By THERESA BROWNGOLD
A recent guest opinion about the shortfalls of Obamacare is rife with irony starting with the name of the organization of which the writer is president, “Citizens Council for Health Freedom.” Freedom for whom? Over 60 percent of bankruptcies in this country are due in part or total to medical bills.
There is no patient freedom if one cannot access care. And where is the freedom in going to the emergency room, getting a $14,000 bill and being told you are responsible for $7,000, as just happened to a family member. Care in the United States is heavily rationed by one’s ability to acquire good insurance. Obamacare came about because of this public health crisis.
The writer makes the point, albeit unwittingly, that Gov. Corbett should expand Medicaid. The Supreme Court made this provision of the Affordable Care Act optional for states. I agree with the writer. We should not have an “entire class of lower-income individuals” left uninsured. Lay that one at the feet of our Pennsylvania governor who refuses to expand Medicaid. Pennsylvania taxpayers will see their share of Medicaid expansion money go to states like the writer’s. Minnesota is covering its low-wage earners by expanding Medicaid.
The writer says, “Experts say more ‘sticker shock’ is coming this summer when insurers release their Obamacare-priced premiums.” Perhaps the “experts” are referring to the price-gouging that could happen before consumer protections kick in. Starting in September insurance companies must justify their premium increases by providing consumers with a “clear disclosure form” justifying the increase. Proposed increases over 10 percent will trigger a more rigorous review by independent experts. The writer would have us believe she thinks this provision of Obamacare does not go far enough. I agree.
And she fails to mention the Medical Loss Ratio provision of the law that requires insurance companies to send rebates to premium-payers if the insurance companies don’t spend 80-85 percent of the premium dollars on actual medical care or care-related services. If insurance companies collect too much, they will have to send out rebate checks.
Today, high deductible health plans (HDHP) are being sold as a way to shift costs to consumers. With HDHPs we pay a premium, and on top of that we need to save thousands of dollars to use for medical bills. Only after we meet that large deductible will the insurance coverage start. High deductible plans require an important understanding of how one can leverage one’s health for financial gain. Obamacare limits the sale of these policies to those under 30 who may be in the best position to leverage their health. (Although I doubt many will fulfill the fiduciary obligation of an HDHP by saving thousands of dollars for a health crisis.) The unfettered sale of HDHPs would leave us with a problem we have today — the under-insured amassing great medical debt because the deductibles are way too high.
The writer gets very technical and is correct when she says that buying insurance cannot be more than 9 ½ percent of the insured employee’s income, and the calculation does not take into consideration the cost of insuring a family. The IRS has taken a very narrow legal interpretation of the statute as we move forward with implementation. No one could have predicted this narrow legal definition, least of all the authors of the law. Many groups are working very hard to change this.
The glitch is easily fixable by Congress but, sadly, a benefit for American families will most likely be used as a political cudgel as the writer has done in her guest opinion. I, for one, will be a strong advocate for American families, and work to have the entire family outlay for premiums be calculated in the percentage of income calculation. We can fix this.
Let us never forget that for-profit insurance companies serve shareholders not patients. If an insurance company can find a way not to pay your medical bills, it will. That’s how profits are made. Obamacare imposes much-needed consumer protections on the health insurance industry.
Theresa BrownGold, New Britain, is a documentary portrait painter who uses art to examine the impact of social issues on real people. She speaks about the health care law and her art project, Art As Social Inquiry, at conferences, churches, senior centers and other venues. www.artassocialinquiry.org