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Someone has to pay, whether there is Obamacare or not

Luis Fábregas
| Monday, Dec. 5, 2016, 4:24 p.m.
An Obamacare sign is seen on the UniVista Insurance company office on Dec. 15, 2015, in Miami.
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An Obamacare sign is seen on the UniVista Insurance company office on Dec. 15, 2015, in Miami.

The problem with Obamacare is its name.

To Republicans looking to repeal it, the Obama in Obamacare is a reminder of the Democratic Party they so despise.

In the six years since the creation of the federal health care law, the care in Obamacare has been muddled and turned into a hodgepodge of politics, policy and vitriol that no one can quite understand.

Obamacare has become a defacto swear word, so much so that we've been led to believe it is a threat. The ensuing confusion has prompted us to forget the progress we've made as a nation when it comes to reducing the uninsured rate.

Because it's easier to focus on Obama than on care, those looking to scuttle the law have forgotten that it comes with benefits not previously afforded to Americans, poor or rich.

The law includes popular provisions such as one allowing young people to stay on their parents' insurance until they turn 26. It also includes rules that prevent health insurers from denying coverage for pre-existing conditions.

Much of the hate for the law stems from what critics say are rising co-payments, deductibles and premiums. But there's a reason for that: Many of the newly insured are showing up at doctors offices and hospitals sicker than anticipated. They're coming in with chronic medical conditions that, plain and simple, increase the amount of money insurers pay in claims.

Medicine is expensive. Period. Those slick new drugs and machines to diagnose and treat heart disease, cancer and diabetes, come with a price. Someone has to pay, whether there is Obamacare or not.

Witness how local health insurers have been affected. Pittsburgh-based Highmark pulled out of 27 counties in which it sold individual health plans on the Obamacare marketplace. Highmark has lost a whopping $800 million in the marketplace since 2014. The withdrawal from these markets means some people will have to change insurers — not an easy proposition for someone with complex medical needs — or forego coverage entirely. It also means decreased market competition, which is crucial to keeping premiums as low as possible.

Problem is, people are still going to get sick. They're still going to need health care. And someone is still going to get a bill. Even if the hospital eats up the cost, the high price of uncompensated care will eventually be passed on to consumers.

No one has laid out a detailed plan to address this, or many of the very complex problems that would ensue from killing Obamacare. Merely dismantling a law that works for 20 million people cannot be the ideal solution. President-elect Donald Trump has said he wants to make health care more affordable and accessible. He wants to allow insurers to sell policies across state lines. And he has talked up health saving accounts as a way to let people put away tax-free money to pay for health care costs.

Trump has hinted that taking Obama out of Obamacare will take time and will not happen overnight. Then again, he has turned to the law's fiercest critic — Republican Congressman Tom Price — to lead the Department of Health and Human Services, which oversees the Affordable Care Act.

Price is an accomplished orthopedic surgeon who has previously introduced bills to replace Obamacare. Among other things, he wants to empower patients to make medical decisions and offer tax credits that individuals and families can use to buy policies.

These are all good intentions until this vicious circle takes us back to where we started: Eventually, someone will have to pay for it.

Luis Fábregas is editor of the Tribune-Review's Pittsburgh edition. Reach him at lfabregas@tribweb.com or follow him on Twitter @LuisTrib

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