T.S. Eliot in his poem “The Wasteland” called April the cruelest month. For American health care consumers, the cruelest month this year is October – thanks to Republican efforts to lay waste to the Affordable Care Act.
Republicans weren’t able to repeal the ACA legislatively because of massive public opposition. Instead, they are actively and brutally sabotaging the law, which has provided health security to more than 150 million Americans living with pre-existing conditions and covers more than 20 million of the previously uninsured.
This month, President Trump revived a contraception debate many of us thought was over decades ago. Under his October 6 executive order, he told working women that their employers could deny them the ACA’s guarantee of cost-free contraceptives. Meaning your boss can now use his “moral” judgment to take away your rights. Your health benefits are not a gift – you work hard for them every day. Now you may have to pay an extra $1,000 or more out of your own pocket – and I’m betting your wages aren’t going to be increased to pay this additional cost.
A week later, on October 12th, the Trump Administration launched their effort to bring us back to the days of “barebones” coverage – insurance policies that are basically worthless because they don’t cover maternity care, mental health or substance abuse services, or even hospital stays. The Trump executive order issued on this day would allow businesses to band together in “association health plans” sold by out-of-state insurance companies ― exempt from most federal and state laws, including comprehensive benefit protections. People with pre-existing conditions and older workers could face higher premiums for skimpy, inadequate coverage. They would pay more and get less. You might not want to go without essential health benefits or lose consumer protections if an insurance company many states away denies your claim or goes belly-up. But once again, your employer could make that decision for you.
Finally last week, in a move opposed by Republican and Democratic governors and insurance commissioners, President Trump decided that he will stop making the federal cost-sharing reduction payments. Those payments are for families with income below 250% of the federal poverty level ― individuals who earn up to $30,000 or families of four with an income of $61,000. President Trump took this action despite all the warnings, saying that since the Republicans in Congress couldn’t repeal the law, he would.
What does this mean to you? If you’re eligible for cost-sharing reductions to help pay your deductibles and copays, you’ll still get them. It’s the law. But now, insurance companies will either raise premiums to cover those costs or leave the market completely. The non-partisan Congressional Budget Office says this one action will increase premiums for everyone by an average 20 percent, cost 1 million Americans their insurance, and add $194 billion to our deficit. If you are eligible for premium assistance, the impacts on you will be limited. If not, you could easily be priced out of coverage.
Of course, the Republican Congress could step in – acting immediately to provide federal cost-sharing payments so premiums don’t go up in January. They could make helping you their priority, instead of focusing on raising prices, cutting benefits, and obscuring the truth. They could give up their partisan fight to repeal the ACA and work with Democrats to improve it. Today’s announcement of a bipartisan deal between Senators Lamar Alexander and Patty Murray could be a start, but we still have a long way to go.
October isn’t over – there is still time to make this a better month for American health care consumers. But, with only 15 days left before this year’s shortened open enrollment period begins on November 1, there is not much time for Republicans to reverse course.