Sohn: Republicans are still trying to murder Obamacare

The BlueCross BlueShield complex atop Cameron Hill in Chattanooga.
The BlueCross BlueShield complex atop Cameron Hill in Chattanooga.

The partisan forge to sabotage the Affordable Care Act has been endless. Apparently, it also has been tragically successful.

Just a month after seeking and receiving federal government approval to raise rates by 62 percent for marketplace insurance plans under the Affordable Care Act - also known as Obamacare - BlueCross BlueShield of Tennessee is now announcing it will bow out of offering individual exchange plans next year in Memphis, Nashville and Knoxville.

Why? To help limit "the risks" of additional losses for Tennessee's biggest health insurer, which is based in Chattanooga. BlueCross officials says the company lost $311 million in the first two years of the program and expects to lose another $100 million this year. Only 7 percent of BlueCross health care plans are Obamacare plans, however, and overall the nonprofit company reported a profit in those first two years and expected a profit this year, as well.

"This is a difficult, but necessary decision," BlueCross Senior Vice President Roy Vaughn said last Monday. "Even with the increases that were approved for us next year, we felt there was too much risk of the federal government changing the rules."

When he says "the federal government," he means Congress.

Yes, it's true that no one can say with certainty who will be elected president in just five weeks. But it is the Republican-controlled Congress that is the real problem.

We all remember Republican Sen. Ted Cruz's filibuster reading of Dr. Seuss's "Green Eggs and Ham" in 2013 and the government shutdown over Obamacare, but it was Republican Sen. Marco Rubio's sneak provision of the "Obamacare Taxpayer Bailout Prevention Act" onto the omnibus government spending bill months later that quietly sent Obamacare into what The Washington Post said may prove to be the ACA's "death spiral."

Of course, what Republicans called a bailout wasn't a bailout at all. It was a rather genius public/private kind of solution to entice reluctant insurers to join the exchanges by creating an insurance-industry funded and government-backed escrow account called a "risk corridor" program to help prop up insurers who lost money in the ACA's first three start-up years. Profitable insurers would pay some of those profits into a pool to help insurers that lost money. If the amount insurers lost exceeded what the companies paid in - something expected in those start-up years as sicker people who were denied insurance previously streamed into the program - the government would step in and make up the difference.

The Congressional Budget Office said the risk corridors would likely eventually break even by 2016. They were modeled after a successful plan that was part of George W. Bush's Medicare Part D prescription drug coverage. Of course, no one referred to W's program as a bailout.

But Rubio's bailout prevention provision, attached to both the 2014 and 2015 omnibus bills, barred the Department of Health and Human Services from dipping into general funds to pay struggling insurers, and the original corridor risk program expires after this year.

Rubio's rider sparked little opposition at the time, but it seems to have proven to be a poison pill - especially coupled with 22 states like Tennessee not expanding their Medicaid programs under the ACA - to the healthier working poor families.

First the co-op insurers folded because they didn't have other insurance lines of business to absorb ACA upstart costs: Just six of the original 23 across the nation remain. Then larger commercial insurers, like BlueCross, began raising rates to offset losses in the ACA plans. Those higher rates lead more healthy young people to opt out, leaving insurers with sicker people who require more care - and more expense.

Now BlueCross contends the federal government owes it about $300 million under that original Affordable Care Act "risk corridor" and a similar backstop known as "risk adjustment.

This death by a thousand Congress and state-house inflicted cuts has given Republican lawmakers a false claim that Obamacare has failed just as they always said it would.

"This is more evidence that Obamacare is falling apart," said our own GOP Sen. Lamar Alexander, who has never missed an opportunity to cut the legs out from under a program that has helped 21 million Americans gain health insurance and reduced the country's uninsured rate to 8.6 percent, a historic low. Meanwhile, health care prices across the nation have risen at the lowest rate in 50 years.

In Tennessee alone, the number of uninsured people declined from 14.4 percent to 10.3 percent last year, according to the U.S. Bureau of Census.

But now BlueCross, in 2017, will drop ACA plans that cover 112,000 Tennesseans in the Memphis, Nashville and Knoxville markets.

Republican politicians in state and federal government should feel tremendous shame that they were so small they could not move past the idea that a health care plan pushed by Democrats and especially by President Barack Obama might have growing American consumer use and respect.

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