Photo credit: Stephen Melkisethian
Issue of the Week reflects the Shepherd Express’ opinions on important issues in the news. It is usually written by the Shepherd’s editor, but at times we invite individuals outside of the paper who are either working in the field or have some other level of expertise. Their names and affiliations will be listed at the end of the column.
If you’re someone who is upset about what you have been hearing about the current debate on health care, you’re not alone. According to a USA Today poll, only 12% of the American public currently supports Congress’ current health plan. So, you could be forgiven for celebrating last week when the Senate announced they did not have the votes and would delay a fast-tracked attempt to repeal the Affordable Care Act. The problem is that the GOP health plan refuses to die.
The Congressional Budget Office, the very well-respected nonpartisan agency tasked with presenting the repeal bill’s impact, has received a lot of attention this week for the number of people they estimate will be forced off their coverage. But there are many more CBO revelations on this bill that bear consideration as we remember this Independence Day how our very health care freedom is being challenged.
Here are three parts of the Senate health bill you may not have heard about yet.
Tax credits—84% of Wisconsinites who use healthcare.gov currently receive tax credits to reduce out-of-pocket costs and monthly premiums, often to purchase a mid-level “Silver” plan. The Senate repeal bill makes three big changes to them. First, it pushes people into riskier “Bronze” plans with thousands of dollars in higher deductibles, exposing us more in emergency situations. Second, it completely ends any out-of-pocket cost reductions for moderate-income consumers. Someone at the poverty line would have to pay half their annual income in deductibles before their insurance company would pay a dime for their care. And, lastly, it suddenly cuts off middle-income families and older Americans in a substantial way from any tax help. A family of four earning $88,000 a year with two kids in college would see their tax credits to reduce premiums drop from $7,500 a year to $0, leaving them to make up the difference.
Discrimination—the Senate health bill doesn’t allow outright discrimination in the same way Paul Ryan’s House repeal did, where insurers could charge people with preexisting conditions like cancer more upfront. Instead, it allows for a back-door style of discrimination where insurers can’t tell a cancer patient to pay more in premiums, but could decide not to cover their cancer drugs. The same is true for diabetes, childbirth, mental health, opioid treatment, basically anything insurers would consider “preexisting.” It was prevalent before the Affordable Care Act; many insurance companies would not cover vital health, services. Maternity, ambulance use, substance abuse treatment, prescription drugs and far more. In the world that the Senate health bill would create, you’d have to either prepare for diseases you don’t know if you’d get, or weigh the potential damage of delaying certain treatment just to save a little money now.
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Medicaid—but the worst part is saved for the poor, which both Senate and House bills go out of the way to sabotage. Medicaid covers one out of every five Wisconsinites, from seniors in nursing homes to children in BadgerCare and people with disabilities. The differences between the two chambers’ bills are not huge, but they both represent a major restructuring that effectively ends Medicaid as we know it. The short explanation is that every year federal funds for Medicaid will be short of what’s needed, leaving states to make up the difference or, more realistically, make drastic cuts. And there isn’t a way to shield certain groups of consumers. Everyone, from children with disabilities to grandparents in long-term care, will be at risk.
22 million Americans are at risk of losing their coverage. Four million are people who have employer coverage and don’t even use healthcare.gov. The rest of us get to look forward to higher deductibles, fewer consumer protections on annual out-of-pocket costs, and nothing done to rein in pharmaceutical costs or for-profit medicine. We cannot allow ourselves to develop a false sense of security about the fate of health care repeal just because the Senate delayed the vote; it isn’t dead yet.
Let’s be clear: This is the moment when the very American promise of life, liberty and pursuit of happiness is put to the test. You cannot be free when for-profit insurance companies decide your fate. Lives truly hang in the balance. At this point, only by building on top of the Affordable Care Act can we provide freedom from preexisting condition discrimination, freedom from outrageous medical bills and freedom from those who want to decide who’s “worthy” of health coverage. Essentially these changes will determine who can afford to live and who will die.
Kevin Kane is organizing director of Citizen Action of Wisconsin.
