Tag Archives: Affordable Care Act

Expanded Medicaid

The Pandemic Case for the Affordable Care Act

New Orleans       There’s no rhyme or reason to it, but bizarrely the Trump administration recently marched into court to once again challenge the legal standing of the Affordable Care Act.  Perhaps someone in the campaign wasn’t sure that former Vice President Joe Biden had enough issues already to make his case, so they wanted to remind him that his work with the Affordable Care Act was still a straight arrow to the heart and health of America ready in his quiver to bleed out the president.

The numbers are no friend to the administration.  In fact, the latest reports seem to indicate that they may be trying to sweep the pandemic surges under the rug by having hospitals drop reporting to the Center for Disease Control and instead cycle them over to a private contractor.  The one set of numbers they can’t really hide are those that indicate the numbers of people who are losing healthcare in the middle of the pandemic.  Job and employer-based insurance doesn’t travel well to the unemployment line.  5.4 million Americans lost health insurance in four months because of job losses, shattering a record according to Families USA.  Kaiser estimates the number is 27 million, counting family members as well.  That’s a lot of Americans who are now facing huge risks with no safety net.

As the virus surges in the South and the West, it is hard not to note that it is in these two regions where redder states have not expanded Medicaid under the Affordable Care Act for largely ideological reasons, leaving jobless victims without health care in double jeopardy. And, why?  The most common rationale was fear over future costs as the government’s initially generous shouldering of the cost ebbs.  Turns out that doesn’t hold any water.  Two Harvard economists have calculated that the money spent on Medicaid expansion more than paid for itself, even after accounting for the fact that benefits that come in the future are worth less today, making the Affordable Care Act a great deal.

The public knows it, especially now.  Ask Oklahoma, a state so red that it’s margin of victory for Trump was close to astronomical in 2016.  They may be conservative there, but they’re not crazy.  They weren’t willing to risk their lives for Trump’s Tulsa rally for one thing, but more importantly, they voted soundly to direct the state recently to add Oklahoma to the expanded Medicaid states under the Affordable Care Act.

Republicans opposing the Affordable Care Act now in the time of pandemic is not a viable healthcare strategy.  It’s a retirement plan, sealed and specially delivered by the American people.

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Paying for Coronavirus and Medical Debt

Pearl River     Ten percent of Americans have absolutely, flat-to-the-bone, no health insurance.  Many others have Trump-plan insurance with high deductibles, covering nothing much at all, but maybe catastrophes up to certain lifetime payment levels.  Many of these same people are exactly the people who have to work, rain or shine, not because they are delivering the mail, although those folks are on the job as well, but because they are the underpaid infrastructure of the service economy from health care to food service to almost anything you can name.

Yesterday, one of the consumers at ResCare, a large national company where we represent workers in Lafayette, Baton Rouge, and New Orleans in their community home operations, tested positive for coronavirus.  He’s still in the home, although with others.  Three of our workers are exposed.  There is no personal protective gear other than gloves, and in having forced the company to share their policies, not much of a plan for the consumers or workforce on any deep and serious level.  The minimal health policy the company offers that complies with the Affordable Care Act takes the fully allowable 9% of wages and then requires a deductible of over $4000, which was not capped by Obamacare.  Out of some 250 workers, less than five, and I’m being liberal here, actually participate, yet all of them are barred from the subsidies and supports available on the ACA marketplace, because their company offers something that is called health insurance and in compliance.  We’re on this like white-on-rice, but if any of our workers get the virus, they could be in big trouble.

Testing is free, reportedly, and the stimulus package forces insurers and employers to cover the tests.  Of course, if you hit the doc and don’t have the virus, that’s good news with a but…since you could still owe for the visit and a copay.  If you have it, the treatment will cost you.  The Wall Street Journal estimates low end $1300 out-of-pocket, but with major complications more than $20,000.  You could also have surprise bills of course, because despite bipartisan agreement, the lobbyists managed to sidetrack Congress this year on that problem.  Of course, if these lower waged, essential healthcare workers had managed to sneak onto Medicaid, under the Louisiana expansion, rare in the south, there would be no cost.  In Texas, no such luck, and same for a bunch of other states like Mississippi, Alabama, and the rest.

If they lived through it, welcome to medical debt.  On Wade’s World,  I was talking to an old colleague, Chuck Shuford, who has become an advocate demanding action on medical debt in rural Virginia where he lives now.  He talked about RIPMedicalDebt.org, where he has become involved.  They buy debt for pennies on the dollar.  Churches and others have pitched in to get rid of millions in debt, and they have created a special fund for Appalachia.

That’s a good thing, but for ResCare workers or anyone in the United States, there shouldn’t be any medical debt.  Period.  Why do we allow such a system?  Isn’t the coronavirus teaching us to build a better system?

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