Oct. 31, 2013 – Leading scholars at the 18th Annual Frankel Lecture agreed Thursday on three points concerning the Affordable Care Act: It remains very confusing to the public; more data are needed to determine whether it is succeeding; and patience is required to see if it will meet its goals and gain public acceptance.
“It’s the debate that never dies,” said Mark A. Hall, professor of law and public health at Wake Forest University, noting that it remains a point of heated contention even though the law was approved by Congress three years ago, upheld by the U.S. Supreme Court, and reaffirmed by the reelection of President Obama. Hall was the keynote speaker in the program titled, “Reforming the Market for Individual Health Insurance: Success is in the Eye of the Beholder.”
Hall said the ongoing malfunction of the Internet insurance registration system was and continues to be a train wreck and embarrassment to the Obama Administration. But, he said, other government programs have experienced similar “glitches” in rolling out major programs, including the George W. Bush Administration’s prescription drug program, Medicare Part D, in 2005.
Hall predicted “Obamacare” eventually will meet all of its measures of success, including changing insurance laws, providing reasonable options through insurance exchanges, funding government subsidies for insurers at or below projections, and substantially reducing the number of uninsured.
He was optimistic that other measures of success would be met such as avoiding crippling medical debt for those facing serious illness and disease; keeping rate hikes at a moderate level; and stimulating competition among providers.
Hall said it is hard to tell how other questions will turn out “because the law really hasn’t taken hold yet.” Those issues include the number of insureds, employers who might drop coverage or limit the number of employees, possible increase in out-of-pocket expenses, and whether the choice of providers will be reduced.
The first of two commentators, David Orentlicher, professor and co-director of the Center for Law and Health at Indiana University McKinney School of Law, agreed more data is needed to grade the ACA, but said the law is “falling short” of many of its goals. It was supposed to lower insurance costs, he said, not limit increases, and it was intended to provide universal health care, yet many will remain uninsured.
“More health care does not mean better health,” said Orentlicher, who holds both J.D. and M.D. degrees. “The connection is more tenuous than one may think.” He faulted the emphasis being placed more on insurance than prevention. “The ACA may do more for economic health than physical health,” he said. “It’s a drop in the bucket. It could have done a lot more.”
Professor William M. Sage, J.D., M.D., of the University of Texas School of Law, said health care just needs a magic wand to make everyone insured and money in the form of affordable reforms. “If we don’t get healthier, we are broke,” he said. Obesity, for instance, is increasing across the country. “We have to fix the underlying health of Americans,” he said.
Law Center Professor Seth J. Chandler served as moderator of the annual program which is hosted by the Houston Law Review and underwritten by the Frankel Family Foundation.