Is Their Hope for Obamacare?

77639392New Orleans     A federal court somewhere gave new hope to the haters that the subsidies the Affordable Care Act to lower income families might be blocked.  The Administration says they will win on appeal.  But, this is only one cloud of many in the building thunderstorm.

            Insurance companies and those that follow them are almost universally saying that there will be significant price hikes in 2017.  Others are dropping by the wayside, largely because of their own bad pricing and marketing decisions, but nothing keeps them from finger pointing as they leave.  In many ways this was predictable.  As the signature legacy of President Obama, they are smart enough to wait until his long goodbye transitions into whatever and both he and Congress are lame ducks caught in a quacking stalemate, and roll up heavy on Clinton or Trump with the fait accompli

            Clinton has flirted towards the left with a vague proposal to potentially allow people 50 or 55 years of age to “buy into” Medicare, which would expand the coverage to millions more, if they have the money.  What it would still not do is solve any of the problems that continue to weigh heavily on Obamacare.

            Drug prices have continued to rise for example.  In fact, drug profiteering still seems a winning business plan despite the problems with Valeant and profiteers. 

            Charity requirements for nonprofits are still largely more pretense than policy.  Modern Healthcare reported 7 of the 10 most profitable hospitals of the top one-hundred in the country, according to a researcher at John Hopkins, were tax exempt nonprofits.  The three most profitable for profits were all part of the HCA chain and all three were in states like Texas and Florida that have not extended coverage under Obamacare.  Nonprofits were very well represented in the top 100, including Herman Memorial which has been the target of campaigns by Local 100 United Labor Unions and community allies in Houston and Ochsner, headquartered in New Orleans, which has also been called out for its miserly charity record.

            Emergency room doctors are reporting that half or more of the patients they are seeing are coming in late and with insurance, but had delayed seeking care because of the astronomical level of their deductibles, equivalent to having no insurance at all.   Employers of lower waged workers continue to develop such minimal coverage programs with impunity.  The coming year will see an even higher level of penalties appropriated against lower income workers who are running from the cost, deductibles, and copays, but will be caught by the mandated penalties.

            The bottom line is that, like any major piece of new potentially groundbreaking, safety net legislation there are problems.  There are pieces that beg to be fixed.  Meanwhile the deadlock in Congress simply lets the sores fester and pain endure without stepping up and fixing what is broken.  Health care continues to be a political football, as politicians maintain the fiction that this is all part of the game, rather than coming to terms with the fact that for many low and moderate income families, it’s life and death.

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