The Failure of “Repeal and Replace”

The Failure of “Repeal and Replace”

Apr 26, 2017

The failure of the “Repeal and Replace” effort made media headlines for days.

For those of you that weren’t “glued to the news”, there were a few reasons that the bill failed according to most that have commented publically about the outcome in the media.

First of all, The Affordable Care Act, or Obamacare, had mandated that every insurance policy sold in the individual/family plan market to those without employer or government coverage had to include 10 essential benefits. Under the Republicans’ plan, that mandate – that all plans include things like prescription drug coverage, emergency room services, maternity care and mental health treatment – would have disappeared.

It also became more of a financial hardship on a demographic that is currently growing in the US: Older Americans. Older Americans would have had to pay more, sometimes thousands of dollars more to get health insurance. In 32 states, millions of Americans with incomes slightly above the poverty line who had gained coverage under their state’s Medicaid expansion program would have lost their coverage.

So, in the foreseeable future the Affordable Care Act will remain in place. My hope is that many that have not embraced this change that started several years ago will now realize that while it’s not perfect, it is the law for now and we should all get on board and support something that has more Americans insured in United States that ever before in our history.

As far as premiums are concerned, let me weigh in on something that I tell my clients because I too pay a lot of money for insurance (there are no discounts for insurance brokers) and my premiums go up every year as well.

As long as technology research continues to grow and expensive lifesaving treatments continue for all ages in our society, there will be a price tag that we all bear for this. If you pay $12,000 a year for insurance that is not much in addition to your annual out of pocket maximum of roughly $6500 if you get cancer and you need surgeries, chemotherapy and radiation to survive it. And if it comes back, that process may repeat itself. Or, what if you have a traumatic injury and then secondary infections and a long hospital stay in order to survive that? How much do you think all of this care cost to the private industry supplying it?

Not too long ago these examples weren’t that expensive for insurance companies to pay for because the mortality rate would come into play, and those afflicted by disease or suffering serious trauma wouldn’t survive long. Technology now keeps the mortality rate lower and the treatment for diseases and injuries longer lasting because people survive them. I feel that advancements in medicine can be a double-edged sword in many cases, medical advancements and their price tag certainly affect the premiums that we pay.

Stephanie Frisch

Stephanie Frisch is the owner of Insurance 101 and is an independent insurance broker dedicated to helping others make “educated decisions” about their insurance choices when it comes to Medicare, Long-Term Care Planning, The Health Insurance Marketplace-Covered California and Life Insurance. For answers to your questions, or an in-home, no-fee consultation, call (949) 351-2443.