- The Washington Times - Tuesday, October 25, 2016

Hillary Clinton ignored the latest bad Obamacare news on the stump Tuesday, as she strived to survive through the November election before confronting the first major challenge for the next president: how to save President Obama’s health law.

The administration’s admission this week that premiums for Obamacare’s benchmark plans will spike an average of 22 percent nationally in 2017 has further dented the law, and left its defenders struggling for answers.

Mrs. Clinton, despite being the original author of HillaryCare, Democrats’ 1990s-era foray into expanding health care, didn’t touch the issue at campaign rally in Florida, keeping her campaign focused on early voting and attacks on GOP nominee Donald Trump.

Yet even if Mrs. Clinton defeats Mr. Trump in November, her plans to put Obamacare on firm economic footing face significant headwinds, as her “fixes” would require politically painful requests for more taxpayer spending and a bigger government footprint in the law’s insurance exchanges.

Her platform calls for a $5,000 tax credit for families with high out-of-pocket costs and fix to the “family glitch” that bars spouses and children from subsidized coverage because employer coverage appears affordable for the worker in the family. She also wants to put a 8.5 percent cap on the share of income someone must pay for a benchmark plan on the exchanges, so that even people making more than 400 percent of the federal poverty level could get assistance in some instances.

Mrs. Clinton also faces a tall order in rallying support for a government-run insurance plan, or “public option,” to compete with private plans in the exchanges, particularly in areas where private insurers have fled the program.

All four of Mrs. Clinton’s major proposals, combined, would increase the deficit by $88.5 billion in 2018, according to a recent RAND Corporation analysis, meaning she would have to push for higher taxes on high-income families or look for cuts elsewhere to make the reforms more palatable to Congress.

“I don’t think the Republicans are going to go along with giving Obamacare a blank check from the U.S. Treasury,” said Robert Laszewski, a health policy consultant in Alexandria, Virginia.

Obamacare is suffering from the early stages of the dreaded “death-spiral.” While older, sicker Americans signed up, younger and healthier Americans have balked, opting instead to pay the tax penalty or claim an exemption. Without them, the insurance companies are having to raise rates or drop out of markets, leaving less competition, chasing still more customers out of the market and spawning even higher premiums.

Some analysts said Mrs. Clinton’s plans could entice those desirable customers back.

“I think if health care was more affordable for higher income people, that would get more people into the risk pool and healthier people into the risk pool, and that’s what we need,” said Timothy Jost, a law professor at Washington and Lee University in Virginia who closely tracks the law.

But Republicans on Capitol Hill have said they won’t ask taxpayers to pick up the tab for rescuing the Affordable Care Act.

“The president and Democrats want to throw more tax dollars at the problem and want to pass more laws to prop up Obamacare, but the last thing we need is more government involvement in health care,” said Rep. Tom Price, Georgia Republican and key player in forging a GOP replacement plan.

Already, House Republicans are suing Mr. Obama over parts of the law that already exist, saying the president broke the law by spending money Congress refused to approve. The administration used the cash to pay back insurers who must help poorer enrollees with out-of-pocket costs.

Mr. Trump, who has vowed to work with congressional Republicans to repeal and replace Obamacare, used the rising premiums as a ballot-box prod Tuesday, arguing rising premiums will hit key swing states the hardest.

He said the Affordable Care Act is “blowing up” and that administration officials used a “phony” figure to downplay the damage.

“That number is so wrong,” he said of the administration’s premium increase estimate.

White House press secretary Josh Earnest shot back Tuesday, saying the vast majority of Obamacare customers “will not see a significant increase in the amount that they pay for their health care,” because taxpayers will pay for higher subsidies.

For her part, Mrs. Clinton says repeal would be counterproductive, since Obamacare’s extended coverage to more than 20 million additional people and provided a pathway to coverage for sick consumers who’ve been denied by insurers in the past. 

She told some news outlets Tuesday there is a “clear choice in this election.”

“Either we’re going to help American families and tackle health care cost issues, or we’re going to throw 20 million people off their coverage and let the insurance companies write the rules again,” the Clinton campaign said in a statement. “Hillary Clinton wants to build on the progress we’ve made and fix what’s broken, while Donald Trump would rip up the ACA, reverse the progress we have made and start this fight all over again.”

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

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