The Affordable Care Act survived another challenge before the U.S. Supreme Court this year. But the still-fragile marketplace is showing the strain of rising health care costs.
Transcript
RENEE MONTAGNE, HOST:
The Obama administration says nearly two and a half million more Americans will have health insurance starting on the first of January. That’s how many new customers signed up for coverage through the government marketplace created by Obamacare. 2015 has been another up-and-down year for the president’s signature health care law. NPR’s Scott Horsley has this look back.
SCOTT HORSLEY, BYLINE: The Affordable Care Act is here to stay, President Obama declared back in June. He took a Rose Garden victory lap after the Supreme Court struck down a potentially fatal challenge to the law that would have stripped subsidies from millions of insurance customers. Gary Brock is a Florida waiter who never had health insurance until Obamacare came along. The 54-year-old says he was ecstatic when the high court left his coverage intact.
GARY BROCK: You have no idea. It’s just kind of like what do you want for Christmas (laughter) you know? It’s like I got health care. This is great.
HORSLEY: Brock says his insurance offers peace of mind if he has to go to the hospital. It also paid for a vaccination to prevent a painful recurrence of shingles. Health Secretary Sylvia Burwell says the Affordable Care Act has given similar comfort to more than 17 million Americans since the law took effect.
SYLVIA BURWELL: For the first time ever, this year the rate of uninsured in America dropped below 10 percent.
HORSLEY: But 2015 has also been a year of economic challenges for the health care law. Some insurance companies found caring for these new customers is more expensive than expected. One big insurer, UnitedHealth, even threatened to drop out of the market in 2017 – a worrisome sign if others follow suit. Many insurance companies are demanding higher premiums and co-payments. Brock says his insurer tried to boost his premium next year from $25 a month to $130.
BROCK: I don’t mind paying extra for insurance, but I can’t afford 10 times the amount they’re going to charge me. That’s just crazy.
HORSLEY: Brock, who makes about $19,000 a year with tips, found a cheaper plan by going back to the government’s website and shopping around – something the administration recommends. Most customers have at least three insurance companies to choose from. But next year, 10 states will see a drop in the number of participating insurers. Drew Altman, who heads the Kaiser Family Foundation, says competition among insurance companies does keep prices down, but it also requires a big pool of patients.
DREW ALTMAN: It will take more people, more robust enrollment, for those exchanges to work more effectively, and enrollment just flat out needs to go up.
HORSLEY: Millions of people who are eligible to sign up for coverage in the government marketplace still haven’t done so, despite mounting penalties for not having insurance. Altman says the law is still unpopular and a political lightning rod.
ALTMAN: The ACA has become the very poster child of partisan division in the country that complicates absolutely everything.
HORSLEY: Indeed, Republican House Speaker Paul Ryan says lawmakers will vote again next week to repeal the Affordable Care Act in its entirety.
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PAUL RYAN: We are going to keep working to give families relief from this law while we work to dismantle it and replace it altogether.
HORSLEY: For the first time, the Senate has also voted for repeal, so President Obama may get to use his veto pen. Obama vowed last summer he would not unravel a law he insists is now woven into the fabric of America.
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PRESIDENT BARACK OBAMA: As the dust has settled, there can be no doubt that this law is working.
HORSLEY: But with rising costs for both the government and consumers, the Affordable Care Act still has to contend with plenty of unsettled dust. Scott Horsley, NPR News, Washington.
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