Is Washington’s plan to gut the Affordable Care Act’s navigator program a proper cost-cutting measure, or a politically motivated attack on ObamaCare? Probably both.
ObamaCare is monumentally, incomprehensibly complex. The ACA organizational chart makes the Los Angeles freeway system look simple. With more than 10 million words in the first round of regulations, and thousands of changes since then, understanding ObamaCare would require several years of study, or your own personal adviser.
To help average Americans work their way through the Byzantine maze of ObamaCare insurance, the ACA created a whole new class of bureaucrats: navigators. They help people deal with a morass of requirements, a jungle of eligibility standards, and a tower of enrollment forms.
{mosads}The complexity that created the need for navigators proves that ObamaCare is poorly designed. A well-designed system is simple, intuitive, and easy for the end-user. If ObamaCare insurance were designed properly, what engineers would call elegantly, there would be no need for navigators.
The Department of Health and Human Services announced its intention to cut as much as 92 percent of navigator funding. Supporters of the ACA worry this could reduce enrollment.
Most people reject ObamaCare insurance based on cost, confusion, and a desire for consumer freedom.
First, the unaffordable expense of health insurance was the original reason for the ACA, hence its name: the Affordable Care Act. Yet, as a direct result of ObamaCare, insurance is now less affordable. Individual health insurance premiums increased 99 percent on average, and family premiums increased 140 percent. Excessive cost is the primary reason people reject ObamaCare.
Second, between a desire to protect one’s family and the federal mandate to purchase insurance, most Americans do consider buying health insurance. When they start looking, they enter a Twilight Zone where gold is not a precious metal and cost does not means cost, where there are incomprehensible abbreviations like APTC (advanced premium tax credit) coupled with eligibility standards and application forms that make no sense. Confusion breeds anxiety and fear. People do not voluntarily buy something that scares them.
Third, U.S. consumers demand the ability to choose. They don’t like being required by law to spend their money. The ACA forces consumers to purchase insurance that the federal government approves. This mandate to buy insurance compromises the personal freedom that Americans claim as a birthright.
By cutting navigator funding, Washington reduces spending. That is certainly a good thing, especially if they use the money to pay providers, though that seems unlikely.
Cutting navigators, however, leaves intact the reason that navigators were created in the first place: an artificially complex and extremely expensive system of ObamaCare insurance mandates.
Eliminating navigators is intended to solve one problem, overspending, while leaving the real problem, mandates, unresolved.
Defunding navigators will not save money. In fact, it is a money loser. Without navigators to help, fewer people will enroll in ObamaCare. The ones who don’t sign up will be healthy individuals, who require less care and therefore are less expensive. Those who do sign up will be individuals who need care, and that care will be very expensive for insurance companies.
When insurers see their costs go up, they will raise their premium prices. Responding to the inevitable public outcry, Congress will allocate additional funds to subsidize the higher cost of insurance. The net effect will be saving millions by cutting navigator funding and expending billions for insurance bailouts.
This is not merely a possible future scenario. This series of events has already played out several times since ObamaCare was implemented.
Now, imagine health insurance without all of Washington’s complex rules, regulations, exceptions, exemptions, tax implications, variances, and compliance oversight. In that world, you purchase what you want using your large health savings account. You choose an insurance policy from competing carriers. Policies that are too complex to understand, that offer benefits you do not need, or are priced too high, just won’t sell. That is the way health insurance should be structured, as a free market, freed from Washington’s one-size-fits-all oppressive mandates.
Rather than fixing health care, Washington protects its tight control of the system. They decide how to spend our money instead of allowing us to spend it as we see fit. The answer to our health care nightmare is simple: release us from federal control.
Eliminating all federal mandates can simplify health care, make doctors more available, and insurance more affordable.
As a side benefit, no navigators needed.
Dr. Deane Waldman (@SystemMD), MD, MBA, is a retired pediatric cardiologist and director of the Center for Health Care Policy at the Texas Public Policy Foundation. He serves on the board of directors of the New Mexico Health Insurance Exchange and is the author of The Cancer in the American Healthcare System.