Welcome to the No-Insurance Emergency Rooms as Long as They Last

New Orleans  The Congressional Budget Office has released its score on the cost and impact of the Senate Republicans version of healthcare coverage. The bottom lines have gotten wide publicity. 22 million will lose insurance by 2026, 15 million almost immediately. 15 million lower income people will lose Medicaid coverage. It wasn’t big news that this will be an income transfer from the poor to the rich, because we had already known that was coming in all the Republican bills.

Elderly people hoping to live long enough to qualify for Medicare will have to run the gauntlet, unless they are wealthy. The New York Times gave two examples from the CBO report that were appalling.

for a typical 64-year-old with an annual income of $26500, the net premium in 2026 for a midlevel silver plan – after subsidies – would average $6500, compared with $1,700 under the Affordable Care Act. And the insurance would cover less of the consumer’s medical costs. Likewise, the report said, for a 64-year-old with an annual income of $56,800, the premium in 2026 would average $20,500 a year, or three times the amount expected under the Affordable Care Act.

Yes, you understand the math. In the first example that’s a quarter of the person’s income and in the second it’s more than one-third, 36% to be exact.

The Senate added an amendment at the request of the insurance industry recently that anyone not on insurance more than 60 days would have to wait 6-months to get coverage and pay 30% more on their premiums. The industry recognized that as bad as this bill is, no one is going to get coverage until they are sick, so they wanted to try and put some boulders in the road.

And, of course they are right. With no mandate and no penalties for not having insurance most people will not get insurance for the plain and simple reason that they won’t individually be able to afford it unless their employer is providing it for them. Young people on insurance will be rare. For the rest of the population, health insurance will be the American version of Russian roulette. How long can you wait before getting insurance? People will be arbitraging their family fiances against their lives.

What if you are diagnosed with cancer or something and have to wait 6-months for treatment? In the short term survival for you and tens of millions of others will mean throwing yourself on the mercy of the hospital emergency room, as long as the law doesn’t allow them to refuse service, and until so many of these hospitals go bankrupt from providing care without government support or private insurance payments.

There’s a reason why hospitals, doctors, nurses, and everyone connected to providing health care services have opposed these bills. It’s not because many will lose their jobs as healthcare facilities go under, which they certainly will. They aren’t politicians. They’ll see the people dying at their door, too late to save, and too poor for the insurance, yet too rich for any assistance. Who wants to live through that?

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Congressional Budget Office Scores House Health Bill with an “F”

Oakland    The Congressional Budget Office finished its nonpartisan, objective evaluation of the costs and impacts of their recently passed bill to replace the Affordable Care Act, and channeling Gertrude Stein found that there was “no there, there,” at least if any of us were looking for health insurance, especially when we have health problems.

Begin with the fact that they estimate that 23 million Americans will lose health insurance. I say “begin,” because there is no way to get an accurate view on how high that number could rise. The Republican bill, as written, gives states the ability to ask for waivers from an anti-healthcare Department of Human Services, which would rubber stamp the ability of states to eviscerate care for the individuals with preexisting conditions, women’s health needs, and allow skinnier and skinnier requirements from the plans, thereby eliminating the minimum health provisions of Obamacare for everyone on the program. Analysts report that the CBO usually consults with states in making its estimates, so the 23 million may include some, but this number would likely swell in the red states with “red” now not referring to the color of a map on election night, but instead standing for the blood draining out of these states’ dying people.

Furthermore in the CBO score, they reject the argument that Republicans have made that such miserly benefits will bring happy days with lower premiums and therefore more participation. The CBO flatly argues that the Republican House plan will end up with higher prices, especially because of the Medicaid cuts, and will collapse insurance markets because of the reduction of subsidies. Young people will get cheaper insurance though that will only be good news in the flower of youth, because if, and when, faced with any healthcare needs, young people will be as screwed as everyone else.

The CBO also totally dismissed the Republicans’ argument that “risk pools” would cover take care of Americans with preexisting conditions. If you read between the lines the CBO believes they will pretty much die as soon as they run out of money, and it won’t take long. The “risk pools” are inadequately funded in their view, and they have never worked. The dustbin of history is calling, but the House Republicans are determined to sell the scam. At least they are if they can keep their tempers when asked to defend their votes in favor of this trash, which wasn’t the case for the Montana Republican Congressional candidate facing a tough contest, who decided to body slam a British reporter for the nerve of asking him about his vote.

Some Senate Republicans might notice that one of the groups being slammed the hardest is older people. The New York Times analysis noted that “The cost of insurance for a 64-year-old earning about $27,000 would increase to more than $13,000, from $1,700 under the Affordable Care Act, even for states that pared back insurance rules.” Bad news, these folks actually vote and even with diminishing basic math skills, all of them will figure out that their bill would be almost half of their income.

There are some winners though, but in the Republican plan that’s the folks with the fatter wallets, especially if they are neither old nor poor. The Times reports, that “The bill makes big cuts to taxes on payroll and investment income for those earning more than $200,000, and provides more subsidies to buy insurance for people earning between about $50,000 and $150,000.”

There is no irony here, though their could be. Fewer subsidies for the poor, but more for wealthier families? How can anyone rationalize that? There’s a clue to their thinking though. Perhaps they are channeling HUD Secretary Ben Carson, and want us all to believe that health insurance is like poverty, “just a state of mind.”

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