Millions of uninsured Americans yearn for public option as insurance giants bail on Obamacare

US President Barack Obama © Jonathan Ernst
President Barack Obama’s decision not to fight for a public option in his Affordable Healthcare Act is coming back to haunt him, as America’s largest for-profit insurance companies are rejecting the landmark legislation across the country.

Aetna is the latest private, for-profit health insurer to distance itself from the reform package better known as Obamacare, announcing it will cut its participation next year, leaving thousands of vulnerable Americans in the lurch.

Even Obama himself admitted the failures of Obamacare, writing in the Journal of the American Medical Association (JAMA) earlier this month. 

“Too many Americans still strain to pay for their physician visits and prescriptions, cover their deductibles, or pay their monthly insurance bills; struggle to navigate a complex, sometimes bewildering system; and remain uninsured,” the president wrote.

His progressive critics say he only has himself to blame, since he’s the one who made “a deal with the devil — the for-profit health care industry — to kill any meaningful public option in exchange for their support for industry-friendly health care reform and campaign cash,” according to Miles Mogulescu, in his 2010 Huffington Post, Who’s Killing the Public Option?

Aetna is now saying it will offer Obamacare in only four states from next year, a significant drop of 70 percent from its current 15 states.

The company reported ACA-related pre-tax losses of $200 million, even though the law’s mandated coverage clause delivered one million new customers to the global corporation, which Aetna admitted would have cost $1 billion to achieve in the free market.

Humana is also withdrawing its Obamacare cover after reporting issues with premiums not covering the cost of claims earlier this year.

UnitedHealth, the biggest insurer in the US, has also ended its cover in most cases. In 2015, the insurers announced $425 million in losses and warned it could cease working with the Obamacare healthcare exchanges.

With three of the country’s largest insurers withdrawing cover, many Americans will no longer have access to plans from their current insurer. Other insurance options are available in each state, but premiums could go up with reduced competition.

What is Obamacare?

Vice President Joe Biden described it as "a big f*cking deal" in 2010.

Obamacare is a regulation of private insurance, presented as a way to give Americans more rights in terms of cover for pre-existing conditions and gender discrimination, but only if they can afford it.

In most communities, health insurance costs have gone up since Obamacare was enacted as a result of insurers being forced to cover those with pre-existing conditions and not being willing to cut into multi-million dollar executive pay packages or their billions of dollars in profit.

The employer mandate which requires companies with more than 50 employees to provide insurance has seen some reducing hours to avoid insuring their staff. 

Taxes for those with incomes $125,000 or higher per year have increased as a way to cover costs, but all Americans above the poverty line are obliged to buy healthcare coverage or pay a fee, whether or not they can afford it.

However, contrary to some anti-Obamacare websites, not paying the fee will not land you in jail or prison.

Forbes wrote last year, after parsing out the section of the law that addresses this, that "by law, you have to pay the penalty. But if you don’t, you won’t go to jail, you won’t be liened and you won’t be levied for collection."

Those who come in just over the federal poverty line don’t qualify for assistance and feel the costs the most, even after the tax credit for individuals with incomes up to $47,520.

The expansion of the Great Society program Medicaid covered an additional 15.9 million people in poverty.

However, states are not obliged to expand Medicaid, leaving nearly six million Americans without insurance just because of where they live.

Overall, the Rand Corporation identified more than 25 million Americans who are uninsured, down from almost 43 million when Obamacare was launched.

Bringing back the public option

Obama recently endorsed the idea of a public option health insurance program which would run alongside the private plans, after failing to push for it when the original bill was passed, much to the ire of progressive Democrats and independents.

Vermont Senator Bernie Sanders and others even threatened to withdraw their support for the law if it didn’t contain a public option, but a number of centrist Democrats refused to support such an option.

Obama now admits the option of a public plan is required to drive down prices offered by private health insurers and save money, similar to Medicare and Medicaid.

Those such as Sanders who have been pushing for a single-payer system would dispense with profit-taking altogether in favor of what they call “Medicare-for-All,” essentially an expansion of the existing elder health care plan to every American.

Clinton has also voiced recent support for the public option, which could be a reflection of Sanders’ influence in the Democratic primary, although during the primaries she and her daughter Chelsea used the idea against Sanders, arguing that it would be too costly.

The runner-up repeatedly educated voters about the shortcomings of Obamacare and how the US is falling far behind the developed world when it comes to caring for its citizens and residents.

Physicians For A National Health Program released its single-payer proposal in May, financed by the federal government through increased taxes, particularly corporations and the 1 percent.

Plus there are the cost savings from reduced administration and prescription drug costs, a focus on preventive care, and streamlined research and development.

The "Everyone in, Nobody out" system has been opposed by Big Pharma allies in both parties for years, while Republicans have been fighting Obamacare since it was first proposed.

GOP presidential nominee Donald Trump continues to make it one of his top issues on the campaign trail.

Assessing the Act’s achievements and shortcomings in his JAMA article, Obama accused “special interests” of presenting obstacles: “[O]thers, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits.”

Referring to “hyperpartisanship,” Obama pointed to aspects of the Act which Republicans objected to despite previous support.

“They supported a fully funded risk-corridor program and a public plan fallback in the Medicare drug benefit in 2003 but opposed them in the ACA. They supported the individual mandate in Massachusetts in 2006 but opposed it in the ACA. They supported the employer mandate in California in 2007 but opposed it in the ACA—and then opposed the administration’s decision to delay it,” he said.  “Moreover, through inadequate funding, opposition to routine technical corrections, excessive oversight, and relentless litigation, Republicans undermined ACA implementation efforts.”