Saturday, October 13, 2018

The GOP is swinging wrecking ball at affordable health care insurance and coverage of pre-existing conditions

A version of this was published in the Sky Hi Daily News October 15-16, 2018

 If Donald Trump has failed to make good on at least one of his campaign promises, "cheaper and better health insurance for all" is the one.  In fact, his party and his administration are hell-bent to make health insurance cost more and even become out of reach for families on a budget.  Worse, some of their actions, if successful, would end all affordable coverage including treatment of pre-existing conditions.  The GOP has tried before to either subvert the Affordable Care Act (ACA) or completely destroy it. Now they have some new stealth tactics and they just might succeed.

 The part of their scheme already implemented is to let the healthy go scot-free without insurance and soak those who need it.  The Trump administration did this to placate the better-heeled who made too much money to qualify for subsidies and did not want all of the bells and whistles and those who felt confident they would never get sick and were never hurt in an accident.  With an executive order, the  Trump administration removed the requirement that all must have health care coverage whether they were healthy or not or pay a penalty. Trump reduced the penalty to $0. Most insurance plans covering casualties mix those they think will not ever use their coverage with those who think or know they will. This varied pool spreads the risk around and keeps premiums to all lowered. This order makes the pool left with more of the sick in it who file expensive claims, raising premium costs or deductibles for everyone.

Another GOP backed action would kick budget-conscious families where it really hurts. It would jeopardize affordable coverage of pre-existing conditions as it takes down the entire the ACA (Obamacare) with it,  premium subsidies, Medicaid expansion and all,  leaving 17 million unable to afford health insurance.  They are doing this through a lawsuit in the courts to try to declare the entire ACA unconstitutional.  The Trump administration has announced it will not defend the ACA   against a GOP initiated Texas court case that seeks to declare the entire  ACA unconstitutional.  Twenty GOP state attorney generals have joined in the suit. That case could make it to the Supreme Court, now firmly dominated by  GOP conservatives.

The Colorado Attorney General race on the ballot Nov. 6 has no incumbent, but the Democrat, Phil Weiser, is committed to defending the ACA. His GOP opponent, George Brauchler, is vague, leaving the ACA up to Congress.

Particularly angering voters is the GOP engineering the loss of pre-existing conditions coverage. 27% of Americans between 18 and 64 have pre-existing conditions.  Under the ACA provisions, those with pre-existing conditions do not pay more than those who do not have them. Pre-existing conditions range from cancer and heart problems to high blood pressure to pregnancy.

Both GOP legislators and Donald Trump pay lip service to retain coverage of pre-existing coverage. The Trump administration argues that only the portion of health care pertaining to pre-existing conditions would be removed by the Texas court case.  Some  GOP members of Congress propose to  "save" coverage of the pre-existing conditions part of the ACA if it is destroyed and the rest of the ACA is left standing by the Courts. That bill is a deceptive and useless ploy.  Not only does their bill not tell at what price you will be charged for coverage, but it also does not require insurers to cover treatment.  it would still permit higher premium costs for factors such as age, sex and where you live.

What if the Supreme Court agrees in total with the unconstitutionality of the entire ACA? Seventeen million consumers will return to the olden days before the Affordable Care Act with nothing to replace it.I had been an executive with a consumer credit counseling agency then helping people get out of debt. The most frequent cause of bankruptcy and dire financial problems were medical bills.  Family finances were being destroyed by the high cost of health insurance. Their choice was to go without insurance or risk no one in their family would get sick,  relying on emergency room and charity and nothing left for cancer screenings or annual checkups or prescriptions. Many gambled and lost, destroying their family finances. I recall constant fundraising in Grand County to cover medical bills of such and such a person who desperately needed help to fend off life-threatening illnesses.   That is not a time you would ever want to revisit.

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