Obamacare Survives Repeal, for now.

There is more happening in Washington D.C. to fix or repeal...

Following the health care debate has many feeling frustrated, grateful, worried, and tired. I think it's fair to say both parties would consider the recent Senate vote a bit of a circus with no progress on either repealing a horrible law (if that's your take) or fixing a law that has helped many but needs some adjustments (that's my take). Either way, the Senate vote ended with a dramatic midnight vote that saw the skinny repeal plan lose by a vote of 49 - 51. Republican Senators Collins, Murkowski and McCain cast votes against the third and last remaining GOP bill to repeal the individual and employer mandates. With only two "no votes" to spare, McCain (with stitches over his eye from his recent surgery) gave a dramatic thumb down and cast the final and decisive vote to defeat this watered down repeal bill. The three health care bills that Republicans tried to pass would have led to between 16 million and 32 million fewer Americans having health insurance, when compared to Obamacare. So, now what?

Both Republican and Democrat lawmakers are already busy with new bills:

• The House Freedom Caucus is already working on a new bill that can pass the Senate, including proposals offered by Senators Lindsey Graham, Bill Cassidy, Ted Cruz, and Rob Portman. Another Freedom Caucus member Rep. Jim Jordan says the group still wants to force a vote for a full repeal in the House.
• Senator Graham was at the White House pitching his own health care proposal to President Trump (turn ACA spending over to the states.)
• Democrat Senate Minority Leader Chuck Schumer held a press conference to invite Republicans to work with Democrats on bipartisan ACA fixes, including permanently funding the law's cost-sharing subsidies for low-income people.
• Democratic Sen. Claire McCaskill is reaching across the aisle and says some moderate Republicans and Democrats have "already begun meetings" on a bipartisan bill. (that's encouraging)

For Californians and other states where the ACA has broadened access to affordable care, the vote was a victory. But there is still much work to do to stabilize the insurance markets, especially in areas of the country where many providers have exited the individual market. California has eleven carriers in our state exchange (Covered California). Covered California will announce rate increases for 2018 on August 1st. The rate increases will likely be shocking to some and greater than past increases, I expect possibly more than 20%. That is an example of the continued work needed to reduce the underlying health care costs that drive up our insurance premiums. That problem existed long before the ACA and will continue until we shift our focus on health care and not just insurance reforms. Deductibles will continue to rise and more Americans will continue to struggle to afford care, even if they have coverage. That is going to be true for a while until a massive overhaul of our fee-for-service health care system. Until then, we will simply shift costs, narrow our provider networks or downgrade to skimpier plans.

Educating consumers of their available options and guiding to best value is a critically important role for licensed agents. The next years will be tough as costs will continue to outpace wages and confusion and frustrations will grow. The buzz around single payer will grow and it may become more appealing to some, if even out of desperation to just try something else. That is why it is critical to remain on message and help explain

Democrats and others who believe the GOP repeal bills would have caused harm to millions of Americans and destabilized an already unstable insurance market celebrated the failed vote. For now, Obamacare will remain the law of the land and bipartisan work to repair the ACA seems more possible. The speech made on the floor by Senator John McCain was very touching and boosted his status as an American hero and statesman. The message cautioned his Senate colleagues to remember their role in service to the country and the ugly partisanship that blocks progress. He calls for regular order and allowing hearings and input from both sides. It's worth a listen.