U.S. Sen. Max Baucus, who famously worried eight months ago that the rollout of the Affordable Care Act’s major components this year might be a “huge train wreck,” looks something like a reluctant prophet now.
But in an interview last week, Baucus — one of the law’s chief architects — said he still stands strongly behind the law, and that it’s not going away.
The botched rollout of the ACA’s online marketplace for individual health-insurance policies this fall and other missteps and delays on various ACA rules and regulations are nothing to be proud of, Baucus said.
But if those who care about ensuring that all Americans have affordable health coverage buckle down and work on it, problems can be fixed, he said.
“You have two choices in life: Try, or do nothing,” Baucus said. “Myself, and others, and the (Obama) administration just have to keep working on this, so it basically works. Why did we do this in the first place? To make sure when people get sick, they can go see a doctor or go to the hospital. …
“There is no question this law was the right thing to do. … (The law) is here, it’s with us. The goal is to make it work. It’s not going to be repealed.”
Baucus, D-Mont., chairs the Senate Finance Committee and led the effort in the Senate in 2009 and 2010 to craft the ACA, also known as “Obamacare.” He spent months and years before that working with health-industry interests and others in studying potential reforms, anticipating a push for major reforms of the nation’s system of health coverage and care.
Baucus is up for re-election next year, but announced in April he will not run, bringing to an end a 36-year career in the Senate and 40 years in Congress.
His announcement that he wouldn’t run for re-election came just five days after he told U.S. Health and Human Services Secretary Kathleen Sebelius at a Senate hearing that he feared the administration was headed for a “train wreck” on implementing the ACA.
Baucus told Sebelius he’d been encountering widespread confusion and uncertainty among Montana businesses, accountants, consumers and others on how the law would work as its main components became effective in late 2013 and early 2014.
Last week, Baucus said he expects enrollment in individual health policies through the online marketplaces to continue to improve in the coming weeks and months. It’s clear a big demand exists for the policies, judging from the interest in the website, he said.
However, he also said it’s important to remember the online marketplace services just a small part of the health-insurance market — perhaps 5 percent to 10 percent.
The ACA is much more than the online marketplace, Baucus said, such as its ban on insurers denying coverage or charging people more for pre-existing health conditions, limits on insurer profits and improved drug benefits for senior citizens.
While polls shows the ACA remains unpopular among a majority of Americans and Montanans, he said when you ask people about these and other individual elements of the law, they tend to support them.
“Compared to what we had prior to the Affordable Care Act, I think we’re in better shape,” he said. “It’s coming along. … People are going to get health insurance who could not get it before. People who have catastrophic illnesses are going to get covered.”
Baucus acknowledged that U.S. health care — and coverage — continues to be incredibly expensive, but said the ACA includes incentives to revamp medical-payment systems that reward providers for quality rather than quantity, with an eye toward reducing those costs.
He also noted that growth in health care costs, while still outpacing inflation, has declined in the past few years, and that the latest government projections show the ACA should hasten that trend, by tens of billions of dollars over the next five years.
As for problems with the law, Baucus said he remains ready and willing to tackle them as they come up, but said “it may take a little time for things to settle out a bit, and see what major changes should be made.”
Fixing the www.healthcare.gov website is a task for the Obama administration, he said, but consumers should not be penalized for not having a policy if it’s not their fault. When asked if that means he’s open to adjusting the law’s mandate that all Americans must have or buy coverage by 2014, Baucus said yes.
Another part of the law that bears re-examination is its requirement that employers with 50 or more full-time employees buy coverage for those employees by 2015, he said.
“There’s going to be a list (of things that may need fixing) in the first part of next year,” Baucus said. “Let’s just see what it looks like next year. Look at all of the changes we’ve made to Medicare and Social Security (over the years). We made changes to help people, to maintain it and to make it a lot better.”
Baucus repeated that, for him, there’s no going back — and he hopes opponents of the law eventually will acknowledge that as well.
“Pretty soon, we’re going to reach a tipping point where it’s here, and it’s no longer a political issue,” he said of the ACA. “I’ll be very happy when we reach that point, and we’re not there yet.”