanges. But with premiums already climbing 25% or more per year, the exchanges have ceased to be a viable source of insurance for most who don’t get subsidies.

Reality is that these same supporters of ObamaCare are actually hoping for the complete demise of the system so they can then propose single-payer healthcare as the solution. But Americans deserve better than the Canadian system of long waiting lines for delayed treatment.  Changes like the Trump Administration is proposing will help us preserve the freedom of choice we all desire.

The Wall Street Journal summarizes:

“The Trump Administration can’t fix all of ObamaCare’s problems with deregulation, but it can at least provide some struggling Americans with lifeboats such as association health plans.”

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