POLITICS: Enough with Obamacare’s 12-year failure — Congress, start here to unwind it

Few Americans lie awake at night worrying about the federal debt — so the Republicans’ plan to end “temporary” COVID-era Obamacare subsidies due to their exorbitant cost won’t win them votes.

It will save Uncle Sam money: A staggering 93% of Obamacare premiums are now paid directly by the federal government to health-insurance companies. 

But will that bring victory in the coming midterm elections?

No.

That’s why Democrats are gloating that reducing the subsidies will mean higher costs for enrollees, and increase the number of Americans who go without insurance. 

Because of it, Republicans “are going to get their clocks cleaned” in November, Sen. Chris Murphy (D- Conn.) predicts.

Democrats cynically insist on continuing to spend huge sums of taxpayers’ money — $450 billion over the next 10 years — to prop up lousy insurance, defending the indefensible because of its Obamacare label.

Even though Obamacare is an utter failure. 

It was supposed to bend the cost curve, but premiums for a family of five can exceed $50,000 a year before subsidies, according to the KFF Health Insurance Marketplace Calculator. 

Premiums are up 129% since the plans were launched in 2014, rising twice as fast as plans offered by employers and four times as fast as inflation.

Deductibles are outrageous, insurers deny claims 10 times as often as before Obamacare, and networks are so skimpy that it can take months to get doctor’s appointment.

Forget seeing an in-network specialist.

But Democrats are counting on the simple truth that something is better than nothing.

Politically, they’re right.

So Republicans who want to stop the skyrocketing subsidies must show their concern about the quality of care for patients — and start to fix what’s broken. 

Armageddon is just weeks away. The enhanced subsidies will expire Jan. 1, immediately hiking costs for every Obamacare enrollee.

Republican lawmakers should offer to extend them, while phasing them out over one or two years.

In exchange, they must demand reforms that will improve the Obamacare experience as Congress considers a broad overhaul.

Republicans finally have a second chance to fix health care.

They should seize it.

Here’s the simple truth: If your insurance company routinely denies claims, or keeps the network so narrow that you can’t get a doctor’s appointment for months, you’re not really insured.

Both these problems should be fixed in the current session of Congress, with Republicans taking the lead.

In 2013, before Affordable Care Act regulations kicked in, insurers denied roughly 1.5% of claims, according to the American Medical Association.

Now ACA plans refuse to pay 17% of claims, and some nix 30% or more. 

Congress should make those denial rates public for every consumer to see.

Insurers are also increasingly demanding prior authorization, even for routine prescriptions, often delaying care for weeks.   

Some states are putting time limits on those rules, saying for example that if the insurer doesn’t respond within 48 hours, you’re good to go.

Whatever bill Republicans agree on to extend enhanced subsidies should crack down on these abuses.

Insurers are also gaming the system — deliberately offering narrow networks that exclude specialists and cancer hospitals in order to discourage people with serious health problems from choosing their plans.

Why?

Because the ACA prohibits insurers from charging sick people more than healthy ones.  

Just 5% of the population accounts for more than 50% of health-care spending, the Agency for Healthcare Research and Quality has found.  It’s a fact of nature.

Asking insurers to cover the healthy and those with pre-existing conditions at the same price is like trying to feed a chihuahua and a Great Dane with equal amounts of kibble — yet that’s what the ACA requires.

President Barack Obama bragged his plan would protect people with pre-existing conditions —  but now those people find themselves stuck in ACA plans without access to the specialty care they need.

Yet Congress can fix this problem, too.  

We can continue allowing consumers to enroll without providing a health history, but once those with pre-existing conditions are in a plan, their insurer can request a special enhanced federal subsidy to cover their needs. 

Call it an actuarially adjusted subsidy, a remedy also proposed by former House Speaker and health-policy expert Newt Gingrich.

It will eliminate the major reason insurers skimp on networks, plus lower premiums for the healthy, who are currently being overcharged.

As Armageddon nears, various Republicans are proposing to cap income eligibility for subsidies, and to curb the massive fraud in the system — all good and needed reforms.

But to defuse Democrats’ fearmongering, they also must improve the patient experience.

The ACA system is an expensive mess.

Pouring in even more taxpayer cash without insisting on immediate quality improvements, while kicking major reform down the road for the next Congress to handle, would be a betrayal.

Twelve years of Obamacare is enough. 

Betsy McCaughey is a former lieutenant governor of New York.