Health care reform didn’t work for Washington but might work for America

The U.S. Supreme Court is expected to announce its
decision Thursday on a challenge to President Barack
Obama’s Affordable Care Act. And it’s bringing back
plenty of memories of what Washington went through in the
1990’s with its own healthcare overhaul.

At the time, state Democrats were running on a platform of
fixing our broken health care system. There were
complaints that the system cost too much money, it was
wasteful and too many people were uninsured.

“The same things that are wrong today,” says Aaron Katz,
with the University of Washington’s School of Public
Health.

Starting in 1990, Katz led two years of research to figure
out what was wrong with the system and how to fix it. His
group provided the background for the state commission
drafting Washington’s health care overhaul.

The Democrat-led Legislature ended up passing a series of
reforms in 1993 that included tighter regulations on
health insurance providers and a mandate that all
Washington residents buy coverage.

“A year and a half later, the political winds shifted much
as they did in 2010 nationally, where the Republicans
gained control of the Legislature. And they had run
promising to get rid of that law,” says Katz.

When the mandates were struck down, there was no way to
sustain many of the other reforms to our state’s health
care system.

As we wait to find out the fate of federal mandates, Katz
says even if the Supreme Court decides they are
unconstitutional Obamacare could lead to changes that
would affect millions of Americans.

“That leaves in place some very important provisions that
would make insurance coverage more affordable for many,
many people. And affordability is the sort of critical
variable,” Katz says.

Under the Affordable Care Act, 16 million people would be
added to Medicaid and another 16 million would get rebates
on health insurance through an online exchange that is
currently being set up. Katz says Obamacare will lower
costs enough to encourage a huge number of uninsured to
sign up.

“With the subsidies, it means that even younger people and
healthy people are more likely to buy coverage than in any
market today,” says Katz.

And that, he says, is the major difference. The federal
government can afford to spend money on subsidies that the
state of Washington simply doesn’t have.

What is more important than what the Supreme Court
decides, Katz says, is what voters decide in November.

“Almost regardless of the Supreme Court decision on
Thursday, except if they throw out the whole law, really
the ball is thrown back into the court of Congress to
decide whether they’re going to fund the coverage
expansions that are in the law. They still have to act,”
says Katz.

The failing of the Washington Legislature back in the
1990’s is the same failure of Democrats today, according
to Katz. They have failed to continue selling the
benefits of the plan after the laws were passed.

It is up to the lawmakers who wrote the bills to convince
Americans not to toss them, Katz says, even after the
lawmakers themselves are tossed out of office.