Despite attempts to bleed it to death, there are new signs that the Affordable Care Act can survive. The question now is whether Democrats will abandon it for some form of Medicare for All.

Among the positive signs, premiums for most ACA plans offered in the Houston area will go down about 1% to 2% in 2020. In contrast, premium rates for Obamacare plans across the country are expected to go up about 3%, but even that is good news given premiums nationally increased about 30% last year.

Those price hikes were in part due to elimination of Obamacare’s individual mandate penalty, which the Republican-controlled Congress repealed in 2017. With the penalty gone, many healthy Americans decided to forgo insurance. That led insurance companies saddled with sicker risk pools to raise their rates.

With the ACA on the ropes, the Trump administration issued new rules benefiting Obamacare alternatives by expanding consumers’ access to short-term and association health plans. These cut-rate plans aren’t as extensive as the ACA’s, which means their policyholders may not have the coverage they need if they get seriously ill or injured.

Outreach funding was cut from $63 million in 2017 to $36 million in 2018 and only $10 million this year.

Despite attempts to blow up Obamacare, it is becoming more ingrained. In fact, several insurance companies, including Cigna, Oscar, Bright Health, and Centene, are expanding the number of states where they will offer ACA plans. That’s a clear sign that companies that once feared losing money with Obamacare have found ways to make a profit.

That doesn’t mean the ACA is no longer in jeopardy. The number of individuals who selected an insurance plan on the ACA marketplace has dropped from a peak of 12,681,874 in 2016, the last year of the Obama presidency, to 11,444,141 this year.

Blame for the drop can’t all be placed at President Trump’s feet. The ACA is in serious need of repair. Flaws that became apparent soon after the first enrollment of participants began in 2013 still haven’t been fixed. Among them: providing an incentive for middle-class families that don’t qualify for the ACA’s tax-credit subsidies.

With only 10 candidates qualifying to participate in the Sept. 12 Democratic presidential debate at Texas Southern University, health care should be a larger part of their conversation. After all the effort it took to pass Obamacare and fight off legal attacks, voters need to know why some Democrats argue the ACA should be abandoned for a different massive program that would be subjected to the same gauntlet.

Encouraging signs suggest an improved ACA is the better choice for America right now, even if it becomes a bridge later to something even better.

An editorial from the Houston (Texas) Chronicle.

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