Shawn Vestal: Obamacare “saved the farm,” and Spokane man wonders: What now?

John Hancock is keeping a close eye on the Obamacare clock.

Hancock has 14 months until he reaches age 65 and qualifies for Medicare. A self-employed consultant who relies on health insurance through the Affordable Care Act, he wonders if he’ll make it to Medicare before losing his current insurance – or if he’ll return to the ranks of America’s uninsured one last time.

Hancock, the former director of the Spokane Symphony, is trying to remain hopeful that the health care system will be improved and not destroyed.

“The ACA was a first step down the road toward universal health care, not the end of the road,” he said. “I think the ACA was the first bite of the apple that helped me and helped a lot of people.”

Obamacare has been a mixed bag, but the upsides are undeniable. Hancock’s experience in 2014 was a good example. After going without health insurance for several years because individual plans were too expensive, he signed up for an ACA plan in 2014. Shortly thereafter, he found he needed heart-valve surgery. He was able to have the operation and recover, without going bankrupt, which would have been the inevitable consequence had he lacked insurance.

As he put it at the time, “A government program saved the farm.”

Will Congress improve upon that program? I find it hard to believe. Congress is getting ready to repeal Obamacare, of course, and there has been a deafening silence on what, if anything, will replace it. Republicans insist there are plans, but there has been a monumental public stillness around specifics – as well as a disconnect with the incoming president’s stated desire for “insurance for everybody.”

My sense is that the popularity of certain Obamacare goals that are not shared by conservatives in Congress – coverage for all, an end to pre-existing conditions denials, portability – has backed lawmakers into a corner where they are scrambling to devise a sublimely weaselly tactic.

They want to do something a lot of people won’t like, while making it look like they’re not.

This may be a reason for hope moving forward. The ACA’s repeal can’t erase the fact that for a lot of Americans, the fundamental set of expectations for the role of government in health care has changed. Even though the law is not widely popular, most of the law’s major provisions and goals are. Eliminating them to give big tax cuts to the wealthy will be a tough sell.

Hancock has always been hopeful that Obamacare represented a first step.

“I come back to what FDR believed in the need for Social Security, which was really a longer-term view of the needs of a society,” he said. “That long-lasting system, which has gradually gotten better, is what I hope happens with health insurance.”

Hancock had a career working for symphonies around the country, including Toledo and Milwaukee. He was director of the Spokane Symphony from 1999 to 2004. He now works as a self-employed consultant to nonprofit organizations and lives with his wife on a farm north of Airway Heights.

He has had excellent health for most of his life, he said. His heart-valve replacement in 2014 was his single major draw on the overall health care system, and he hasn’t had any further problems since. He is covered by a silver plan through Molina, about three-quarters of which is subsidized. His monthly portion of the premium is $106, and that has only increased by a few dollars, he said. His deductible is $2,000.

That is not everyone’s experience, by any means. Some people have seen steep premium increases, and rising deductibles have made actual access difficult for some people even if they are insured. There’s room to work on improvements, if Congress were so inclined.

The fact that our representatives in Congress cannot speak with any degree of specificity about possible changes and improvements, after years and years of obstinate opposition, is telling. Rep. Cathy McMorris Rodgers – who has gone fishing unsuccessfully online for Obamacare horror stories more than once – has been typical on this point.

“I sent a detailed appeal to Cathy last week,” Hancock said, “and didn’t get a response.”

Shawn Vestal can be reached at (509) 459-5431 or shawnv@spokesman.com. Follow him on Twitter at @vestal13.