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Passive resistance won't kill ObamaCare either

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By Barbara Shelly
Saturday, May 4, 2013, 9:00 p.m.

ObamaCare haters first looked to the U.S. Supreme Court to kill health care reform. When that didn't work, they fixed their hopes on Mitt Romney's election and a Republican takeover of the U.S. Senate. Foiled again.

Opponents in Washington and state legislatures are now turning to passive resistance. If you follow the legislatures in Missouri and Kansas, you see how it works. Refuse to set up a state insurance exchange. Turn down an opportunity to reform Medicaid and get more people into health insurance. Cheer Congress as it denies federal agencies the funds needed to get the Affordable Care Act up and running.

Make the rollout as bumpy as possible. And when you detect a stumble, declare the entire law a failure.

There's just one problem with this self-fulfilling prophecy. For consumers, the law is actually working very well.

Insurers can no longer not cover a child with a pre-existing condition and that protection will apply to adults in 2014. Lifetime limits on coverage have been banned. At least 80 percent of what consumers pay in insurance premiums must be spent on medical care. New insurance plans must pay for checkups and preventive measures without co-pays or deductibles. Health plans are easier to read and understand.

A tracking service compiled by the Henry G. Kaiser Family Foundation shows that, of 57 provisions scheduled to be carried out by the end of 2012, all but two are in place, and the provisions for this year are rolling out on schedule.

The biggest, trickiest parts of the law are yet to come, however, and the efforts to obstruct are making a mark. Congress didn't expect 33 states to default to a federally run insurance marketplace. Getting the exchanges set up and ready for the start of open enrollment on Oct. 1 is looking like a titanic task, made harder by Congress' refusal to allocate sufficient funds to educate consumers on how to use the new system.

It also appears more than half the states won't expand Medicaid eligibility this year, despite the extraordinary flexibility from President Barack Obama's administration in allowing states to craft their own models.

That will prevent the Affordable Care Act from achieving its coverage goals, no doubt to the glee of the Republican governors and lawmakers who refused to cover more people. But those same obstructionists will have to explain why hundreds of thousands of citizens still can't have access to a doctor and why hospitals remain burdened with uninsured patients when federal money is available to provide them with coverage.

ObamaCare haters are too fixated on their cause to realize it is doomed. The consumer protections already in place are popular, even if the law itself isn't. Having come this far, we can't go back to the old way, in which the only real guarantee of being able to afford health care was to never, ever get sick.

The jalopy called health care reform needs money for parts and is carrying too much excess baggage. But it will continue to lurch forward, the journey made easier as the forecast disaster fails to materialize.

Barbara Shelly is a columnist for the Kansas City Star.

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