After Democratic and Republican proposals addressing ACA subsidies failed to pass a Senate vote, Brian Gantwerker, MD, expressed worry about how the move will impact patient access.
Dr. Gantwerker, of the Craniospinal Center of Los Angeles, shared his concerns about the vote.
Note: This response was lightly edited for clarity.
Question: What does the ACA vote mean for spine care over the next 12 months?
Dr. Brian Gantwerker: The failure of Congress to enact meaningful reforms to the ACA and instead simply letting the subsidy expire, which everyone knows actually goes to the insurance companies, rather than patients, is a very poor showing. This demonstrates to the American people that Congress is unable or unwilling to show seriousness with regard to reforming the ACA. And as I predicted before, when premiums do go up, which they will, and no one has demonstrated that they won’t, it will make it more likely people will ask for single payer. There’s a lot of pomp and circumstance and screaming about free markets online and in certain discussion circles, but those folks are not making policy. Moreover, it’s pretty clear that a lot of those same folks making a lot of noise are simply engagement farming. And with the crowning of the nation’s first trillionaire, a lot of people will see that and not be happy. There’s a very large income gap in this country, and for some, a premium increase of even 20% to 50% is very jarring and will likely cause financial distress.
Some have spoken about bringing back catastrophic plans — fine. I think that’s a terrible idea. But OK, then, where’s the plan? Yes, they are prohibited in the current ACA, but where is the mechanism to make them OK again? It kind of feels like we are living “Waiting for Godot.”
Folks are going to see this inability to fix things and not care about the downstream effects of single payer. They will want a fix after all this time spent waiting and need something that will help them now. Frankly, I don’t blame them a bit. Who I will blame are our lawmakers on both sides of the aisle who seem unable to get past the party to help our patients.
