WASHINGTON (AP) More Americans are going without health insurance, and stable premiums plus greater choice next year under the Obama health law arent likely to reverse that.
As sign-up season starts on Friday, the Affordable Care Act has shown remarkable resiliency, but it has also fallen short of expectations. Even many Democrats want to move on.
President Donald Trump doesnt conceal his disdain for Obamacare and keeps trying to dismantle the program.
During President Barack Obamas tenure, open enrollment involved a national campaign to get people signed up. The programs complexity was always a problem, and many lower-income people didnt understand they could get financial help with premiums.
For example, the nonpartisan Kaiser Family Foundation has estimated that some 4 million uninsured people may be eligible for coverage at no monthly cost to them, after taking subsidies into account. Zero-premium plans are skimpy, but experts say it beats going uninsured.
But the Trump administration says its not specifically advertising that. Early on, it slashed the Obamacare ad budget. Officials say theyre focused on providing a quality sign-up experience and keeping the HealthCare.gov website running smoothly.
Democrats who once touted the health overhaul as a generational achievement now see it as a stepping stone, not the final word.
Presidential candidates Bernie Sanders and Elizabeth Warren would bring the 20 million people covered under the law into a new government-run system for all Americans. Its time for the next step, says Warren.
Former Vice President Joe Biden, who asserts Obamacare is working, is proposing a major expansion of current ACA subsidies and a whole new public option insurance program.
For John Gold, a self-employed graphic designer from Maine, health care thats stable, affordable and comprehensive still feels more like a goal than a reality. Hes been covered by the ACA since 2014.
Its a great start, but its not the be-all and end-all of health care, he said.
Health care takes up too much of my budget, and it doesnt need to, explained Gold, who lives near Portland. There are appointments my doctor suggests, that I turn down because its going to cost me $300.
Golds income fluctuates, and when he makes too much to qualify for subsidized premiums, he must pay full freight. Hes in his 50s, so his monthly cost is higher, about $700. On top of that, the plan comes with a $4,000 deductible and an $8,000 out-of-pocket limit, potentially leaving him on the hook for a lot more.
Nonetheless, Gold said he hasnt looked at the cheaper alternative the Trump administration is touting, though it can cost up to 60% less. One reason is short-term plans dont have to cover pre-existing medical conditions.
With the economy strong, its unusual for progress to falter on Americas uninsured rate. Yet the Census Bureau reported that 27.5 million people were uninsured in 2018, an increase of nearly 1.9 million from 2017, and the first time the rate went up in a decade.
