Health

This Teacher's Prediction About What Will Happen When Obamacare Is Repealed Is Going Viral

February 10th 2017

A high school teacher at a Tennessee town hall on Thursday made a concise argument defending a health care mandate that may be repealed.

The exchange between Jessi Bohon and Rep. Diane Black, R-Tenn., went viral after a CNN reporter shared the video on Twitter.

"It's my understanding that the [Affordable Care Act] mandate requires everybody to have insurance, because the healthy people pull up the sick people," Bohon said. "If we take those people and we put them in high-risk insurance pools, they're costlier, and there's less coverage for them. That's the way it's been in the past, and that's the way it will be again" if the mandate is repealed.

High-risk insurance pools — state-run programs designed to cover individuals who didn't qualify for employer-based or government health insurance plans — lost much of their value after the ACA was enacted, guaranteeing coverage for people who were previously denied on the basis of pre-existing conditions, for example.

The Kaiser Family Foundation released a report in 2011 that showed about 20 percent of people who applied for health insurance were denied. The uninsured rate in the U.S. dropped from 17 percent in 2013, before the ACA rollout, to a record-low 11 percent in 2016, a Gallup poll found. And the mandate Bohon referenced was a critical part of that decline.

pollGallup - gallup.com

Bohon pointed out that high-risk pools proved costlier and offered less coverage than plans provided through the federal health care law.

Though states offered subsidies on premiums for these enrollees, the premiums cost states about 150 to 200 percent more than average market value — and enrollees suffering from more serious conditions such as HIV were often charged more for their premiums, Kaiser explained.

In terms of coverage options, most high-risk pools excluded coverage for qualified enrollees with pre-existing conditions for the first six to 12 months. And many states set dollar limits on covered services and prescription medications.

"I want to know why not, instead of fix what's wrong with Obamacare, make companies like Aetna that pulled out and lied to their consumers about why they pulled out and said they pulled out because Obamacare was too expensive — but they really pulled out because of a merger — why don't we expand Medicaid and have everyone have insurance?" Bohon asked.

woman-holding-obamacare-signFlickr/LaDawna Howard - flic.kr

That gets at the central divide between Republican and Democratic proposed plans to replace the ACA mandate.

Democratic lawmakers have proposed a single-payer health care system that covers everyone through Medicaid expansion.

Republicans are weighing the prospect of cutting costs, replacing the ACA mandate with high-risk pools.

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