In our opinion: The Affordable Care Act needs a bipartisan overhaul

Deseret News editorial

Published: Wed, July 30, 2014, 12:00 a.m. MDT

 March 23, 2010 - President Barack Obama signs the health care bill in the East Room of the White House in Washington.

March 23, 2010 - President Barack Obama signs the health care bill in the East Room of the White House in Washington.

(J. Scott Applewhite, Associated Press)

Former House Speaker Nancy Pelosi , D-Calif., infamously told the American people that Congress needed to pass the Affordable Care Act in order to find out what was in it. Her statement seems emblematic of the massive and continuing problems bequeathed by the legislation. Lack of clarity in President Obama’s signature health care law has already brought the ACA before the Supreme Court twice. Now the law is facing another significant legal challenge.

At issue is the wording that requires that government subsidies used to help individuals purchase health insurance be through exchanges “established by the state.” The D.C. Circuit Court of Appeals determined that this wording unambiguously requires ACA subsidies to be distributed through state-run exchanges. Those are currently operating in only 14 states and the District of Columbia. In addition, the ruling could put Utah itself in a uniquely awkward legal position, as our state exchange Avenue H is designed to provide health insurance for individuals through small business employers, not to individuals directly.

Just two hours after the D.C. Court of Appeals issued its ruling, the U.S. Court of Appeals for the Fourth Circuit in Richmond, Virginia, found the opposite. They said the Obama administration’s workaround of offering subsidies through federal exchanges was a “permissible exercise” of its authority. Such contradictory rulings suggest that the ACA may find itself before the Supreme Court for a third time in four years. Even four years after passing the law, we still don’t really know what’s in it. This is problematic.

The federal government’s relationship with health care has always been a complicated one, and the confusion surrounding the ACA is making a bad situation worse. The health care industry constitutes a large chunk of the American economy. All of this uncertainty is wasting a great deal of time and money.

Some critics of the Affordable Care Act are hoping that the latest legal mess will finally put an end to the Affordable Care Act. Yet many who are eager to see its collapse are offering few alternatives to address the nation’s pressing health care problems. Returning to the pre-Obamacare status quo is not an acceptable option. Congress needs to focus on workable reforms to improve the system, and Utah Sen. Orrin Hatch ’s health care bill could provide a good starting point for future discussions.

In the meantime, the Obama administration needs to recognize that they can’t be selective which parts of the ACA they’re willing to enforce. The ACA is deeply flawed legislation. But addressing these flaws is the work of Congress. Once we get a new Congress following the November elections, President Obama must put his preconceptions about the ACA aside and negotiate in good faith for substantial changes to the law with which legislators from both parties are able to live.

1. The Real Maverick
Orem, UT,
July 30, 2014

It needs it but it won't get it.

One political party is determined to kill Obamacare. There's no negotiation or compromise with them.

Our only hope is to retain the senate and take back the house.

2. marxist
Salt Lake City, UT,
July 30, 2014

I and many of my friends on the left begged for "medicare for all." It's doubtful Obama could have gotten that through Congress, but he should have tried.

The future of health care looks bad in the United States given our current politics. It's as though the political right wants to punish low and moderate income people through denial of health care. Politicians of all stripes need to understand there is building rage among the U.S. electorate.

3. prelax
Murray, UT,
July 30, 2014

Obama just gave waivers to people living in US territories, including Puerto Rico. Everyone now has a waiver, except the American taxpayer.

4. Mainly Me
Werribee, 00,
July 30, 2014

The Not Very Affordable Care Act needs to be repealed. That will require a bi-partisan effort.

5. Bob K
Davis, CA,
July 30, 2014

A-- The entire idea was originally proposed by republicans, but, since it would cost rich donors lost income, they abandoned it.
B-- Health care reform should have been done in the Nixon, Ford, Carter, Reagan, Bush, Clinton, Bush administrations, but the lobbyists for those donors stopped it.
C-- President Obama practically made a fool of himself asking republicans over and over again to contribute ideas to the bill when it was before Congress.
D-- No bills improving the ACA have been introduced by republicans.
E-- About 50 attempts at repeal have come out of the House, while nothing on fixing unemployment, immigration or the infrastructure has been done.

The DN is correct that the ACA should be kept, but, I am sorry to say, totally dreaming to suggest that the present version of the republican party will assist in improving it.

Hospital corporations, multimillionaire doctors, pharmaceutical companies, insurance companies, and others give obscene amounts of money to Congress. I would venture that every poor child could be fed with half that money.

Why not call for lobbying reform that might change Congress, or the end to "safe districts" that effectively kill the 2 party system?