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“We are going to see this through.”

Posted by John McDonough  October 30, 2013 05:57 PM

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I was prepared to be unimpressed listening this afternoon to President Barack Obama talk in Boston's Faneuil Hall about the Affordable Care Act and the problems it is facing: i.e. the website ordeal, the individual health insurance policy cancellations affecting policy holders in the individual market, and more.

Instead, I came away impressed. Despite breath-taking Republican and media determination to turn every negative development into health reform Armageddon, implementation of the ACA is working and has already made life-saving and life-improving differences for many Americans. Here are some worthy things I heard the President emphasize:

"the strongest consumer protections this country has ever known"

"no more discriminating against kids with pre-existing conditions"

"no more dropping your policy when you need it most"

"no more life time or annual limits"

"full coverage of clinical preventive services"

"young adults stay on their parents plan until age 26"

"insurance companies ... can't use your medical history to charge you more"

"tax credits that will bring the cost down even further"

And that's just for starters.

The President did not shy away from the issues with the website,

"Ultimately this website,, will be the easiest place to shop for these plans ... no denying, the website is too slow, too many folks have gotten stuck, and I'm not happy ... there is no excuse for it, and I take full responsibility for making sure it gets fixed asap ... and already more people are buying these policies successfully online than there were two weeks ago ... we're going to get these problems fixed."
Likewise, he addressed the issues of policy cancellations, which he labeled "the latest flurry":

"One of the things health reform was designed to do was to help the underinsured as well as the uninsured from cut rate plans that don't offer serious protection. Before the ACA, these plans had free rein and the worst of these plans routinely dropped thousands of Americans every year and premiums for these plans shot up every year. If you had one of these substandard plans before the ACA, you have been able to keep it. 

"Now, if your plan changes, you have to replace it with quality affordable coverage that includes core essential benefits covering things such as asthma, mental health, having a baby .. If you are getting one of these letters, just shop around in the new marketplace ... because of the tax credits, and the competition in the market place, you're going to get a better deal. A fraction of Americans will pay more for better benefits but nobody is losing their right to affordable health care coverage.  And for the fewer than 5% who buy insurance on their own, you will be getting a better deal."
Lots more worth mentioning.

"Giving people health care should be a no-brainer. Anyone defending the remnants of the old broken system, especially when these folks offer no plans for the uninsured or for the underinsured, those folks should have to explain themselves. I don't think we should go back to discriminating against kids with pre-existing conditions or back to the daily cruelties and indignities of a broken health care system."
Lots of folks, I know, don't like to hear these things.  Old news.  What's new?  But these truths need constant repeating as we head toward the day of full health reform implementation on January 1 2014. 

I hope they can get the website fixed no later than November 30th and I reserve judgment until I see it. And I don't believe everyone getting a policy cancellation will get a better or status quo deal -- though I do believe the vast majority of those affected will end up in a better place. One thing we know from behavioral economics is that the folks who face losses always speak more loudly than folks who realize even larger gains. I think we see that now.

I also watched Health & Human Services Secretary Kathy Sebelius testify this morning before the House Energy and Commerce Committee. More than three hours and you can watch her, too. She's had rough exposure over the past month, for sure, and her appearance today showed marked improvement.

Bottom line is same old/same old.  Republican law-makers, to a person, make it clear they do not want to fix the website problems. They want to undermine confidence in the ACA so they can take another stab at repeal, with no alternative of their own. Yes, individual House members have filed their own bills -- and that's meaningless because they have held the majority for three years and have approved nothing other than repeal after repeal. Nothing.

"We are going to see this through," said the President.   I'm sticking with the President and the ACA.
This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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