In the battle to win the hearts and minds of Americans over the repeal and replacement of Obamacare, both Republicans and Democrats are waging fear-mongering campaigns based on lies and deceptive tactics.
Bernie Sanders, in his debate with Senator Ted Cruz claimed that repealing the affordable care act would leave pregnant women and children of families that could afford healthcare without coverage. This seems to be the ongoing reframe. On Meet the Press, this Sunday, March 11th, Kathryn Sebelius, representing the Democrats, told us that the Republican plan would leave additional lower income pregnant women and children without coverage. This woman should know better. The CHIPs program, enacted under the Clintons, which Bernie Sanders voted for, was in full effect when Ms. Sebelius was responsible for running the Department of Health and Human Services. In fact she was responsible for its implementation. The CHIPs program provides coverage for all kids and all pregnant women who do not have insurance whose income does not qualify them for Medicaid. If anyone’s income increases or, due to changes in the law they no longer qualify for Medicaid coverage, they will be covered by CHIPs. This is the fact. As to pregnancy care, as a Democrat, this was her chance to put in a plug for Planned Parenthood, which provides free pregnancy care for all comers, whether they have insurance or not.
The Republicans are just as bad. In his interview on the same program Current HHS Secretary Tom Price said that people will not lose coverage; in fact, the program will cover more individuals that are currently covered. The is patently false. The problem is economics. If people can’t afford to pay for their coverage, then the Republicans believe that is not a loss of coverage, but simply a decision not to buy. The CBO said that 24 million Americans are estimated to lose coverage. This estimate seems a bit low. Healthcare cost for a family plan in 2117 is estimated to be $18,000 per family. Next year, health insurance policies are estimated to increase between 20% to 40%; which would mean policies family policies would cost an estimated $23,000 per year. Under the Republican plan, any family that buys a plan would have to advance the entire cost of the plan for the entire year before they would see any premium support from their tax credit. Setting aside between $1500 to $2000 per month from one’s after tax income is an impossible goal for most families. This, coupled with the fact that health insurers are not particularly interested in supporting the individual/small business market[1], means that insurance companies have no incentive to reduce prices for this group. With premiums going up, deductibles up, 5 states with one insurer offering coverage, these numbers seem a bit low. Price also said “I firmly believe that no one will be worse off financially in the process that we are going through understanding that they will have choices that they can select the kind of coverage they want for their choice and their family.” This is false and misleading on two levels. First, as long as insurance companies are required to provide coverage for the essential health benefits, they have very little flexibility on the types and pricing of policies they do offer. If Benefit offerings are fixed, the only variables that would create choice for an individual buyer are deductibles, co-pays and networks. Second, the statement that there will be no financial impact to families is patently false. Premiums will increase; deductibles will increase; and, the insurance company’s latest game, classifying expenses as co-pays and then not counting those co-pays towards your deductible, is sweeping the nation.
All the Republicans are saying that over time, multiple providers will enter the market and there will be an array of choices. Multiple provider concept is a myth since the number of eligible health insurers in each state is limited. How can there be an array of choices? This bill equalizes the tax treatment of the purchase of health coverage for folks who get it through their employer and folks that aren’t getting it from their employer. We support making it equal for those who are getting from their employer and those who are not getting it from their employer.
Here are the facts:
· None of the political solutions offered, including the ACA, address accessibility, affordability and/or the creation of healthcare options.
· Keep, repeal and/or replace, the cost of insurance will go up.
· Consumers that purchase insurance will pay more of the cost of their healthcare. In addition to increases in premiums, deductibles will go up, co-insurance payments will go up, and, not only will co-pays go up, but any co-pay paid will not count towards your deductible.
· In future, things that used to be paid by insurance, like surgery, will be subject to a “co-pay” rather than a co-insurance payments.
· Insurance companies will exert greater influence over healthcare decisions. If you are sick and the doctor recommends more frequent testing, if your insurance company only pays for testing once a day, that is what you will get. If you can’t pay for your own testing, you are out of luck.
· Delay, deny die will become even more a reality. If you need surgery and the health insurance company drags their feet you will have to wait. If waiting results in your death, that’s on you.
The truth is the solution to these problems is at our fingertips, but our representatives would have to have the political willingness to take on the insurance companies. It involves combining health savings accounts with catastrophic policies and by limiting administrative costs to 30% of premium dollars. The remainder must be paid to healthcare service providers.
[1] Urgent Care, Minda Wilson. I speak about this in my book; how corporations were forced legislatively to provide services for the individual and small business markets but were allowed to charge more for it.