Is There a Way to Fix Obamacare?

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President Obama’s signature healthcare law, the Affordable Care Act, is in dire straits. According to polls, most Americans favor repealing the law altogether. Insurance premiums have reportedly risen in numerous states and some of the nation’s largest insurers are pulling out of Obamacare marketplaces. Obamacare’s fate will likely hinge on the presidential election, as Donald Trump promises to repeal the Act, while Hillary Clinton wants to use it as a starting point for an expanded policy.

I. Barack Obama

President Obama defended his Affordable Care Act in a speech last week. Obama argues that most Republican criticism of the Act “has proven to be false.” However, he says there are “growing pains” involved in implementing such a massive change. The president notes that, under Obamacare, 20 million people have gained access to health insurance. Now, Obama believes it is up to leaders at the state and national level to take further steps. For instance, he recommends expanding Medicaid to cover more low-income Americans and introducing new subsidies and tax credits for those buying from the marketplace. This, he argues, will resolve the remaining 10% uninsured rate and help guarantee that all Americans are healthy and able to contribute to the country.

II. Paul Ryan

Rep. Paul Ryan (R — Wis.), the House Speaker, has led calls for repealing Obamacare. He says the system “can’t be fixed,” pointing to rising costs and reduced care options for middle-class Americans. Ryan has instead spearheaded a replacement plan. The Ryan proposal would remove the main components of mandates and subsidies. It would also allow customers to purchase plans across state lines, to encourage competition. Along with reforming malpractice laws to reduce doctor overhead, Ryan believes greater competition would drive down costs. Ryan would also change Medicaid to a block grant system, providing states with lump sums and allowing them more flexibility in finding ways to save on healthcare for poorer residents. Ryan would retain some of Obamacare’s popular secondary elements, like protecting those with pre-existing conditions while allowing young people to remain on family plans up to age 26.

III. Bernie Sanders

Senator Bernie Sanders (I — Vt.) is a leading champion of the Affordable Care Act, but he recognizes its imperfections. One big problem for Sanders is that the law still leaves many uninsured. The U.S. currently outspends every other nation on healthcare. This means Americans are paying more while still failing to insure everyone. Sanders attributes these high costs to the complex, profit-driven insurance system, which requires huge administrative investment by doctors and insurers. The liberal senator believes, therefore, that Americans should view Obamacare as a stepping stone toward a fully inclusive, single-payer system. Single-payer health insurance, Sanders argues, would resolve these costs and complications while guaranteeing care for millions who remain uninsured under Obamacare.

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Further Reading: Reuters / Time / Bernie Sanders

This brief was written by Jared Metzker.

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