Two views on Affordable Care Act: Replace it or fix it?

Travis Bard and Bobbi Leverich have health insurance through Arizona’s Health Insurance Marketplace, the state’s response to the federal Affordable Care Act, better known as Obamacare.

Their views on the federal law, and insurance offerings, are polar opposites.

A self-employed owner of a local real estate business, Bard and his wife, Kerry, are marketplace customers who are not eligible for federal subsidies based on their incomes.

In the early years of the Affordable Care Act – launched in 2014 – the couple had a number of choices as Arizona was the land of plenty when it came to companies seeking a slice of the medical insurance pie. Over the course of the last two years, however, those choices have dwindled, such that the couple was forced to switch from United Health Care to Blue Cross Blue Shield of Arizona last year when the other company stopped offering policies. In the coming year, the couple will have only Blue Cross Blue Shield of Arizona as an option.

“Here is my challenge,” Bard said. “We are very, very healthy … it’s just my wife and I. Our three adult children have their own policies. We haven’t had to make any claims. And we’re going to pay over $15,000 (this year).

Bard said he now pays five times what he paid 2.5 years ago. And that is for a plan with a $12,000 deductible.

Leverich, executive director for the Prescott Area Shelter Services, is also a marketplace customer. Her annual income, though, allows her to reap a subsidy so her monthly premium is $440 a month.

She, though, does have a pre-existing medical condition, and without the marketplace Leverich said she would be paying $1,200 a month for a plan.

Though she recognizes the concern over just one provider in most places across the state, Leverich said she would much prefer to have one provider than no provider. And she would rather have the Affordable Care Act than no system for those who without it would be ineligible for health care.

“People don’t remember how bad it was before this came to be,” Leverich said.

Bard sees it far differently.

“There is no way, looking at this being an insurance policy-based system, that this could ever work,” Bard said.

What has just happened in Arizona, essentially boiling down to a single-payer system, goes to show that this federal law was flawed from the start, he said.

“I think this is an absolute indication that the system was flawed by design, or corrupt by intent,” Bard said. “And I’m not a militant political guy.”

Before this happened, medical insurance, like all insurances, was based on risk, Bard and other health professionals have stated.

The flaw in the Affordable Care Act that has become more and more evident is that insurance carriers who flocked to participate at the start imagined they would garner a larger pool of premium-paying customers that would balance out the risk. Instead, younger people with fewer health problems have opted to take their chances, and simply pay the income tax penalty that this year was $695 for an individual, or 2.5 percent of a family income, whichever is higher.

“So insurances haven’t received the premium payers to offset the high risk folks they were forced to take,” said Bard who is looking at off-exchange options but notes they must still comply with law and, therefore, may not be any less inexpensive.

As for federal subsidies to offset insurance company losses, Bard said that is also controversial because many feel the government should not interfere with free enterprise.

“It’s a no win system,” Bard said.

Leverich agrees the system has its share of flaws.

But she would rather see Congress repair what exists than return to the way it was.

“We have to fix it,” Leverich said. “I believe health care is a human right.”

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