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Rep. Earl Blumenauer Headshot

Overcoming Willful Blindness to the Successes of the Affordable Care Act

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This morning, the House Ways and Means Committee held another in a seemingly never-ending series of hearings on the Affordable Care Act. Today's topic: problems with the launch of the healthcare.gov website. Of course, it would be incorrect to say that the launch of healthcare.gov has gone smoothly. Many Americans have faced problems in the application process, and the administration should do everything necessary to fix it as soon as possible.

However, what struck me so clearly at the hearing today was the fundamental lack of understanding about the workings and benefits of the Affordable Care Act.

For example, there has been talk in recent days that some people may not be able to keep their doctor or their insurance. But the government has never had the ability to force doctors to stay with a particular insurance carrier or to prevent insurance carriers from changing the health insurance plans they offer. Because of this, there has always been high turnover -- 35 to 67 percent of enrollees in the individual market leave their plan after a year -- in part because insurance carriers often cancelled plans or individuals found their plans didn't cover all they thought it did when they tried to use it. As insurance companies adjust to comply with the Affordable Care Act, some plans may disappear, but they'll be replaced by new plans that usually offer better benefits and services.

There is a distinction between cancelling a plan because it does not provide the necessary, mandatory, essential benefits and withdrawing coverage from someone because -- as they would in the pre-Affordable Care Act days -- they have a preexisting condition, or have reached their lifetime coverage limits. The Affordable Care Act will actually prevent people from getting thrown off of their insurance plans. Before the Affordable Care Act, when you got sick or had medical emergency, insurance companies would pore through your application to find discrepancies or some overlooked previous condition so they could deny your claim. Now, the Affordable Care Act prevents them from denying you insurance based on a preexisting condition.

Before the Affordable Care Act, if you hit your lifetime limit for coverage, that was it. Your insurance company would not pay for any more care and you would not have insurance. Once again, the Affordable Care Act put an end to this practice, and now there are no lifetime limits.

Republicans are often touting their own health care plans, but we have yet to see them bring them to the floor for a vote or discuss any specifics. But I seriously doubt that their plan would force doctors to work for insurance companies against their will, or address the twin specters of lifetime coverage limits and preexisting conditions.

The open secret in Washington is that Republicans are so afraid that the Affordable Care Act will succeed that they are barely able to contain their glee when talking about problems with healthcare.gov. I am struck by their rhetorical flexibility: Only a few days ago they shut down the government in an attempt to prevent anyone from signing up. And yet, today, they are outraged that not enough people are signing up? It's clear to the rest of us that the ban on refusing coverage based on preexisting conditions, the lifting of lifetime limits, allowing young adults to stay on their parents care, covering preventative care at no cost, and a slew of other provisions are winning over more Americans every day.

In many respects, the Affordable Care Act is succeeding. But there are some who just can't, or won't, see it.