Friday, January 20, 2017

Silent no longer: When politics gets personal

I’m one of the 18 million Americans*** who will lose health insurance coverage if the Affordable Care Act, AKA ObamaCare, is repealed, or “repealed and replaced” with one of the half-mentioned ideas, such as HSA’s or vouchers.

Why is that?

First, I’m in the (estimated) 27% who are impacted by the pre-existing conditions clause.  That means that nothing related to any of 3 conditions would be covered by an insurance plan that I could buy. One of those conditions is treated with birth control hormones, which would also not be covered if the ACA is repealed, meaning I would be out of pocket every three weeks for medication, on top of paying for an insurance policy that refused to cover such medication or alternative surgical treatment. (I've lived this once already; going backward is NOT an option I want to live with). Further, this means that if I have a related health issue or need other surgery the insurance company could refuse to cover it, arguing that it falls within that pre-existing condition. You might say, no, they wouldn’t – but I have been there. Literally arguing with Blue Cross Blue Shield THE AFTERNOON AFTER MORNING SURGERY about covering a procedure they previously approved, that had NOTHING to do with the (non-covered) pre-existing condition because they felt like they could relate the 2 and not have to pay for anything.

Second, I work for a small business which is not obligated to cover its employees. Luckily, they are decent people who DO reimburse my premiums – for now. But, if I have to go insurance shopping for an individual policy in a skyrocketing market --- they will not be able to afford it, nor would I ask them to. {See also:  Premium increases actually decreased under the ACA. https://t.co/g3OzhILSXt }

So where does that leave me? Without insurance, seeking lesser employment strictly to have corporate coverage, or??? Even if I can ‘buy’ coverage, that coverage is no good to me if it doesn’t cover basic care, preventative tests, and pre-existing conditions. {The true problem is really simple, but it’s not sexy enough for talk radio to care about – the pharmaceutical companies and insurance lobbies are getting rich, while real people suffer. All you have to do is compare drug prices in the U.S. with other ‘civilized’ nations; compare the cost of routine procedures in the U.S. with the cost in other countries. The problem is NOT the ACA; it’s a systemic problem with our “healthcare system” that ACA was meant to fix. Not to mention that ACA could have gone further, had Congress worked in a bipartisan manner and put country before party, but that is a different discussion.}

The 24 year old in my office will likewise be affected. Because of ACA, she is still on her stepfather’s insurance. This is a huge benefit to a kid in her first ‘real’ job, who is paying back student loans and also who is newly engaged. She can focus on building her adult life instead of worrying about “what if”. If the ACA goes away, she will likewise have to shop for an individual policy (which also won’t cover things such as birth control), and, for example, face a 1 year wait until pregnancy is covered. Think about how that, in and of itself, will affect young women across the country. 

My newly-retired mother, who has pre-existing conditions of her own, will be affected. Did you know that ACA prohibits insurance companies from charging folks over 60 more, simply because of their age? My youngest brother, who works full-time hours, is insured through the marketplace because his company lists him as ‘part time’ so as not to give him corporate benefits (apparently reserved for management only). Chances are you, someone in your family, and someone in your circle of friends have all benefited from pieces of ACA.

I’ve seen the arguments – “get a job” seems to be a popular one, which only illustrates the blind hatred without comprehension. With small businesses making up even more of local economies than ever before, millions of Americans work for small companies or are self-employed and buy individual health insurance policies. Some, like me, don’t receive subsidies to help pay for our policies (Although I learned a month ago that because premiums increase, I may now fall into the range to qualify – how is that for a forward-thinking law? When costs increase and salary doesn’t, you might actually get some help!?!) I’ve been employed full-time since graduating from college, most of that time working at least one part-time job, besides. In only one of those jobs was I on corporate health insurance. The rest – either no insurance at all, or I bought and paid for COBRA or individual insurance on my own. The difference between pre-ACA and now is like comparing night and day. I’ve lived it. Please educate yourself until you truly understand what it is you’re in favor of taking away from your fellow middle-class, working Americans and their families.

What about the expansion of Medicaid programs that have helped fund local health clinics for the under-served and expanded coverage to almost every child whose parent fills out the appropriate paperwork? That happened because of ACA. Local healthcare infrastructure companies grew under ACA; what about those jobs? Early estimates state that 59,000 jobs in Tennessee alone will be lost by 2019 if ACA is repealed. Take that number and imagine the ripple affect across the country. Some states (primarily in the south), still have thousands in a “gap” without coverage – because they refused federal money. Again, this is not the fault of ACA; this is party before country; party before its people – despite what those doing it want you to believe. If ACA AND Medicare and Medicaid are all gutted, there will be millions and millions of people who literally die because they can't afford basic care.

Finally – what about people who are truly sick? I can live with my conditions, albeit lose a few days of work here and there, possibly need additional surgery I'll have to figure out a way to pay for out of pocket, and pray a lot that I don't develop a cancer that insurance will claim is due to one of these conditions they won't cover. 

What happens to the diabetic who has to choose between medication and food or rent because his insurance (if he can get it) is now not required to cover his pre-existing disease? What happens to the parents of the severely disabled child who hits a lifetime insurance limit while he is only 2 years old? What happens to the millions who have high blood pressure when the insurance companies triple premiums to anyone on HBP medications?

You can argue that health insurance doesn’t really matter: reality is, studies show and I have seen with my own eyes, those who are insured receive more thorough, better care – and go for wellness visits where potentially devastating conditions are caught earlier – than those who are uninsured. 

Which America do you want to live and raise your family in?


*** If ACA destroyed without replacement, here is what the Congressional Budget Office says will happen:
"In brief, CBO and JCT estimate that enacting that legislation would affect insurance coverage and premiums primarily in these ways:  The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026.
Premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by 20 percent to 25 percent—relative to projections under current law—in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026.” https://www.cbo.gov/publication/52371

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