By Margaret Flowers for Health Over Profit for Everyone. Photo: Michael Fleshman/flickr/cc
As the White House and Congress play political football with our health care, it is critical for us to keep our eye on the goal of pushing for National Improved Medicare for All.
Both the White House and Congress are taking steps to change the US healthcare system, but neither is proposing steps that will guarantee people will be able to afford the care they need when they need it. Instead, they continue to politicize health and to prop up health insurance industry profits.
Here is more information so that you can speak about current events and continue to advocate for the much-needed solution to our healthcare crisis: National Improved Medicare for All.
The Trump administration has taken steps to change the current market-based healthcare system in a way that will place an even greater burden of costs on those who have health needs. On October 12, the White House ended the cost-sharing subsidies that assist people earning under 250% of Federal Poverty Level (FPL) with out-of-pocket costs. If it goes into effect, it will begin in 2018. The President also signed an executive order that sets a path in motion to allow private insurers to (1) sell association health plans, which can cover fewer benefits and charge more than plans in the Affordable Care Act (ACA), to more entities such as small businesses and individuals; (2) sell short term plans, which are also less regulated, for longer periods of time; and (3) sell insurance across state lines.
The impacts of these changes, if they are implemented, are as follows:
- Reducing subsidies for cost sharing will raise premium prices and provide justification for health insurers to leave more areas. Already, CareFirst Blue Cross in the DC area is claiming they will need to raise premiums an extra 20% to cover the loss. Bear in mind that this ‘non-profit’ insurer has excessive amounts of money in reserves and compensates its CEOs tens of millions of dollars each year. It could easily offset the loss of subsidies without raising premiums.
- Selling cheaper, skimpier plans will leave people without coverage when they need it. It is likely that healthy people will be attracted to these cheaper plans, which will leave those with health needs in the ACA plans and drive the cost of those plans higher.
- Selling health insurance across state lines will create a mess as health insurance companies set up in states that have the fewest regulations. They may avoid requirements to cover certain services or even to guarantee that they have enough health professionals in their networks to meet the needs of enrollees.
Meanwhile, chairs of the Senate Health, Education, Labor and Pension (HELP) committee, Lamar Alexander and Patty Murray, have agreed to a set of changes to the ACA, which they tout as a bi-partisan agreement. They propose retaining the cost-sharing subsidies, making it easier for states to receive waivers from ACA provisions, allowing states to have greater flexibility in approving insurance plans and allowing people over 30 to buy catastrophic “Copper” plans. They would also provide more funds for states to peddle (market) insurance plans. The bottom line is that these changes will allow health insurers to sell skimpier plans.
This Alexander-Murray plan still has a long way to go and no guarantee of success, but it is good to know their positions. Politico reports that the Senators will seek support from their colleagues and then send the plan to senate leadership for the next steps.
Overall, these are attempts to make a market-based health system function ‘better, but they will continue the same complicated system that rations care based on ability to pay. Cheap plans with high deductibles and low coverage push people to delay or avoid care and face serious financial consequences if they ultimately have to seek care. This is a cruel system that hurts patients and places physicians in the position of having to make financial considerations when ordering tests or treatments. And it is happening in the country that spends the most on health care.
This is why we need to continue to be loud and visible in our advocacy to say that there is no way the market-based healthcare system can meet our needs as people. We need to abandon the market and make health care a public good. The first step on that path is National Improved Medicare for All.
Contact your members of Congress. Urge your Representative to support HR 676: The Expanded and Improved Medicare for All Act. If they have signed on, urge them to do more – speak about it, write about it, gather more supporters, etc. And urge your Senator to support National Improved Medicare for All. S 1804: The Medicare for All Act is a vehicle that can be used to meet with your senators. Be honest about its short-comings. We need a bill in the Senate that starts out as strong as it can be because we know that as it goes through the process of becoming law, it will be weakened.
Health care is still on the national agenda. Use every opportunity to educate and advocate for National Improved Medicare for All.