In the first Arizona CD8 debate, Ron Barber  was vague about his support for the Affordable Care Act (Obamacare), so  I’ve prepared a list of provisions in the law that most Americans support (and one or two they don’t).

In the next debate, I’d like Ron Barber to ask Jesse Kelly why he would repeal these provisions. I would suggest he start with the one that gives seniors a 50% price-cut on their brand drugs when they end up in the Part D donut hole.

CHANGES ALREADY IMPLEMENTED UNDER THE AFFORDABLE CARE ACT (from the American Medical Association):

Created a temporary high-risk pool with subsidized premiums for certain people with pre-existing conditions.

Ended health insurance rescission abuse.

Banned coverage exclusions of pre-existing health conditions for children.

Requires public disclosure of overhead/benefit spending by health insurance issuers.

Eliminated lifetime limits on benefits and restrictions on annual limits on benefits.

Requires insurers that offer dependent coverage to allow children to be covered on their parents’ insurance policy up to age 26.

Developed uniform explanation of coverage documents for enrollees.

Medical loss ratios set at 85% for large group plans and Medicare Advantage plans, and 80% for individual plans: In the past, some companies bragged about spending only 50-60% of premiums on medical claims. The rest went to profits and million dollar salaries and bonuses for top management, while premiums went up every year.

Requires plans to cover certain preventive health services at no cost. With most plans, especially individual plans, having $1,000 to $5,000 deductibles, some people were paying $800 per month but had to pay out-of-pocket for every medical service until they reached their deductible. Now they get a little something for their money because their annual checkup and a list of preventive screenings (like mammograms) will be paid for by their plan.

Provides tax credits to small employers with 25 or fewer full-time employees and average annual wages of no more than $50,000 that purchase health insurance for their employees.

CHANGES TAKING EFFECT IN 2014

Bans coverage exclusions of pre-existing health conditions or rating or coverage restrictions based on health status for adults.

Requires guaranteed issue and guaranteed renewability of coverage.

Allows states to form compacts for the interstate sale of insurance.

Increases transparency by requiring health insurers to provide a summary of coverage to applicants and enrollees.

Insurance exchanges: Creates by 2014 state-based and state-administered health insurance exchanges (marketplaces) for the individual and small group market.

Premium subsidies to individuals: Provides refundable, advanceable, and sliding-scale premium credits for individuals and families with modified gross incomes up to 400 percent of the federal poverty level.

The Individual Mandate: Requires most individuals to have minimum acceptable coverage or pay a tax penalty beginning in 2014; exemptions allowed for those who cannot afford coverage, religious objectors or if the individual has income below the tax filing threshold.

MY TWO CENTS:

The mandate was a Republican idea until it was put into the Affordable Care Act. This is about personal responsibility and everyone paying something into the system that protects us all.  If healthy people can opt out, but then opt in when they get sick, the entire system will fail – much like it does now.

One of the Supreme Court justices compared the mandate to requiring everyone to buy broccoli, even if they don’t like it or want it. Health care is not like broccoli because nobody really needs broccoli – but everyone will need health care at some point in their life. And if they don’t have health insurance, the rest of us end up paying for them.

And Ron, please ask Jesse Kelly to explain his statement that health care is a privilege and not a right. What would he tell a parent with a young child born with serious health problems? If the parent worked for a small company, his sick child could be refused health insurance. Before the Affordable Care Act, the parents of that sick child had no right to buy health insurance because that child had a pre-existing condition.  Does Jesse Kelly think it’s a good idea to repeal the provision that guarantees those parents the right to buy health insurance for their child?