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THE ARGUMENT

Should the Affordable Care Act be repealed?

YES

Mark Mezzina

Danvers resident, Massachusetts coordinator of Campaign for Liberty

Mark Mezzina
Mark Mezzina(Handout)

Obamacare has not worked. The politicians that support it want to double down on the program, and some want to go even farther. Common sense says that we need to try something new.

Obamacare’s failings are clear to anyone watching. Three of the largest health insurers — Humana, Aetna, and UnitedHealth Group — have significantly scaled back their participation in the program after huge financial losses. That is not a symptom of a healthy program. In addition, mid-level premiums are set to skyrocket by an average of 25 percent next year. This isn’t a meaningless political fight. This is hurting people in the real world.

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Some in Washington, like House Minority Leader Nancy Pelosi, have voiced support for moving closer to single-payer health care — complete federal government control of the entire health care system. But common sense would conclude that competition and freedom are a better solution. Vermont, a left-leaning state like Massachusetts, tried single payer. Officials pulled it back when they realized the costs and tax increases associated would devastate the state’s economy.

We can’t afford that for the entire country. Instead, we need to go in the other direction: repeal Obamacare and replace it with a system that gives power back to the states and encourages healthy competition.

Instead of big insurance companies teaming up with government to dominate the marketplace, we need to free up the entire system. Let people buy whatever insurance they want. Give them thousands of choices, not just the big companies with lobbyists on Beacon Hill or Washington, D.C.

Centralized government hurts everyday people. It might work for the political elites and power brokers who stand to gain from it, but for regular people like us, it is money out of our pocket. A 25 percent premium increase is a difficult hit for a middle class family to take. Maybe if our elected officials were required to enroll in the program themselves, they would understand.

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We can do so much better than Obamacare, or single payer. Government control of the economy always fails. Freedom works.

NO

John Silva

President and CEO, Greater Lawrence Family Health Center

John Silva
John Silva

The Affordable Care Act has been a lightning rod for Republicans since it was adopted in 2010. During that time, Americans have been able to purchase health insurance regardless of preexisting conditions. The insurance exchanges established by the law enable anyone to purchase coverage for themselves and their families, with a variety of plans available and subsidies for those who need it. In six short but contentious years, the ACA has enrolled over 20 million Americans in health insurance plans.

That expanded coverage has reduced health disparities and emergency room visits, improved access to primary and specialty care, and saved millions of dollars that would otherwise have been spent on ER visits and previously undiagnosed health issues. The ACA has saved lives, and reduced illness.

It is not without its flaws. Some state exchanges have no or very limited choice for consumers because of insurance companies opting out of the market. The prices of some plans have escalated to a level too high for those most needing coverage. Many states still refuse Medicaid expansion or to support their own health insurance exchanges. Costs have risen in many states because of the influx of the previously uninsured into the health system.

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But let’s remember that prior to the law, workplace health insurance grew by an average of 10 percent to 12 percent annually, sometimes 20 percent or more. Some folks seem to forget those times while blaming the ACA for rising costs. When it comes to our health care system, special interests, for profit insurance companies, outrageous bills and expenses, increased regulations, and our tendency to reward high cost specialty care at the expense of affordable primary care seem to be larger issues than any shortcomings of the ACA.

Together, we can fix what’s wrong with the ACA and strengthen and expand what is right with it. Those seeking to undo the law offer no real options for the 20 million Americans who would be left uninsured. The call for repeal only reinforces the growing belief that this incoming administration cares very little about the working poor and minority populations.

As told to Globe correspondent John Laidler. He can be reached at laidler@globe.com .