Nothing brings out the hate in American culture like a threat to the dominance of white men in blue suits. Barak Obama’s election left us looking at our first black president being lynched in effigy and an unprecedented level of obstruction. Hillary Clinton’s run for office left us with Donald Trump. We could, and will, debate for years what she did or didn’t do wrong, but a look at the facts leaves a clear message. Anyone who challenges the supremacy of the white male in America will be punished. How else can we explain the childish symbolism and sexism of an all white male committee making women’s health decisions. Even great, great, great grandpa on the frontier knew he he did not belong in the conversation about birthing babies, but now we have old white guys posing for photo ops. The old white guys must be really shaken to go so far. The linked article looks at research on this topic and the scary picture it provides.
5 ways the House GOP Obamacare Repeal and Replacement would affect Missourians
Republicans say their proposal would "rescue" Americans from the failures of the Affordable Care Act, which they have blasted as a one-size-fits-all law that forced consumers to purchase expensive insurance plans they didn't necessarily need and often could not afford. Democrats say the GOP's efforts to repeal-and-replace the ACA, or Obamacare, would strip health insurance from millions of Americans and shred the current safety net for the poor.
The Congressional Budget Office clearly agrees with the Democratic Interpretation. In its two reviews of bills from House and the Senate the CBO has pointed to how hard the GOP will be on the very poor, the working poor, the chronically ill, the old and women.
I worked as a Navigator for the Affordable Care Act in 2010 and 2011 in a rural Missouri County. I live in a farming community composed of mostly small family farms where the wage earners usually have to have jobs to supplement farming income. It was not at all unusual for most to have little or no insurance for the adults in the family relying on insufficiently staffed and provisioned clinics. Children were covered by the CHIP program.
I am proud to say that several dozen of my neighbors got health insurance they could afford that covered them very well thanks to the ACA. Sadly ost of them voted for Trump and the GOP believing his promises to lower their premiums, expand coverage, and improve accessibility and now nearly all of them face an end to the kind of care they have gotten used to and most of them do not realize what is coming their way.
Here is what I have been sharing with them based on a number of state based research findings:
A) The state’s uninsured rate would rise.
More than 200,000 Missourians have gained insurance since the Affordable Care Act took effect, with the uninsured rate dropping from 13.2 percent in 2010 to 9.8 percent in 2015.
Forecasts show that nearly 80 percent of those Missourians would no longer be covered. 160,000 Missourians will no longer be insured.
Some people would choose to drop their coverage, because the GOP repeals the individual mandate that requires most Americans to purchase insurance. Others would no longer be able to afford health insurance under the Republican plan.
B) The mandates on individuals and businesses would be nixed.
Under the Affordable Care Act, people who failed to buy insurance faced a tax of as much as $2,676 in 2016. The penalty would go away under the GOP plan.
However, if an individual or family dropped coverage and then decided to re-enroll, the House GOP plan would allow insurers to charge them 30 percent more for premiums for one year.
The ACA also requires businesses with at least 50 full-time employees to provide its workers with “affordable” insurance — essentially, a plan that cost less than 10 percent of a worker’s household income. Failure to do that currently costs business owners up to $2,260 per employee annually. The GOP plan would nix that tax, so those business owners could stop offering insurance.
C) Insurances rates would vary wildly (as would coverage benefits) and costs would increase significantly for older, low-income consumers.
Much of the criticism of Obamacare has centered on the rising cost of private insurance plans, especially for individuals buying insurance on the health care exchanges with no federal help to offset the costs.
In Missouri estimates are that premiums would rise for most of the insured by 15 to 20 percent over the next three years. Of course, many would be forced to drop insurance since their ages and medical conditions would permit far higher premiums for those who most benefit from having insurance. Additionally, since GOP plans allow states to eliminate many of the guaranteed coverage benefits, a number of insurance plans will be economical but will provide few benefits.
In general, the cost of buying insurance on the individual market would go up for low-income, older Americans, and it would go down for younger, wealthier Americans. Both plans (although with each using different formulas) offer far less in the way of tax credits to those who qualify. They actually increase the number of those who will get no credits at all because the "working poor" will be excluded. The "working poor" are those who make less than 138% of the Federal Poverty Guideline. The assumption was that those individuals would qualify for expanded Medicaid. Missouri chose to "take advantage" of the Supreme Court ruling that said states could opt out of the expansion.
In addition, the House GOP bill would ease limits on how much insurers could charge older consumers, who tend to have more health problems than younger ones. The GOP change is aimed at drawing younger people into the market, but it could mean higher premiums for seniors.
D) Missouri hospitals could take a financial hit.
With more Missourians uninsured, hospital officials fear they would have to provide more uncompensated care. Hospitals are required to serve patients who have no ability to pay their bills, but those costs have diminished under Obamacare, as fewer uninsured patients arrived at their doorstep. The GOP bills will leave those hospitals with much more uncompensated care.
The Missouri Hospital Association estimates that the Republican plan could cost the state’s hospitals $5.5 billion over the next decade. The MHA also estimates that 30 public clinics and 9 hospitals will be forced to close their doors. Hospitals would be paying for a significant portion of the new law, at the same time as uncompensated care costs explode and Medicaid comes a less reliable source of care for the poor.
When the hospitals take a hit so does the local economy. In many of the counties in my state the hospitals are one of the top employers. Closing hospitals hits the local economy and makes the poor poorer.
E) Missouri would lose federal funding for Medicaid even the state chose not to participate in the expansion option.
Missouri never took advantage of the Obamacare provision that allowed states to expand Medicaid, the joint federal-state health insurance program for the poor and disabled. So in some ways, the GOP plan — which phases out the Medicaid expansion — will be less painful here than in other states that have come to rely on a generous federal match to expand coverage for low-income residents.
But Missouri — like every other state — would still lose federal funding under the GOP bills because of other changes the measures would make to Medicaid.
Right now, the federal government pays about 65 percent of the health-care costs for Missourians who are on Medicaid, and the state pays the other 35 percent. Under the GOP bills, that formula would be nixed, and states would instead get a capped amount of money for each Medicaid enrollee.
The capped federal contributions would not increase as much as the projected cost of treating Medicaid patients, so states would face a growing tab for the program. In other words the GOP programs pass the expanding costs on to the states such that they become responsible for more and more of the costs of Medicaid.
Critics say that would blow a hole in state budgets, prompting governors and state legislators to cut benefits and restrict eligibility for low-income residents. Supporters of the bill say Medicaid’s costs are unsustainable and the GOP bill puts the program on a more fiscally responsible course.
In Missouri the largest single bloc of Medicaid holders are the elderly with more than half of these in nursing homes. If Medicaid is reduced what happens to them. Medicaid in Missouri is generally for the very poorest who can barely hold on now. What happens to them?
I am a member of two Indivisible Groups that are focusing on the Health Insurance Bills. In meeting after meeting with GOP staff and members of Congress.....all they have is generalizations and platitudes.....they cannot respond substantively to concerns and questions. In my opinion they know how terrible their bills are.