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If the churches cared for the poor then the government would save trillions over the years. But the churches ceded that...

Cheaper health insurance remains out of reach

Health Care Overhaul What Now

The HealthCare.gov website, where people can buy health insurance, will feature plans from Blue Cross and Blue Shield of North Carolina for all 100 counties, some with lowered premiums.

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Saturday, August 11, 2018

It’s unexpectedly good news that Blue Cross and Blue Shield of North Carolina wants to lower some of its premium rates for 2019, as the Journal’s Richard Craver reported Wednesday. This is the first rate decrease in Blue Cross of North Carolina’s history since it entered the current individual market in 1993.

But rates could be much, much lower, had President Trump and Republicans in Congress not been fooling around and undermining health care.

To flesh this out a little: Blue Cross, which will offer plans in all 100 counties next year, requested permission from the N.C. Department of Insurance to lower premium rates by an average 4.1 percent for individuals signing up for 2019 coverage on the federal health-insurance exchange, aka Obamacare. Premiums would be increased in some areas, reduced in others.

But the rate-reduction request could have been for 15 percent or more.

“We’re moving in the right direction, but even with a lower rate, premiums are still too high — particularly for those who don’t get a subsidy,” Dr. Patrick Conway, Blue Cross Blue Shield’s president and chief executive, said in a statement earlier this week. “With more certainty from Washington, rates would be 15 percent or more lower. We must address both market instability and the rising price of health care.”

The lack of certainty and stability comes because Trump and Republicans in Congress, having failed to “repeal and replace” Obamacare, have been subjecting it to death by a thousand cuts.

They’ve drastically cut funds for navigators — community health centers, nonprofits and private companies that help people access Obamacare. In North Carolina, the drop is from $3.4 million for the 2018 sign-up period to $500,000 for 2019, even though we had the fourth-highest overall enrollment in 2018, the Journal reported.

They’ve also cut funds to advertise Obamacare — to make people aware of available options — by 90 percent for the 2018 enrollment period.

Also on Wednesday, the Trump administration finalized rules that allow short-term, limited-duration insurance plans that cover far fewer services than Obamacare and fail to ensure coverage for pre-existing conditions. Their lower costs are likely to attract healthier people who will pay more out of pocket if they become sick.

Congress also eliminated penalties to enforce the individual mandate beginning in 2019.

All of these moves will reduce Obamacare enrollment, thus increasing prices. None of this is close to the “beautiful,” ‘‘terrific,” ‘‘unbelievable” health care plans President Trump promised as he campaigned for office.

On top of all this, our state legislature still refuses to expand Medicaid to cover an additional 500,000 North Carolinians, using its flimsy excuse that the federal government might not pay its share.

We understand that many Republican legislators despise Obamacare. But even while controlling government on many levels, they’ve not been able to create anything better.

Blue Cross stands to draw more customers by lowering premiums, but it’s probably not going to be willing to go much further without assurance of an advantageous path forward. And that’s not likely to happen with Republicans working hard to decrease access to health care rather than increase it.

On Monday, an analysis produced by the conservative George Mason University-based Mercatus Center reported the surprising — perhaps accidental — conclusion that a “Medicare for All” program could insure 30 million more Americans, eliminating out-of-pocket expenses, while saving Americans $2 trillion over 10 years, The Associated Press reported. That’s a direction worth exploring.

Health care in America is complicated, as even Trump acknowledged after taking office. Yet ours is the only advanced nation that has not figured out how to provide decent, affordable health care for all. It looks more and more as if that won’t happen until Republicans put their neighbors’ health care ahead of their party and vote accordingly.

The Winston-Salem Journal

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