After repeal scare, Obamacare has never been more popular
Underscoring the adage that you don't know what you've got until it's (almost) gone, the popularity of Obamacare is surging.
Only weeks after Republicans in Congress failed to repeal the landmark health reform law, 52 percent of respondents hold a favorable view of the Affordable Care Act (ACA), according to a recent Kaiser Family Foundation August poll. That's up 10 percentage points since June of last year and nearly 20 points since November 2013, when public support for the ACA was at its nadir.
A July poll by CBS News after the repeal effort collapsed found that a plurality of Americans favor a bipartisan push in Congress to improve Obamacare.
The shift in sentiment coincides with other positive developments for Obamacare following its close call in Washington. With several large, and some smaller, insurers pulling out of the program over the past year or so, until recently it looked as if more than 92,000 participants spread out over 82 counties would have no insurer in their local health care exchanges, Cynthia Cox, associate director of Kaiser Family Foundation, said. But state insurance commissioners and other officials in states in jeopardy of losing Obamacare coverage have worked closely with insurers to negotiate continued coverage.
In Ohio, for instance, there were 20 counties without insurers, but officials ultimately convinced five health plans to cover all but one. Then, on August 24, the Ohio Department of Insurance announced that Paulding County, the last "bare county" in the country, would be covered by insurer CareSource.
In addition, the exchange marketplace overall has shown signs of stabilizing. After big financial losses in 2014 and 2015, individual market insurers saw improved performance in 2016, a trend that has continued this year, according to a different Kaiser Family Foundation study.
If Obamacare's popularity is up, the program's shortcomings remain clear. At last count, more than 2.6 million enrollees across 1,300 counties were expected to have only one insurer in their exchanges. More insurers also could pull out or move to sharply increase their premiums. The deadline for insurance companies to commit to participate in an exchange is September 27.
Until then, many insurers are watching closely to see if the Trump Administration will continue funding the federal cost-sharing subsidies that help low-income members pay for deductibles, co-pays and other out-of-pocket costs. Industry players are also waiting or Senate hearings to start after Labor Day in which which insurance commissioners, lawmakers and state governors are expected to testify about what can be done to stabilize the individual marketplace.
Meanwhile, some states are beginning to take matters into their own hands, moving to rewrite the ACA rules by applying for what's known as a "Section 1332" waiver. Oklahoma is asking for a waiver to establish its own reinsurance program using some federal funds, which would cover the highest-cost individual marketplace cases. Alaska recently received approval for a similar reinsurance waiver. Oklahoma, however, is also looking ahead to more major structural changes that may spur debate.
Iowa, which is undergoing huge premium increases in its individual marketplace, has submitted a waiver that would overhaul the state's insurance marketplace by redistributing federal tax credit money. The plan would create a single standard health plan and offer a flat tax credit based on age and income.
Critics argue this would increase health care costs significantly for Iowa's low-income population, putting coverage out of reach for many. Proponents argue that increasing Iowa's pool of healthy insured people is the best way to stabilize Iowa's individual market and lower premiums for everyone.