Tag Archives: Affordable Care Act

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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Lessons from the South for 2020

New Orleans      It may be too early to make a definitive list of lessons learned from the off-year elections in Louisiana, Mississippi, and Kentucky, but the one thing that seems crystal clear is that the Democrats have some hope, the Republicans have some deep worries, and to the degree President Trump makes these elections all-about-me, he’s a loser.  Nonetheless, there are some trends worth noting one year before the 2020 US electoral sweepstakes.

When Trump heats it all up to boiling to pull his base out of the woods, he also pulls out his opponents, and those in the middle, as heavily.

In Louisiana for example, 385,000 more voters came to the polls in 2019, than 2015.  John Bel Edwards was reelected as governor at the head of the Democratic ticket with 28,527 more votes out of Orleans Parish, which is coterminous with New Orleans, with a surge of black votes, but also taking some Lakeview and Uptown precincts that are typically Republican.  He pulled 66000 more votes cumulatively from East Baton Rouge Parish and Orleans.  He won suburban Jefferson Parish which is nearly the size of Orleans and was the original landing spot of white flight, and the heart of Representative Steve Scalise’s congressional district and the legislative district that was represented earlier by Scalise and KKK stalwart, David Duke.  Early turnout and significant effort by African-American churches were also key.

Moderate, suburban voters outside of Louisville and Lexington were key to a Democratic governor winning narrowly in Kentucky as well.  The closeness of the race in Mississippi was also partially due to suburban voters outside of Jackson and in the northern Mississippi counties that include Memphis suburbs, where many voters had leaned and loved Republican candidates from top to bottom.  Observers in Mississippi have argued to me that Jim Hood could have won had the party been more united behind his candidacy, so there may be some stories beneath the headlines there as well.

Here’s another takeaway:  The Affordable Care Act is an election winner.  I heard Eddie Rispone’s ads over and over every time I was at the gym on an elliptical machine, and they were nasty about healthcare giveaways and money to illegal immigrants in Louisiana.  Edwards campaigned on extending Medicaid coverage in Louisiana, and it mattered.  Andy Beshear, the Kentucky winner, was also clear that he would do his darnedest to expand Medicaid under the ACA there as well.  Medicaid for All may not be a good political sell yet, but fix and expand the Affordable Care Act offerings definitely delivers votes and turnout.

Make sure to remember the fact that women have the ability to hold up more than half the sky when it comes to the 2020 election, and educated, suburban and urban women, have not changed their mind about Trump and his apologists should be on every list.  The impeachment circus may not yield much, but few women are going to miss the point of a former ambassador being bullied and intimidated by Trump or the courage of the women professionals willing to stand up and speak out about the president’s foreign policy narcissism.

So far Trump is doing a better job at pulling out votes against him than we are at pulling out votes for anybody else.  There’s no comfort in that conclusion, but it gives us hope and some paths to travel.

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