- The Washington Times - Thursday, October 20, 2016

President Obama fiercely defended his signature health care law Thursday, saying it has slashed the uninsured rate to historic lows, though he implored his successor and Congress to cure the “growing pains” that have battered the program politically and left millions of uninsured on the sidelines.

Saying no law is perfect, Mr. Obama said the Affordable Care Act covered more than 20 million people but that some Americans will face rising premiums and meager choices on the law’s web-based exchanges, which failed to attract the right mix of customers in the early rounds.

Yet repealing the law isn’t the answer, the president warned, as he urged lawmakers to build on his reforms after he leaves office in January.

“I don’t care about credit. I just want it to work because I care about the American people and making sure they’ve got health insurance,” Mr. Obama told students at Miami Dade College in Florida.

Obamacare sign-ups for 2017 start Nov. 1, and Mr. Obama knows the final enrollment period of his tenure will be critical to the fate of his law, as insurers cry foul over a crush of costly customers and the healthy consumers who could improve the companies’ ledgers balk at the resulting rate hikes.

He said, for most customers, income-based subsidies will absorb the rising costs of 2017 plans that will be available on the exchanges through Jan. 31. But he said Congress should think about extending those subsidies to more people, since budget-minders reported that the tax credits haven’t cost taxpayers as much as expected.

Mr. Obama implored Republican lawmakers in 19 holdout states to expand Medicaid, the government-run insurance program for the poor, to those making 138 percent of the federal poverty level so that an extra 4 million Americans people would be covered.

He pushed Capitol Hill to consider a government-run plan, or “public option,” to bolster competition under his program.

Mr. Obama is hoping to hand the keys to his signature law to Democratic presidential nominee Hillary Clinton, who has vowed to defend and build on the law if she wins in November. She too wants to provide the public option that Mr. Obama endorsed.

Yet Republicans say doubling down or expanding the program will only exacerbate the program’s stumbles.

“After listening to the president’s speech, I’m not sure what health care law he’s talking about,” said House Speaker Paul D. Ryan, Wisconsin Republican. “He wondered out loud why there’s been such a fuss. It’s no secret: It’s because of Obamacare.”

Major insurers such as UnitedHealth Group and Aetna are fleeing the exchanges, citing heavy losses, while insurers that remain say double-digit rate hikes are needed to improve their ledgers after Obamacare’s carrots and sticks failed to prod enough young people into the program during the early rounds.

That’s because millennials are effectively being asked to subsidize older customers, Obamacare’s critics charge, since insurers cannot charge their oldest enrollees more than three times what they charge their youngest customers.

The administration says it will urge young people to sign up for 2017 through social media, a better browsing experience on smartphones and targeted mailers from the IRS to those who paid a tax penalty for choosing to remain uninsured.

As it stands, Health and Human Services Secretary Sylvia Mathews Burwell estimates that 13.8 million people will buy plans in 2017 during open enrollment on the exchanges, compared with 12.7 million who initially signed up for 2016.

That is still short of the 15 million that congressional scorekeepers predicted just a few months ago, and some analysts say it is an optimistic goal that, even if achieved, would help to stabilize the market but fall short of what’s needed to put the law on firm economic footing.

Robert Laszewski, a health consultant from Alexandria, Virginia, said the administration seemed intent on generating positive headlines ahead of the election.

“I do not see any material improvement in the risk pool next year,” he said. “Premiums are higher, deductibles are higher, and networks are narrower. There are fewer carrier choices. Everything is worse for the consumer than it was last year. How do you get a better result?”

Mr. Ryan says it isn’t possible, so Congress should replace Obamacare’s government mandates and coverage requirement with free market incentives designed to entice customers into private market plans.

“It’s time to give every generation of Americans the real hope and change they deserve,” he said, mimicking the campaign mantra that Mr. Obama rode into office in 2008.

Mr. Obama took a few shots of his own at Republican critics who have opposed his reforms at every turn, despite its strides in connecting more Americans with coverage.

Obamacare, he said, has allowed young adults to stay on their parents’ plans until age 26, improved the quality and reach of coverage and drove the uninsured rate down to 8.6 percent.

“The Affordable Care Act has done what it was designed to do. It gave us affordable health care,” he said.

“So what’s the problem? Why is there still such a fuss? Well, part of the problem is the fact that a Democratic president named Barack Obama passed the law. And that’s just the truth.”

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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