Whether you love the Patient Protection and Affordable Care Act (PPACA) provisions that affect the commercial health insurance market or hate them, the law affects the insurance ordinary people use to pay for checkups and heart transplants.
The U.S. Supreme Court refused to kill PPACA in 2012, and the court refused a second chance to kill PPACA this summer.
In the days before the court ruled on King v. Burwell, even many congressional Republicans had trouble coming up with a PPACA alternative. Some worried about the consequences of killing PPACA without providing an alternative.
I think the lesson is that opponents of PPACA should separate the idea of trying to kill PPACA from the idea of making genuine bipartisan efforts to improve the law. Health insurance is too important to try to let it operate as poorly as possible just to make the Democrats look bad.
Similarly, supporters of PPACA should stop repeating talking points, over and over, that boil down to, “PPACA is nice. It helps people,” and get serious about improving how PPACA World works.
Here are some ideas about where to start:
1. Make the U.S. Department of Health and Human Services (HHS) comply with serious reporting and operational transparency requirements.
The exchange system has been up and running since January 2014, but HHS still hasn’t made any effort to give us clear, complete data on any aspect of PPACA compliance or any part of the PPACA exchange system.
We have a little data on exchange plan selection numbers, the uninsured rate and minimum medical loss ratio rebates. Beyond that, lies monsters.
2. Consolidate the state-based exchange system.
States like California, Colorado and Connecticut seem to have exchanges that operate reasonably well, with a reasonably high level of transparency.