Triage for Obamacare

Anyone who thinks Obamacare – The Patient Protection and Affordable Care Act (most just call it the Affordable Care Act) – is not truly in need of fixin’ probably isn’t remotely aware of what its main points are. The statute was passed in March of 2010, is over 900 pages long, and the resulting regulations would fill a substantial bookshelf. The law was phased in over time, with the last provisions set to kick in early next year.

And like every piece of seminal legislation of this size and scope (Social Security, the Federal Income Tax Code, Medicare, the Voting Rights Act, most Civil Rights legislation), neither Congress nor the President remotely got it right on the first pass. While Tea Partiers dispute this finding, the benefit for the country, assuming folks actually comply with the law, will be an actual long-term reduction in the federal deficit, according to the Congressional Budget Office, by spreading the cost of healthcare over a wider coverage base.

While there are thousands of tweaks that will be necessary to make the law work in the near term, and while the software technology of the federal version of the healthcare exchange is glitched to the max (but slowly getting under control), it actually does pay to listen to the criticism from the left and the right to see where the big fixes need to be addressed. If people will sit down and repair the obvious problems – instead of an all or nothing approach which seems to be the only thing that our gerrymandered House of Representatives seems to be capable of – the law can be made to work… and actually work reasonably well. And it will take a few years of experience to get the process down to a workable and manageable level. Don’t expect smoothness and a miracle… it never happens with such complex legislation.< o:p>

Let’s start with the fact that everyone who can afford health insurance is forced either to pay a penalty for not getting coverage or has to find coverage somewhere within the statute’s four corners. But there are obvious problems with the “invincible” youth, those who are not covered under their parents’ policy (up to age 26) and don’t think they need coverage. They wink and smile noting that if they have an emergency, since pre-existing conditions cannot be excluded, they can sign up in the ambulance and get covered before the wailing siren gets them to the ER. Why get coverage when they can wait? Okay, let’s add a waiting period for those who either could afford to opt in but did not or elected to pay a penalty instead. Stop the cheaters.

For all that “job loss” GOP Senator Ted Cruz is happy to point out, there is a solution that works just fine, thank you. For those who have been shifted to part-time work, under 30 hours a week, by big companies seeking to avoid the cost of coverage, let’s apply the easy button. There is no reason to reinforce loophole seeking conglomerates cutting back their workers’ benefits. For less than 30 hours a week, let’s amend the law and have the employer be required to contribute a fraction of the middle level exchange care policy cost based on hours actually worked against that 30 hour minimum. Thus if a worker only works 20 hours a week, the employer contribution would be 20/30 (two thirds) of the cost of the middle level policy. Thus, there would be no benefit in cutting full time workers to part-time, since the aggregate hours would still add up to the full workforce at that company.

Likewise, for big companies using small subcontractors which fall under the 50 employee minimum for coverage under the Act (they have to pay a penalty instead), to the extent that such workers are not otherwise covered by healthcare insurance, apply the same standards against such contractors as would be applied by the main company engaging the individuals doing the work. We cannot encourage big companies to find little contractors simply to avoid paying benefits.

We can run down the list of issues, but if instead of throwing the baby out with the bathwater, if rational minds sit down with an intention to make the law of the land, reinforced by a Supreme Court decision to that effect, function in the best interests of the American people… we can do it! Or we can get back to manufactured crises and appealing to Congress people who represent gerrymandered districts where conservatives dedicated to kill the Affordable Care Act only run against even more diehard opponents to the Act. 42 efforts by the House to defund or kill the Act didn’t even make it past the Senate! And still they keep trying.

I’m Peter Dekom, and simply repeating the words that the Affordable Care Act is the worst thing ever to hit the United States over and over again without even trying to fix the obvious is profoundly counter-productive, wasteful and makes us a global laughing stock.