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In An Election Year, Is There Political Will On Any Side To Fix The ACA?

While the  health insurance system set up under the Affordable Care Act, sometimes called Obamacare, remains in place, premiums are expected to rise again significantly this fall. That has members of Congress from the Commonwealth pointing fingers and also floating ideas for how to protect patients from rising costs.  But it's not clear any of the ideas have enough support to become law.

The administration has successfully unwound many parts of the Affordable Care Act. The GOP tax bill killed the health insurance mandate and the Health and Human Services Department wound bound back what Democrats say are crucial ad campaigns intended to get people to sign up for the exchanges.

But Northern Virginia Democrat Don Beyer says the administration’s attempt to stop some coverage of pre-existing conditions highlights how the GOP isn’t putting consumers first. He says they’re set on killing Obamacare no matter the cost to people.  “Oh yes, and every way it can administratively. You know, probably the worst case was trying to use the courts to undo the waiver of preexisting condition. I do think that’s where it’s going to come back and bite them because I think it’s a huge political danger to the Republicans,”  Beyer says.

With premiums expected to rise yet again this fall Democrats are calling on the GOP to help them fix it, but Central Virginia Republican Dave Brat says it’s Democrats who need to realize their party’s policy hasn’t worked.  “I mean after Obamacare failed, and it seems to me the onus is on the Democrats, they own the failed system. None of them would come over to us to help fix it. So costs have gone up 150% over the last six years," Brat says. "So that’s under Obamacare, that’s not under Republican policy. So we need Democrats to be willing to work with us.”

President Trump’s administration has also halted more than ten billion dollars in payments intended to help insurance companies under the Affordable Care Act, which Democrats are fuming over. But Virginia Beach Republican Scott Taylor says that’s hypocritical because they’ve been demonizing insurance companies until now. “So they’re not the greedy insurance companies anymore? Is that what the Democrats are saying," Taylor asks? "Listen, I think in my opinion that health care, — whether you’re  a Republican or Democrat, the bills have been written — are top down and not bottom up and that  we need a complete disruption. So exactly the people who they’re demonizing, the insurance companies, they have before. Now they’re fighting to give them free money?”

While the Trump administration has been active in unwinding many of the elements of the policy that President Obama directed from the White House, many House Republicans recognize that’s not a long term solution. Southwest Virginia Republican Morgan Griffith says it’s time for Congress to act, because he contends Obama should never have been directing insurance payments without an act of Congress. "This is a Congressional issue, It’s not an administrative issue," Griffith says. The President is absolutely right on the law.  The Obama administration robbed Peter to pay Paul and ultimately would have been found that until the admin says they’re not doing it anymore, it would have been found they didn’t have the authority to do it. They didn’t have authority to do it.”

Griffith says Democrats have put his party in between a rock and a hard place, so while he wants a full repeal he says he would support legislation to help people out with their deductibles in the meantime.  That help could come in the form of a subsidy called a Cost Sharing Reduction or CSR.  "They never had the authority to do it. They created that whole class and spent money that they didn’t have authority from Congress to spend. They couldn’t get the Democratic Senate to go along with it. But they did it anyway," Griffith says. "It’s very hard to go back to people after they’ve had insurance at one price and say 'Hey it’s gonna make it a lot more expensive.' And until we have something to replace it I think we’re gonna need to do the CSR’s."

Still, Congressman Beyer, the northern Virginia Democrat, believes the courts are going to rescue his party in at least that one area and will compel the administration to restart those payments. “I think it’s probably against the law. And the good news is the law is still on our side. People will be seeking injunctions of court relief. But it’s a terrible thing, you know, the whole idea of the executive branch is to lead but to follow the will of what the law of America is,” Beyer says.

The GOP spent the last few election cycles running against Obamacare, but this year Democrats have regrouped and are running ON Obamacare. So even while individual lawmakers have ideas for making coverage more affordable, election season seems to be standing in the way.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.

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