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by Richard Howie, CSA- Certified ACA Health Exchange Navigator

Dear President-Elect Trump,

Congratulations on your victory and god–speed in your first term as president of our great country.

 I’m writing you today regarding the pending initiatives to Repeal and replace the ACA without a viable alternative.  I am a registered Republican and am horrified by the 60 some-odd attempts by my party to repeal the ACA without having a viable alternative to replace it with.  This is crazy!  I reminds me of a dog that forever chases the school bus – What would he do if he ever caught it?

 Has our party truly thought through what will happen if they succeed?  I think not.

 I have been pretty deeply involved with the ACA effort.  Along with having an MBA and being a licensed Navigator with the New York State of health,  I am also a licensed by the State of New York to sell health insurance.  In the course of my job as a Navigator, I have completed over 1,000 ACA applications ranging from Medicaid to Qualified Health plans at full price to the consumer.  This experience has given me an extensive insight into the good and bad of the ACA, especially as it applies in New York:

 The Good:

1)      As you have correctly noted, the ability for people with pre-existing conditions to get coverage is a god-send to many.

2)      The CDC has reported that the percentage of people without health insurance fell from 16.0% in 2010 to 8.9% nationwide.  This is a tremendous achievement!

3)      As you have also correctly noted, it is nice to be able to keep children on their parents policies up to age 26.

4)      Even those people who are not entitled to subsidies get access to a regulated, vetted, and impartial market.

5)      I have personally experienced many families who have been saved by Medicaid from bankruptcy

The Bad:

1)      The plans tend to be local narrow-band HMO’s that are not widely accepted. Currently there are no PPO’s available.

2)      The communications and processes, while getting better,  are still in need of improvement.

3)      Individual Mandate – Some people object to the requirement to be covered or face the penalty by the IRS.  As you know this was the deal made between the government and the insurance companies to avoid only sick people applying and thereby sending rates through the roof.

 All of these “Bad” items, except for item #3, are fixable.  My suggestions are:

1)      I’d like to see the insurance industry step up and offer national plans, and maybe require each carrier to provide at least one Preferred Provider Organization (PPO) plan. I love your idea of being able to sell across state lines.  Cooperation between all 3 branches of our government would go a long way towards settling these markets.

2)      The communications and processes need to be put thru a thorough review.

3)      As far as the Individual Mandate goes, outside of universal coverage, is there a better way to encourage everyone to sign up, not only the sick.

 The ACA is far from perfect but as flawed as it is now it is the best that could happen with only one party on board.

 I respectfully submit that you are in a far better position than Barack Obama ever was to get this right.  You are in a position to force the parties to think this through before acting.  With both parties on board, acting in good faith, we can’t help but get it right.

 You know that if the ACA is repealed before a viable, proven, and better replacement is in place that it will be a disaster for our country and that it will happen on your watch.  I am confident that the voters will support you in taking the time to get it right.    Twenty three+ million Americans are counting on it – 2.8 million in NYS alone.

 What will be your legacy?

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