Obamacare repeal would affect 28,000 South Dakotans

Aberdeen American News (SD)

Jan. 16--As a certified marketplace navigator at the Small Business Development Center in Aberdeen, Carla Burns has helped dozens of South Dakotans select coverage available under the Affordable Care Act.

"I've seen so much good come out of (Obamacare)," Burns said. "It's been a lifesaver for so many people."

She said most of the people she assists are surprised that their rates are so low.

But that's not what Aberdeen insurance agent Mark Mehlhoff hears from his clients. Most, he said, are concerned about how high the premiums are going to be.

"They should have called it the Attainable Care Act," he said, "because you can get it, but it's not affordable."

Today, the Affordable Care Act is under fire by President-elect Donald Trump and Republicans who vow to "repeal and replace" the health care law.

The act requires that health insurance is obtained and maintained or a tax penalty is paid. But not everyone qualifies for lower rates and subsidy reimbursements offered through HealthCare.gov.

Since enacted in 2010, 20 million Americans who either could not afford, access or qualify for health insurance due to pre-existing medical conditions now have coverage, according to government statistics from the U.S. Department of Health and Human Services.

Those same statistics show that 27,909 South Dakotans had signed up for marketplace coverage for 2017 by Dec. 24, which is more than at the same time last year.

U.S. Sen. Mike Rounds, R-S.D., said there's a sense of urgency to repeal and replace Obamacare before more companies go out of business and more people cancel policies that they can't afford.

"This ship is sinking. We're looking to provide a life raft to allow transition," Rounds said during a news media conference call last week.

Part of that life raft might mean giving control of health care to individual state governments, Rounds said. But the key is to get back to a competitive market, he said, where more Americans can afford coverage.

In the last few years, Mehlhoff says he has seen 30 percent rate increases on top of 40 percent increases.

And that's not the only problem he sees with Obamacare.

Mehlhoff estimates there were 25 insurance companies when he began working in the industry 25 years ago. But now South Dakotans who are seeking individual coverage only have two options, he said.

The local health systems that provide insurance coverage -- Avera and Sanford -- are the "only winners in this game," Mehlhoff said. And that's simply because they can drive traffic to their own hospitals.

"Even Blue Cross Blue Shield can't afford this, and look how big they are," he said.

Wellmark Blue Cross Blue Cross still offers group coverage, which is often obtained through an employer, but the company no longer offers individual coverage in South Dakota.

Despite a looming repeal, increased costs and fewer providers, nationwide statistics from the U.S. Health and Human Services show that more people are signing up for and using Obamacare. That means the act is not the "death spiral" that its opponents claim it to be, said Aviva Aron-dine, a U.S. Department of Health and Human Services senior official.

Because a "death spiral" is defined as a market that is rapidly shrinking, "We can officially announce that the death spiral claims are false," she said on a recent news conference via phone.

However, the department did acknowledge that, more and more, people are calling and asking if they should still sign up and pay for marketplace coverage without knowing what will happen with Obamacare in 2017.

The answer is always yes, they should, said Christen Linke Young, another Health and Human Services official. She referred to Obamacare as the "lay of the land" and as something people rely on for peace of mind.

Repealing it without immediately replacing it would be like standing at the edge of cliff and then jumping, she said.

Burns tends to agree with that analogy.

"They would have to have something to take its place. There's 20 million people (on Obamacare)," she said.

Even if it were repealed, she doesn't believe that's something that will happen quickly.

"It's not going to happen overnight. Nothing good happens that fast," she said.

Mehlhoff agrees that a replacement plan is needed. "I'm sure they are working on it," he said. "They can't dump all these people out in the streets again, but they need to make insurance fair and they have to make it affordable."

Reporter Elisa Sand contributed to this story. Follow @vlusk_AAN on Twitter.

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