C.A.R.E. The Republican Alternative to Obmacare

One of the key criticisms of  Republicans by Democrats and others is a lack of a concrete plan as an alternative to ObamaCare.  The Republicans say they were shut out of meaningful negotiations and discussions about the Affordable Care Act.  This is  hard to believe since Republicans were part of the legislative process, investigating and listening to experts in heath care prior to making informed decisions.  Discussions broke down between opposing parties.  Each side needed to take responsibility and cease the heated rhetoric for the benefit of the American people.

Citizens are rightly fed up with  Congress’s lack of cooperative legislation not only in health care, but in many other areas of legislation. Congress overall has a large disapproval rating by Americans.

Now, after the initial enrollment period has brought a measure of progress Republicans are offering generic improvements to the law;

Republican opponents of the reform law continue to propose alternative solutions to the ACA. For example, The Patient Choice, Affordability, Responsibility, and Empowerment Act (CARE) would revoke the ACA's individual and employer mandates, cancel Medicaid expansion, lower tax credits for buying insurance, and eliminate ACA-related taxes and fees.

''Just talking about repeal is not going to make it with 7 million people getting insurance on the exchange. And it has to be something reasonably credible ... it can't just be repealed. We are beyond that," economist Gail Wilensky, who ran Medicare under President George H.W. Bush, told the AP.

Affordability remains a major issue leading into next year. Insurers must determine the characteristics of new members to set 2015 rates, FierceHealthPayer previously reported. The economic risk insurers made when the law was created remains unknown. If insurers were conservative right from the start, that would take some pressure off next year's premiums, notes the AP.

So far, the average premium increase is 11 percent in the small group market and 12 percent in the individual market, according to a survey of brokers who sell coverage in the individual and small group market, reports Forbes.

Four main factors are driving the rate increases, including commercial underwriting restrictions; the age bands that don't allow insurers to vary premiums between young and old beneficiaries based on the actual costs of providing the coverage; new taxes on insurance plans; and new benefit designs, notes Forbes.

Another affordability concern deals with the cost of deductibles and copayments consumers must pay when they use their insurance benefits. Insurers should be allowed to sell high-deductible plans on all health insurance exchanges, says America's Health Insurance Plans President and CEO Karen Ignagni. To keep premiums low, many plans have high out-of-pocket costs.

One thing for sure, the ACA is a goal in progress.