With the death of Justice Ruth Bader Ginsburg earlier this month, and a case that could undo the Affordable Care Act coming before the Supreme Court in November, the issue of health insurance has taken on fresh urgency for political campaigns as well as people affected by the 2010 law sometimes called Obamacare.
Candidates of both major parties agree the consumer protections that are part of the Affordable Care Act, particularly those for people with pre-existing health conditions, should still exist in some form. Candidates also agree it’s often too expensive to get health care and that insurance premiums are too high.
“We have to confront the fact that there’s a major challenge to the Affordable Care Act at the Supreme Court,” said Lucy Hodder, a professor at the University of New Hampshire School of Law and the director of health law and policy programs for the university’s College of Health and Human Services.
Right now, Hodder said, the Affordable Care Act is what we have to make sure people who don’t get insurance from employers and don’t qualify for programs like Medicare and Medicaid are able to buy health insurance.
If the law is about to be struck down, Hodder said, “We’d better figure out what our alternatives are. Because health care is too expensive for people right now.”
But while Democrats argue that the protections for pre-existing conditions that are part of the Affordable Care Act cannot exist without other parts of the law, Republicans say they want to find another way to offer coverage to everyone.
Corky Messner, the Republican running against U.S. Sen. Jeanne Shaheen as she seeks a third term, is adamant that government should not be involved in the health insurance market, not even as a facilitator of the “exchanges” where individuals can shop for insurance.
While he does support finding a way to make insurance more affordable and said he believes people with pre-existing conditions should be able to buy insurance, Messner said he believes this can be accomplished by letting insurance companies sell scantier insurance to people who do not think they need robust plans, and finding ways to let patients compare prices and shop around for different procedures and for insurance.
If more health insurance companies could somehow be persuaded to sell insurance in New Hampshire, Messner said he thought prices would fall.
But in New Hampshire and around the country, providers and insurance companies are consolidating. Harvard Pilgrim and Tufts Health Plan, two of the largest insurance companies in New Hampshire, are finalizing a merger.
Democrats, including Shaheen and Rep. Chris Pappas, who is seeking a second term in the First Congressional District, say they want to maintain the Affordable Care Act. They are focusing their messages on the thousands of people who have health insurance as a result of the law, while agreeing that insurance premiums are unaffordable for many.
“This election is about protecting the health care coverage that keeps millions of Americans safe and healthy,” Shaheen said in a statement earlier this month.
She said repealing the Affordable Care Act before there is a replacement would mean up to 100,000 New Hampshire residents would lose their health insurance, including the nearly 70,000 low-income people who get insurance through the Medicaid expansion, according to data from the state insurance department.
On the campaign trail, Pappas is touting the vote he took as an Executive Councilor to expand Medicaid in New Hampshire.
Republican Congressional candidate Matt Mowers said some people who feel they need less-robust health insurance can save money for health emergencies in a tax-protected health savings account, and he supports raising the amount someone can save in those accounts each year.
Like Messner, Mowers said he wants to achieve lower premiums by letting insurers offer more kinds of insurance, including the kinds of plans deemed insufficient by the Affordable Care Act.
“If you’re giving individuals more flexibility and more freedom,” Mowers said, “you’re ultimately going to have lower cost.”
Pappas said in a Zoom call last week that these kinds of measures would force seniors and people who do need more robust insurance to pay higher prices, calling it an “age tax.”