How Congress is sabotaging Obamacare in North Carolina

The Observer editorial board

Republicans, including House Speaker Paul Ryan, have emphasized Obamacare’s deficiencies so that a replacement will be more appealing to Americans.
Republicans, including House Speaker Paul Ryan, have emphasized Obamacare’s deficiencies so that a replacement will be more appealing to Americans. AP

News this week of potentially steep Obamacare rate hikes in North Carolina next year comes close to a worst-case scenario for many in our state. The proposed 22.9 percent hike by Blue Cross and Blue Shield will hurt those who can afford it least, and it seems like yet another sign of the trouble the Affordable Care Act is in here and across the country.

But the 22.9 percent increase also represents a worst-case scenario of sorts for Blue Cross and Blue Shield, and the story behind that number shows exactly who’s to blame for Obamacare’s latest struggles.

In explaining the proposed rate hike this week, Blue Cross pointed a finger directly at uncertainty surrounding the cost-sharing subsidies that the government pays insurers to help keep premiums down for Obamacare customers. The Trump administration has threatened to eliminate those payments, and Republicans in the U.S. House have sued to stop the cost-sharing program.

To make matters worse, the Trump administration asked the U.S. Court of Appeals in D.C. this week to delay a ruling on the Republican lawsuit for 90 days. That’s awful timing for insurance companies that are filing for 2018 marketplace rates in states like North Carolina and want to know if those government payments are coming.

Video: Republican Rep. Ted Budd said if the AHCA becomes law, it will "significantly reduce insurance premiums in" North Carolina. That’s not entirely accurate, says PolitiFact NC.

If the cost-sharing subsidies were guaranteed – as they had been under the Obama administration – premium increases wouldn’t be nearly as harsh. In fact, Blue Cross put a number on that hypothetical increase – 8.8 percent, which is more in line with insurance rate hikes over the past two decades.

It’s one more example of how Republicans are working to sabotage the Affordable Care Act – even if that means hurting their constituents back home. Already, Republicans have gutted an ACA “risk corridor” program that reimbursed insurers for the losses they endured by taking on less-healthy and higher-risk customers. The GOP goal is simple: force insurers to hike premiums or leave the exchanges altogether, as many already have, so that an Obamacare replacement becomes more appealing to Americans.

Problem is, the plan isn’t working. The American Health Care Act passed by House Republicans would result in 23 million fewer Americans being covered by insurance, according to a Congressional Budget Office analysis this week. The CBO also warned that the House bill would likely increase insurance costs substantially for millions of others, including those with pre-existing conditions.

This editorial board has said often that the better path for Americans is for Congress to fix Obamacare’s flaws, not replace it with an inferior alternative. Guaranteeing cost-sharing subsidies and restoring risk corridor payments would go a long way toward bringing insurers back to Obamacare exchanges. It’s worth noting that Blue Cross also said this week that the exchange was stabilizing because more healthy people were signing up.

In poll after poll, Americans overwhelmingly want to keep Obamacare or the core benefits it offers. North Carolinians should say so again if Sens. Thom Tillis and Richard Burr have the courage to listen to them at town halls during the upcoming Senate recess.