Opinion Columns & Blogs

The health care blues not all due to Republicans

Any Georgians who thought Congress could simply move on from its Obamacare-repeal debacle — including our delegation in Washington — should have been set right by the news of Blue Cross Blue Shield’s partial retreat from the state.

The company, the only one available today throughout Georgia on the Obamacare exchange, said this past week it will reduce its footprint next year to 85 counties. (This does not affect those who buy insurance through their employers.) And it’s remaining in those 85 counties only after some pleading by state officials: The company’s original plan was to leave Georgia’s individual market altogether.

Blue Cross cited “continued regulatory uncertainty at the federal level and the current state of instability in the individual market” for its decision. But anyone anxious to pin this turn of events all on Republicans may be suffering from short-term memory loss.

Yes, Senate Republicans in particular could have given the markets more stability by coming together on a repeal-and-replace plan. They earned the criticism they’re getting for whiffing so far. But the instability Blue Cross mentioned isn’t new. You might call it a pre-existing condition.

Almost exactly a year ago, when most political observers assumed Hillary Clinton would be moving into the White House, Aetna was the one pulling out of Georgia and hundreds of counties elsewhere, citing $430 million in pretax losses from its individual-market business. That followed United Healthcare’s departure from the state.

The spin at the time from Obamacare backers was that the market was simply sorting itself out after some bad decisions by insurers and would soon stabilize. That prediction already looks as wrong as the ones about the November elections.

In the 85 counties where it remains, Blue Cross will be the only insurer on the exchange. In 11 others, a company called Ambetter will be the only option. More ominously, metro Atlanta — where there ought to be enough potential customers to support real competition — will be down to just two insurers. That was already true of some other Georgia cities.

The falling number of insurers across the board is a predictable result of Obamacare’s design. The law imposes so many regulations on qualifying plans, from what they cover to significant elements of their pricing, that there’s precious little room for insurers to differentiate their products. The result is a “marketplace” so unappealing that the young and relatively healthy would rather pay a tax, and get nothing in return, than buy one of the offerings. That has driven prices up, making people even less inclined to buy insurance, making matters worse.

All of this was true before 2017. Before Congress’ botched attempt at fixing this mess.

And that’s worth remembering as we move forward. Yes, Republicans will increasingly deserve blame the longer they go without agreeing on a solution. But much of the opposition to their proposals seems to be based on a willful blindness to Obamacare’s dire problems, a form of status quo bias to the extent it’s not pure partisanship.

That’s misguided when the status quo is so clearly bad, and getting worse.

Wingfield writes for The Atlanta Journal-Constitution. Reach him and read more at www.bit.ly/KyleWingfield.