June 19, 2018
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Politics say otherwise, but the time isn’t right for Obamacare changes

Arminda Murillo, 54, reads a leaflet at a health insurance enrollment event in Cudahy, Calif., recently.

Maine Sen. Angus King is teaming up with a group of moderate Democrats — including some locked in tough re-election battles this fall — to propose a handful of amendments to the Affordable Care Act.

“We’re trying to make something that’s worthwhile better,” said King, who has been an Affordable Care Act supporter. King is working with Democratic Sens. Heidi Heitkamp of North Dakota, Mary Landrieu of Louisiana, Mark Begich of Alaska, Mark Warner of Virginia and Joe Manchin of West Virginia.

It’s past time members of Congress committed to having an honest conversation about how the Affordable Care Act is working and could work better. We appreciate the nudge in that direction King and his colleagues are offering.

Some changes they’re discussing are largely harmless amendments that might help in small ways. Other adjustments border on undermining key goals of the Affordable Care Act.

What concerns us most, however, is that the changes suggested are a response to a political need rather than a proven need to change the law so it can work better. The most significant provisions of the Affordable Care Act are still in their infancy. And the most significant problems to date have been matters of implementation, not legislation.

King has signed on to three of the group’s amendments.

One would offer a low-premium, high-deductible plan ostensibly as a way to lower costs and spur more competition. While the Affordable Care Act allows this type of plan for people younger than 30, one of the law’s goals was to move the nation’s health insurance market away from high-deductible plans that leave patients with little actual coverage and the bulk of responsibility for costly medical bills.

The Copper Plan — which would be available to anyone — would be of higher quality than pre-Obamacare, high-deductible plans since it would conform with the law’s basic requirements. But it would interfere with the law’s goal of making true health insurance coverage affordable.

Another King amendment would apply the health reform law’s employer mandate to firms with the equivalent of at least 100 full-time employees, up from the 50 specified in the law. The employer mandate hasn’t even kicked in yet; it will take effect in 2015 for employers of 100 or more and the next year for those with 50 or more.

The provision — which would apply to just 4 percent of firms nationwide, at least 96 percent of which already offer their employees insurance — hasn’t had a chance to work, much less prove unworkable. We don’t see a reason to change it now.

King’s other proposal, to simplify and expand a tax credit that helps businesses pay for employee health coverage, would be a welcome move to encourage more employers to provide coverage.

King said Friday he’s also interested in requiring greater transparency from insurers about the limitations on health care provider networks in their plans. That would be a welcome change after many signing up for coverage in recent months found their doctors weren’t covered by the plans in which they enrolled. King said there’s a good chance that change — along with other minor adjustments that have been and might be necessary — can happen without legislation.

Members of Congress who have supported the Affordable Care Act are in a bind this year as many run for re-election in areas where the law is unpopular. Showing a willingness to change the law can have political benefits.

However, it’s important that those changes not undermine the Affordable Care Act’s core goals. And in this political environment, simply putting individual elements of the Affordable Care Act on the negotiating table could have the effect of exposing even more fundamental elements of the law to legislative attack.

The Affordable Care Act deserves a chance to work. Congress should respond if there’s a demonstrated need to change an aspect of the health care law, but members should proceed with caution.


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