08 May 2017
Barbara Comstock is on record as saying “Our current path under the ACA is flawed and ultimately unsustainable.” On Friday, her political opponents called Comstock out on her obvious attempt to confuse voters, noting that she had already voted for repeal on six previous occasions. There is another important aspect to this story, however, which is that Comstock and the GOP have been actively sabotaging the ACA since it’s inception.
Attack #1: Medicaid Expansion
One of the many policy aims of the original ACA bill was to expand Medicaid coverage within the states. Large sums of money were set aside for states to cover more people under their state Medicaid program. The CBO had estimated this part of the bill alone would have covered 17 million uninsured low income Americans. Desperate to deny Obama a political victory, several states sued the Obama administration and won the right to “opt out” of Medicaid expansion.
While serving in the House of Delegates, Comstock voted against an amendment to the state’s budget bill, that would have accepted Medicaid expansion under the ACA.
Attack #2: Risk Corridors
The ACA required insurance companies to sell policies to everyone, including those with preexisting conditions. It was expected that insurance companies might experience huge losses in the first few years of the program, which is why they established a mechanism known as risk corridors.
The government promised to cover a portion of the losses (paying less each year) until the insurance companies found a way to reach profitability. It’s not a new concept either - it’s based on what was done successfully under Bush’s Medicare prescription drug coverage program.
Once the Republicans took control of Congress they got to work undermining this critical piece of the ACA. Led by Marco Rubio, they labeled these payments as “bailouts” even though they had always been anticipated, and were in fact already paid for by a tax increase on the wealthy.
Comstock voted with the Republicans to block CMS from making these payments. Insurance companies are now owed more than $8 billion in back payments, yet Comstock pretends to be surprised when they decide to bail on Obamacare after getting stiffed.
Attack #3: Cost Sharing Payments
Another component of the ACA is something known as “cost sharing”. The basic idea is that the federal government would subsidize insurance plans for low and moderate-income Americans. Again, all of this was already paid for with the new taxes on those with the highest incomes.
Congress actually voted back in 2014 to sue the federal government to stop CMS from making these payments. Comstock wasn’t yet in Congress (she was too busy voting against Medicaid expansion), but the lawsuit continued after she took office. Comstock and her Republican colleagues have refused to act by either appropriating the money or withdrawing the lawsuit. Without these subsidies insurance markets will quickly unravel.
Ironically, both sides of the lawsuit are now asking for extensions because neither side wants to win! If Trump backs down then it could send shockwaves through the insurance market. If Congress backs down they will be seen as supporting Obamacare.
Comstock and the Republicans have certainly gotten us into a fine mess.