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 The 2010 Affordable Care Act tipped off a long and bitter political
and legal battle between the White House and Republicans in the U.S.
Congress who said the 2010 law creates unwarranted government
intervention in personal healthcare and private industry.
Republicans have been quick to highlight a recent barrage of
negative headlines about rising health insurance premiums and
shrinking doctor networks for people participating in subsidized
insurance plans offered under the law.
Obama acknowledged the law is not working perfectly, but said the
problems could be fixed by legislation, encouraging lawmakers to
create a government-run health insurance option to help U.S. states
where there is little or no competition among private insurers.
"Maybe now that I'm leaving office, maybe Republicans can stop with
the 60-something repeal votes they've taken and stop pretending that
they have a serious alternative ... and just work with the next
president to smooth out the kinks," he said in a speech at Miami
Dade College.
"They can even change the name of the law to Reagancare, or Paul
Ryan care," Obama said, evoking the name of the Republican speaker
of the House of Representatives. "I don't care. I just want it to
work."
But Ryan, in a written response, said he would continue to seek to
repeal and replace the law. "At this point, one thing is clear: this
law can't be fixed," Ryan said.
Obama was later slated to headline a rally in Florida, a
battleground election state, for Hillary Clinton, the Democratic
candidate in the Nov. 8 presidential election. Clinton has said she
would add a public option and expand tax incentives for healthcare
costs. Republican nominee Donald Trump has pledged to repeal and
replace the law.
The government forecasts 13.8 million people will sign up for
Obamacare plans in 2017, up 1.1 million from 2016.
There are 10.7 million uninsured people who are eligible for the
exchanges but have not enrolled, and about 40 percent of those are
young, Health and Human Services Secretary Sylvia Burwell said on
Wednesday.
Obama said that nationwide, not enough young and healthy people have
signed up to provide a revenue stream that offsets the costs of
covering members with serious illnesses.
As a result, several big insurers, including UnitedHealth Group Inc,
Aetna Inc and Humana Inc, are pulling out of the online marketplaces
selling the subsidized plans, citing bigger-than-expected financial
losses.
Monthly premium prices have climbed, which further discourages some
people from signing up.
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"Next year will tell whether those are growing pains, or they are
more serious issues," Drew Altman, chief executive of the Kaiser
Family Foundation, said in an interview.
Analysis conducted by the nonpartisan foundation suggests at least
16 million people need to enroll before the online Obamacare
insurance marketplaces stabilize.
Obama said expanding insurance coverage for millions of people and
reforming the healthcare system was a key reason he ran for office.
He said he gets letters from Americans every day thanking him for
the difference it has made in their lives.
The law cut the number of uninsured Americans from 49 million in
2010 to 29 million in 2015.
Much of the decline is due to the law's provision allowing states to
expand Medicaid health coverage for the poor.
The law also prohibited insurance companies from denying coverage to
Americans for existing medical problems, and allowed parents to keep
children insured on their health plans until age 26.
Some health policy experts on both the political left and right say
Congress may be more receptive to bipartisan efforts to fix the
Affordable Care Act after Obama leaves office. Some Republican
governors who refused to expand Medicaid may also be more willing to
do so after the election - a change that would expand coverage for
about 4 million people.
"I think the piece of Obamacare that people don't like is Obama,"
Kathleen Sebelius, Obama's former Health and Human Services
secretary, who oversaw the program's launch, said in an interview.
"This has become a very personal battle about this president, which
is I think really unfortunate."
(Additional reporting by Timothy Gardner and Ayesha Rascoe in
Washington and Caroline Humer in New York; Editing by Bernadette
Baum and Leslie Adler)
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