It is fitting that the healthcare.gov website crashed on the ostensibly final day of open enrollment for the Affordable Care Act. Now comes word from the Obama administration that the government will accept paper applications until Monday, April 7 — and continue to process unfinished applications and permit a range of additional exceptions for natural disasters, domestic abuse, errors by insurance companies or application counselors and, of course, website malfunctions.
This latest snafu doesn’t come as a surprise to a nation weary of President Barack Obama’s signature health care legislation. The implementation of ACA has been a debacle from the outset. Even its most ardent supporters have come to recognize the deep flaws in this effort to restructure a substantial sector of the American economy in a divided and partisan manner. Many now question whether the law can be salvaged or if it must be scrapped altogether.
Certainly Republicans have sought to repeal the law for more than four years. Until recently, their eagerness to see the ACA fail has not been matched with an effort to provide viable alternatives to the measure. The ACA was a response to many deeply sought needs for improvement to the American health care system. And given the many changes wrought by the law, returning to the pre-ACA status quo doesn’t seem realistic. If the GOP wants to get rid of the law, it needs to come up with a workable solution of its own.
Thankfully, Utah Sen. Orrin Hatch and two of his Republican colleagues seem to have gotten that message. Along with Sens. Richard Burr of North Carolina and Tom Coburn of Oklahoma, Hatch has proposed the Patient CARE Act, a more market-based approach to health care. The PCA would allow greater flexibility for insurance companies to craft their products to meet the needs of their customers, allowing them to provide the kind of streamlined, less expensive plans that have been cancelled by the ACA. Under the PCA, if you liked your previous low-cost insurance, you would indeed be able to keep it.
Perhaps the most innovative element of the PCA is its significant restructuring of Medicaid. The PCA would allow Medicaid patients to get private insurance instead of government coverage, which would likely lower costs to taxpayers. The PCA approach would go a long way toward making Medicaid sustainable for future generations.
The PCA also includes malpractice insurance reforms and eliminates the requirement that people buy medical products that violate their religious principles. Both of those are necessary and welcome changes to the current system.
The Patient CARE Act represents a good-faith effort to build a better system rather than just tear down the Affordable Care Act. It is a step in the right direction.