Ohio officials announced on July 23 that they’ll take a hands-off approach to promoting the Affordable Care Act (“Obamacare”), leaving it to the federal government to inform citizens about opportunities and benefits provided under the law.
For many, that might seem obvious. Why would a Republican-controlled state government that opposes Obamacare take part in promoting it? But the real issue isn’t so much about promoting the controversial health care law as it is about getting young adults insured.
Under Obamacare, the federal government is aiming to insure 7 million people around the nation. By federal officials’ estimates, about 2.7 million of those people need to be young adults, who can soften insurance premiums with their generally good health and limited, cheap use of the health care system.
Outreach is particularly important in Ohio, a sizable state with 549,000 uninsured young adults, according to data from nonprofit group Young Invincibles. That means about 22 percent of Ohioans aged 18 to 34 currently lack insurance — a huge potential market that could help tamp down high costs.
The sign-up goal is vital to the law’s success: If officials fail to enroll enough young adults, premiums will spike as older, sicker people fill up the health care pool without healthy youth to balance out their costs.
That’s especially true because Obamacare also bans insurance companies from discriminating against people with preexisting conditions, which means a lot of people with predisposed illnesses are now trickling into the market and driving up costs.
To accomplish the enrollment goal, the federal government, states and various hired agencies are deploying a massive promotional campaign.
Tactics will include television commercials, billboard displays and even advertisements directly stamped on Kentucky bourbon.
The campaign will mostly focus on teaching young adults about Obamacare’s benefits, particularly lucrative tax subsidies that can be used to pay for most premiums and expanded coverage rules that require insurance companies to provide contraceptive coverage at no extra cost.
Put another way, federal officials are trying to reach out to Ohioans and other Americans to essentially hand them health insurance and other benefits. All young adults have to do is sign up for coverage made possible by Obamacare.
But with the state now refusing to participate in promoting Obamacare, the federal government and nonprofit groups are forced to do the heavy lifting in Ohio. That’s not just a hit to Obamacare in the state; it’s a hit to the many young adults who could genuinely use Obamacare’s benefits but might never hear of them.
This isn’t the first time Ohio Republicans have decided to attack Obamacare at the cost of Ohioans’ collective health. Republican legislators refused to expand Medicaid eligibility in the state budget, despite estimates from the Health Policy Institute of Ohio that found the expansion would actually save the state $1.8 billion and insure nearly half a million Ohioans in the next decade.
Republicans rejected the expansion, citing their general opposition to government-run health care programs and concerns that the federal government won’t be able to uphold its commitment to the expansion — even though for decades the federal government has paid for 57 percent of Medicaid nationwide and the millions of Ohioans it insures.
For Republicans, the motive for obstructing Obamacare is obvious: If the law fails, they can pin the blame on Democrats. This, they estimate, is worth the political gain, even if it directly hurts millions of Americans who desperately need health insurance.
It doesn’t have to be this way. Republicans can, as West Chester native and U.S. Speaker John Boehner briefly did in November 2012, acknowledge that Obamacare is the law of the land. It might not be their preferred approach to health care reform — although it certainly was when Gov. Mitt Romney passed Romneycare in Massachusetts — but the solution to that issue should be to help make the law as workable as possible for those affected, not make it difficult to implement even if it drags down hundreds of thousands of Ohioans.
To his credit, Gov. John Kasich has partly taken the balanced approach by embracing the Medicaid expansion. Unfortunately, Kasich has joined the rest of his party in being purposely obtuse about promoting the law.
Maybe it’s a good time to remind Republicans that they lost in 2012, when a majority of voters in Ohio and nationwide approved of President Barack Obama. It’s unlikely Ohioans made those votes with the expectation that Ohio officials would purposely block Obama’s signature law.
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