For the Party that just regained the House in Congress this last election based on their messaging that Obama and the Democrats were “taking our liberties” from us, the new House speaker, John Boehner , has vowed to remove the new freedoms we recently gained with the passage of the Affordable Care Act (ACA) passed last year. What I believe to be a monumental error in judgement begins next week. In their efforts to repeal the bill the new GOP leadership is rushing a vote on this shortly after regaining the majority and will likely restrict debate on it, a tactic many of them hollered foul at towards Democrats just last year when they were in the majority.
Shortly after the victories came for the House Republicans last November Boehner told reporters he believed “that the healthcare bill that was enacted by the current Congress will kill jobs in America, ruin the best healthcare system in the world, and bankrupt our country. That means we have to do everything we can to try to repeal this bill and replace it with common sense reforms to bring down the cost of health care.”
WHAT WILL CHANGE?
What is in this bill that kills jobs, ruins the best healthcare system in the world (that many Americans are unable to afford anyway) and threatens a financial holocaust on our economic system? And what, after nearly 60 years of efforts blocked by Republicans to implement health care reform, will the new Congress do different to correct this? Conservative Democrats and some Progressives who crafted the ACA claim that if this bill is repealed we could return to a failed health care system: “one with skyrocketing costs bankrupting families and our budget, fewer people with access to quality care, and more people at the mercy of the health insurance industry.” (“How Conservative attacks on health reform will hurt you”, by Tony Clark, 1/5/11)
Health care costs and the bills impact on the national deficit seem to be the prevailing concern of many on both sides of the issue. The GOP claims the package deal will raise the national debt but provides no data to support exact figures. Conversely they offer no information on what the taxpayer is already paying in out-of-pocket expense as an individual. Could private industry costs exceed those realized by this legislation?
Records show that premiums for family insurance policies increased 130% over a ten year period from 1999 to 2009. If this expense on private citizens could be cut significantly would tax changes that impact income to fund this bill be more or less adverse. You decide. The non-partisan Congressional Budget Office (CBO) says “those receiving help [as a result of the new health care reforms] in the individual market would see their premiums reduced by 56 percent to 59 percent less than they would pay without the law”. In other words the cost of your health care will actually depreciate over time as this law kicks in, where if it is repealed, they would likely continue to increase over that same period.
And despite the mantra from Republicans that health care reform is a “job killer”, Ezra Klein points out in his recent column that the “GOP lifted the claim from this Congressional Budget Office report (pdf) — but the report never says the bill will kill jobs. What it says, rather, is that the law will slightly reduce labor. It’s not that employers will fire workers. It’s that potential workers — particularly older ones — will retire somewhat earlier”.
Small businesses would actually receive federal assistance in the form of low cost exchange pools and tax credits to cover health care benefits for their employees that would help prevent any cutback on profits to run and expand their businesses. The ultimate saving feature of providing all employees with adequate health care coverage is a more reliable, productive work force; one where fewer employees miss work or are forced to quit due to poor health, requiring employers to expend time and money to hire and train new workers to fill these losses. This all equates into a gain of 400,000 jobs saved that would otherwise be lost from workers’ poor health
THE GOP AND HEALTH INDUSTRY ALLIANCE
The attempts by Speaker Boehner and the new GOP leadership in the House to marginalize these gains we have made with the ACA by inferring it will hurt the economy is a weak argument that attempts to conceal an alliance many of them have with the health care industry, especially big insurance companies. There is no government run health insurance provider here. The new law works with the private insurers to increase their market share while essentially making these insurers do what they are designed to do – cover costs for health needs for their customers.
Because it is a for-profit business part of our premiums go to health insurers’ bottom lines. The necessity of this arrangement insures that the company will provide the administrative bulwark essential to sustain the company that helps us cover our health care costs. But what happens when companies become more bent on their profits than providing beneficial coverage we need?
Over the last half century the profit margin of major insurers has gone from about 5% to as much as 40% in some cases. That means your premium dollar has lost its health care value eightfold. The average profit margin is around 20-25% but is creeping higher outside the purview of federal watchdogs. Without the power of the ACA to curtail this eating away at your health care dollar, more people will be forced to pay higher out-of-pocket expenses at a time when their paychecks are remaining stagnant or even dwindling.
Matters are even worse for the 1 in 10 Americans who are still out of work and lost their company paid benefits. They assimilate into that large number of Americans who were already without insurance, some 45 million, because costs are out of reach for them. The new legislation helps these people with subsidies to cover the burden of these high costs. As their income status improves more of the costs pass from the government back to the consumer.
The biggest objection from the opposition to this bill is what is called the individual mandate. The law requires that everyone purchase a health care policy, including young healthy-types who are not covered with a company policy. This influx of revenue into the health insurance industry pool is designed to reduce premium costs at all levels. It is one of the few aspects of the ACA legislation that the health insurance industry has actually pushed for, although they did so through back doors deals with legislators so as not to appear to be the bad guys on this. This provision has put the industry at odds with the GOP who have an historical relationship going back to the 1950‘s to block most any and all health care reform.
WHAT WE’LL LOSE
Clearly there are aspects of this bill that raise questions and legitimate concerns for taxpayers and consumers but anyone who closely watches the growth of the the for-profit health care sector there can be no doubt that health care costs have skyrocketed without any so-called interference from government. To presume as some do that we will actually lose more than we already have is absent the reality of what is within the bill many opponents call “Obamacare”. Here is a list of some of the more important things that will be taken from you if Republicans are allowed to repeal this bill.
- Health Insurers will cancel your insurance if they deem your condition too expensive for their bottom line.
- The can deny you coverage for a non-life threatening pre-existing condition that hasn’t appeared in over a decade. The new law was especially protective of children 19 and under that could be affected by these decisions.
- Health insurance providers can randomly increase their Medical Loss Ratio (MLR) beyond the 20% limit the law now sets. This means no more than 20 cents on every premium dollar is all that is allowed to go to their bottom line. The remaining 80 cents has to be spent on your health care needs.
- Children up to 25 years old will no longer be allowed to be covered under their parents policy. This loss will create undue hardships on college students and young working adults at risk who can’t afford their own policies
- The life of the Medicare Trust fund will not be extended to at least 2029 because the actions mandated in this bill that would reduce waste, fraud and abuse, and slowing cost growth in Medicare will be removed.
- The 50% discount on brand-name drugs seniors are schedule to get this year when they hit the “donut hole” will be eliminated.
- Protections for Medicare Advantage Plan members, set to kick in in 2014 will be killed These protections would take steps to limit the amount these plans spend on administrative costs, insurance company profits, and things other than health care.
- You will lose valuable rights to challenge decisions of your insurance plan if it denies payment for a treatment or service.
- Policy holders will lose their protection to prohibit health plans from putting a lifetime dollar limit on most benefits you receive. The ACA also restricts and phases out the annual dollar limits a health plan can place on most of your benefits—and does away with these limits entirely in 2014. This protection will disappear too if the GOP repeals this law.
- Small businesses with fewer than 25 employees and provide health insurance for them will no longer qualify for a small business tax credit of up to 35%
Contrary to much misleading information made by opponents of this legislation your rights to choose or retain your own personal physician will not be denied and women can still see an OB-GYN doctor without needing a referral from another doctor. Also, the right to seek end-of-life counseling from your physician, portrayed by Sarah Palin as “death panels”, may still become a reality since it was eliminated from the ARA by pressure form opponents to remove it from the bill. The aspects of Advanced Care Consultations as pointed out in Section 1233 of the HR3200 was intended in part to help seniors and their families establish advance directives, including living wills and durable powers of attorney, and their uses and to better understand the role and responsibilities of a health care proxy. The expense to this meeting would be covered under Medicare.
MORE OF THE SAME?
The hope by some that new legislation implemented by Republicans to retain some of these items and create a “better bill” that doesn’t break the American economy should be taken with a grain of salt. The GOP as mentioned earlier has an extensive track record of doing the bidding of health insurers and some health care providers to insure that their profits are not only protected but are enhanced through policies that increase premiums and deductibles while removing essential services vital to sustain a healthy and productive workforce.
To date the GOP has offered nothing to curb high health care costs outside of the failed practices they supported during the Bush administration. It is likely that part of what GOP leaders offer is more of the same with so-called “market principles” that allow the private sector to address the issue of lowering costs. Does the expression “allowing the fox in the hen house” seem pertinent here?