Everyone is saying “We don’t know what will happen with Obamacare when President Trump gets into office!” But that is not true. We do know. We just don’t want to believe what we already know and face what will actually come about.[1]
The story of Obama care is a series of lies debunked. First, we were told we could keep our insurance, when the law required that all non-compliant policies, such as those that didn’t cover men for pregnancy, be discontinued. Second we were told we would be able to keep our doctors, when any insurance company could tell you that in order to meet the cost criteria set for “affordability” they, for all their policies, would narrow available physician networks and only negotiate costs with low cost providers. And the lies kept coming.
Biggest of them all was the promise of affordability. For 2017, an unsubsidized Gold plan for a family of 4, when you add back the deductible, will cost more than $25,000. If your family income is more than $97,200 you will have to pay the entire amount; and remember, this is in after tax dollars![2] If you live in California and you make $250,000 a year, paying your insurance bill will represent between 25% to 35% of your after tax income. Since the policy cost is the same for any family of 4, the less you earn, the bigger a chunk of your income the cost of healthcare represents. Those with subsidies, their payments for the policies are capped at 9.5% of their income. On top of that they have to pay their deductible before insurance costs kick in.
So here is the truth, once the administration repeals the subsidies, those who are on gold plans will be on the hook for the entire $25,000, independent of their income. If you want to keep your insurance, no matter what policy you bought, you will have to pay the entire cost.
But what about people on Medicaid?
In California, Peter Lee, the Executive Director of Covered California, has been making the media tour assuring people that no matter what happens in Washington, Californians will be able to keep their coverage.
Prior to the adoption of the Affordable Care Act, the Federal government reimbursed the states approximately 57% of the cost of providing Medicare for those who qualified under the federal guidelines. Passage of the Affordable Care Act called for expansion of Medicaid to those whose income is 133% of the poverty level. For those newly enrolled, those who didn’t previously qualify but now do, the Affordable Care Act provides that the Federal government will reimburse the states for about 90% of the cost.[3]
So what happens when the Act is repealed and the subsidies go away? Technically, the states are no longer required to cover those who received Medicaid as a result of the federal expansion of benefits. If the state chooses not to cover them, they will lose their healthcare. If the state chooses to continue coverage for those people, where will the money come from? Certainly not the federal government. According to the Kaiser Family Foundation, this cost per individual as $6,500 in 2011, the most recent data available.[4] I am sure now it is more. Twenty million American’s at $6500 in 2011 dollars, that would mean the states would have to come up with more than $130 billion dollars each year. Good luck!
In the end, it’s the promise that people will be able to continue on as they are that is damaging. Especially when we know the truth.
Minda Wilson, J.D., is a corporate attorney specializing in healthcare. A recognized expert on the Patient Protection and Affordable Care Act, she consults with clients regarding its proper implementation. She is founder of Affordable Healthcare Review, an educational organization providing information about healthcare legislation, its application, and impact. Her book Urgent Care was recently published.
[1] At a certain point, when someone keeps telling you what you want to hear instead of telling you the truth, you might want to consider that you are being lied to. Why stick your head in the sand and wait until the truth emerges? A rational person stops relying when they are told what they want to hear and starts looking at the cold hard facts.
[2] http://obamacarefacts.com/2016-2017-federal-poverty-guidelines/
[4] http://kff.org/medicaid/state-indicator/medicaid-spending-per-full-benefit-enrollee/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D