“Throwing the Baby Out With the Bath Water” is such an overused phrase now mostly in American and British politics. Used by both the right and left, people usually pointing at the other side say it to describe a policy which gets rid of good, essential results to fight inessential faults. And while I disagree with many of my fellow conservatives that the Affordable Care Act nationwide was an example of this, Obamacare in Hawaii definitely was the perfect example of throwing the baby out with the bath water — perhaps even throwing out the baby and keeping the bathwater.
To see where we went wrong with healthcare in Hawaii, let’s see where we came from. In 1974, Democratic Representative from the Big Island Yoshito Takamine championed a bill called the Hawaii Pre-Paid Healthcare Act. The PHCA required businesses to offer health insurance coverage to employees after only 20 hours. This meant that even those working part time had access, by law, to healthcare insurance in Hawaii. At one point, through the PHCA, Hawaii had the highest insured rate at 98%. Even when unemployment rose during the 2008-2009 Great Recession, our state insured 93% of the population — second only to the Commonwealth Health Insurance Connector Authority in Massachusetts, or Romneycare, which the ACA was eventually based on.
When the Affordable Care Act came into full effect in 2014 in Hawaii, healthcare requirements for employers were almost immediately cut. Employers were no longer required to offer paid health insurance to employees at 20 hours, but instead allowed companies to work employees 30 hours before paying for health insurance. Where before someone working part time (less than 30 hours) would have access to healthcare, Obamacare (which was foolishly described as “socialized medicine” by many on the right) actually made health insurance less accessible to thousands of workers in Hawaii.
The Affordable Care Act didn’t even make healthcare more “affordable” as its name would suggest. In October 2016, it was revealed that Obamacare premiums would rise once again in 2017 on the shoulders of subscribers which don’t qualify for Federal subsidies. Because the costs of living in Hawaii are higher than the mainland, the cut off for subsidy qualification actually falls below the supplemental poverty line meaning the premiums for impoverish people (as determined by the supplemental poverty metric) would rise.
The rise in premiums is often blamed on a lack of participation by younger, healthier individuals to pay for the care of older, sicker ones. And while this I’m sure is a major factor, there is no doubt the Affordable Care Act has wasted millions of dollars on its various failures. In Hawaii alone, the enrollment program had a cost of approximately $15,ooo per applicant (whether they ended up insured or not) and $300,000 per successful applicant — the worst in any state. $1.2 million was spent in Hawaii on public relations alone. Mercifully the Hawaii Health Connector, the ACA market place for Hawaii, imploded and was shut down; but not before State Representative Bert Kobayashi said, about the costs, “that does not sound like it is even possible.”
The only question remaining is why we rid ourselves of an adequately effective system in favor of the broken one we have now — one which Republicans are poised to repeal this year. Imagine yourself a Democrat in President Obama’s home state and the answer becomes clear. Riding the coat tails of an insanely popular president took precedence over patients keeping their doctors (which I personally was unable to do post-Obamacare), prevalence of well-funded private healthcare insurance and access, and unstable, rising premiums for people already struggling to make ends meet.
If (and when) Republicans in Washington repeal the ACA nationwide, Hawaii will once again be searching for a healthcare solution. And I hope that our politicians do their homework and due diligence this time around and learn that when something ain’t broke, don’t fix it.