Attempting to pivot from her previous support for “Medicare for All” and her call to eliminate private health coverage, Vice President Kamala Harris is embracing the Affordable Care Act (ACA). A couple of growing problems with the ACA — massive fraud and a preponderance of low-quality coverage — could undermine this pivot. At the debate on Tuesday, former president Donald Trump said that Obamacare is not good health care but that he does not yet have a fully developed health-care-reform plan. What follows is an outline of the main problems with ACA coverage and potential reforms that his administration could pursue if he wins the election.
Previous research by the Paragon Health Institute has revealed that millions of people have enrolled in the ACA exchanges under false pretenses to claim more subsidy than they are eligible for — leading to large windfalls for insurers, unscrupulous brokers, and call centers. This work led Congress to open an investigation and contributed to the Centers for Medicare and Medicaid Services’ suspending 450 brokers. A second major problem is now getting attention — the deteriorating quality of ACA plans. A comprehensive analysis by the Kaiser Family Foundation shows that narrow ACA-plan networks are now the norm, and a new Paragon research paper offers reasons for the decline in coverage quality and recommendations to improve the ACA.
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