Archive for the ‘Health’ Category

Jon Stewart Discusses States Refusing Obamacare Medicaid Expansion

I recently wrote about how Obamacare (the Affordable Care Act) has a coverage gap in many states after a supreme court ruling striking down part of the law requiring states to expand Medicaid to cover everyone who earns an income below the poverty line, and recently discussed that my home state of Maine is one of the states refusing to expand Medicaid by virtue of Governor Lepage vetoing the bills passed to expand Medicaid. While I’m not happy to say this has not yet been fixed, I am happy to say Jon Stewart tackled this issue at the beginning of The Daily Show this past Thursday. The clips below show the issue explained as only he can.

Both of the above explain the issue in a brief, easily accessible manner. After that, feel free to read the posts I linked above if you have not yet seen them, or take a look online for more stories about this for a more in depth explanation of what is going on with this and how some of this country’s most needy are being left out in the cold on health insurance.

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Maine Has not Yet Passed Medicaid Expansion

I recently wrote about how Obamacare (the Affordable Care Act) has a coverage gap after a supreme court ruling striking down part of the law requiring states to expand Medicaid to cover everyone who earns an income below the poverty line. Maine, where I live, is one of the states that has not yet enacted a law to expand Medicaid to cover all of these people. Our legislature has passed a bill to do so, but Governor Lepage vetoed the bill. When the Maine House of Representatives voted to overrule his veto, they were two votes short of doing so.

That’s better than I hoped for, but obviously not good enough to get the law passed. I actually have health insurance through my employer, so this doesn’t impact me directly, but it does impact a number of people I know who simply don’t earn enough money to qualify for health insurance subsidies but earn too much to get on MaineCare (Maine’s Medicaid system) or don’t meet the conditions to get off the waiting list. These are people who either can’t get reliable work because it’s not available, or can’t work due to health issues they can’t get addressed because they have no insurance.

Yeah, that’s right, there is a group of people that can’t work because of health issues, can’t get health insurance and health care because they can’t work and so can’t afford it, and can’t get the state to step in and help them out because they still don’t qualify for MaineCare. This is one of the situations Obamacare was intended to prevent, and would have prevented had it been implemented in it’s entirety or if the current congress were willing to fix it. It could also be fixed in my state if Lepage didn’t veto the Medicaid expansion bill we passed.

I’ve not yet found a list online of who voted for and against the bill or to override Lepage’s veto. If I find such a list, I will link to it or post it to get that information out too. For now, I’d encourage anyone in Maine to get on the phone with their legislators to encourage them to pass this expansion the next time it comes up for a vote, and to contact the governor and let him know we want this bill passed and in force to allow citizens of our state better access to health insurance.

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Obamacare Has a Glaring Coverage Gap

The idea behind Obamacare is great: get everyone in the United States affordable health insurance. It could have been done better, such as with a single payer system, or even providing a public option, but what was put together was pretty good. There’s a problem though: if your family is below the poverty line, and your state doesn’t participate in Medicaid expansion, you get no subsidy for health insurance, and no Medicaid option if you didn’t already qualify for it. Basically, in this situation, you’re stuck paying full price for health insurance, and nothing changes for you.

Perversely, the people who are poorest and most in need of help from Obamacare will actually be no better off once it goes into effect in states that don’t participate in Medicaid expansion. When I originally voiced concerns about Obamacare, I had expected middle income people to get shafted, but it looks like middle incomes will actually come out more or less ok.

There’s a reason things turned out this way. When the Affordable Care Act was drafted, it was mandatory for all states to expand Medicaid to cover people who were below 138 percent of the poverty line. Subsidies to purchase insurance were then put in place to provide help to people at 100 percent to 400 percent of the poverty line on a sliding scale. Basically, this would have provided assistance to everyone, from those well below the poverty line to those earning a decent chunk of change above it.

Then the Supreme Court intervened. While they upheld most of the ACA, they struck down the portion of the bill that would have required states to expand Medicaid to cover all people below 138%  of the poverty line or lose all federal funding for Medicaid. Leaving the gap in coverage that the poorest of our country now fall into. While it would be sensible to just expand subsidies to them, this would require a new bill amending the law to do so. That seems unlikely to pass, nor is it even really being discussed. People need to be aware of this so it is discussed, and pressure can be put on Congress to fix this issue.

Related Articles on Other Sites:
Missouri’s Poorest Residents Won’t Benefit From Obamacare
Obamacare’s Forgotten Faces

Also, here’s a subsidy calculator you can play with if you want to see what you may qualify for in subsidies. I assume it’s relatively accurate, but can’t make any promises. When you’re done playing with the calculator, or better yet, before you pick it up, spread the word so people know this is happening.

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The Republicans Do Have Some Ideas on Health Care

Now, that’s not to say I’m at all happy with the congressional republicans right now. Too much bluster, voting no all the time, and refusing to budge on anything. And I don’t think most of their ideas will do the job either. Tort reform just isn’t going to do the trick, and cooperatives just wouldn’t be anywhere near as effective at lowering prices as the public option would be, because the cooperatives would have far less bargaining power as fewer people would be signed on to them.

However, they do have one idea, that’s really quite simple, that we should put into practice. Let people buy insurance across state lines, and force all the insurance companies in the country to compete with each other. Make them earn our business instead of being the only place to turn in a given area for coverage. As far as I’ve seen, it hasn’t been added to any reform efforts yet, and it really should be.

Now, I understand that this could cause some insurance companies to go under. While that isn’t great news, it would mostly be a result of having more companies than we need taking more money from the market of buyers than they can afford. And the health of our country comes before company survival. Of course, if too many companies fall out of business, then we’ll end up right back where we are now. I think this is unlikely to happen since there would be a much larger pool of people, so the presence of enough companies to foster competition could be supported.

That doesn’t mean we should do away with the public option though. I’m still a huge supporter of the public option, and I think it’s one of the most important parts of health care reform, along with eliminating clauses about pre-existing conditions and eliminating the ability of insurance companies to rescind coverage. The public option provides us with a non-profit option for health care, will help to keep the insurance companies honest, and can also be used to make sure a basic level of care is offered at a rate as affordable as possible. Besides which, the public option provides us with cover in case the remaining insurance companies after the dust settles decide they would like the idea of a rate hike.

But, when an idea is good, it’s good, and we ought to acknowledge that and think about how it might be incorporated into the larger policy package. Perhaps we’d hear more about it though, if the republicans would stop obstructing and start conversing.

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The Public Health Care Option and Mandate to Purchase Health Insurance

Two of the major reforms being proposed in the health care package being debated by congress are the addition of a non-profit public health insurance option (which is NOT single payer and is NOT socialized health care) and mandating that everyone purchase health insurance, with a fine levied on those who fail to do so. The mandate for purchasing health insurance needs to be tied to the public option, and if the public option isn’t passed, the mandate to purchase must not be passed either.

I understand why the mandate is seen as a good idea. There are many people who are uninsured who will have their bills footed indirectly by taxpayers and those who do purchase health insurance, and by requiring other people to purchase insurance, we’ll be spreading the cost around more and asking them to contribute to the pool of money that will likely end up helping them or their families at some point in their lives.

Here’s the problem though: many of the people who do not purchase health insurance can not afford it. They simply haven’t found a way to earn enough money to do so. Fining people money they don’t have is not the way to help them get insurance or get on their feet. While I understand there is a system of tax credits in the work, such a system does sometimes render people who need help to make such purchases ineligible for help. See the recent fiasco with food stamp benefits for an idea of what I mean. If this were to happen with health insurance, it could deal some families a financial blow they can’t deal with. The public option would be another layer of protection to prevent this from happening with a mandate to purchase in place.

I know there are also talks of having insurance co-ops instead of having a public option. I don’t think co-ops can replace having a public option when it comes to providing affordable insurance to the largest number of people possible. I think they would be a great supplement to the public option and give people more choices in their plans to pick one that best suits their needs, but a non-profit will likely be most able to offer the most inexpensive insurance, which is what some people need.

I’ll be honest, on their own, I think the public option is a good idea, and the mandate to purchase is a bad idea. As a package though, having the public option and the mandate together is still quite good, and I’d be very happy with a bill that did include both. I just don’t want to see a mandate to purchase health insurance pass, then see families who can’t afford health insurance fined because the assistance system put in place to help them overlooked them.

As a final note, I’m no expert on health care, I’ve just been reading a lot about it lately. So, this is true to the best of my knowledge, but there is a lot of information and misinformation going around, and it really is difficult to pick the good out from the bad right now. I’ve also mentioned my biases about the two major topics, so you know where I’m coming from on this. In addition, the bill is still being hotly debated, is constantly changing, and different ideas seem to be going on and off the table all the time, so it’s hard to keep up with all the developments. I’ve tried to be accurate in my representation of what is being talked about, but I know that I may be missing some pieces, so feel free to add your own voice in the comments if need be.

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Another Reason We Need Better Health Care In the U.S.

Ah, health care. Something we all need at some point in time, yet many can’t afford for one reason or another. It’s expensive after all. There are lots of reasons people like to list in saying we need either universal health care or less expensive health care. A lot of these arguments talk about how health care is a right, no one should be turned away simply because they can’t afford it, and similar ideas. I agree with these thoughts, but you’ve heard them, and many others, argued about quite often by now I’m sure.

I want to talk about another reason we need better health care, one that might even get through to those who have oodles of money and don’t want to “subsidize everyone else’s health care.” Because this reason effects them too.

Remember the outbreak of swine flu we had recently? Remember how it wasn’t a big deal, but many people seemed to think it would be? Well, what happens when we have a real epidemic?

Under our current system, those who can afford it get preventative treatment, whether it be a shot, some kind of medication, or some other way to prevent the disease. Those who can’t afford it will go to the emergency room after they get sick. Guess what happens then? The disease spreads like wildfire, because it has plenty of carriers who simply couldn’t afford preventative treatments. And then it’s more likely to infect those who could afford preventative treatments, because said treatments aren’t usually 100% effective, especially when they’re new treatments, or general treatments for a variety of illnesses. Which means, by letting the poor get sick, the rich are also more likely to be sick, because more carriers of disease means that there are more chances for everyone to get infected.

Now, if we had universal or inexpensive health care, we’d see something different. Yes, some people would still get sick. But, with everyone getting preventative medicine, fewer people would get sick, which will leave fewer chances for the disease to spread. This is good for everyone, not just the people who have health care who otherwise wouldn’t.

Basically, the point I’m trying to make is that no matter who you are, it is in your best interest that everyone have access to affordable health care. Because really, your health will be affected by the health of everyone around you, and the people they’re around as well. So, even if you don’t believe health care is a human right, at least bear in mind that by denying a segment of the population health care, you’re putting yourself at greater risk too.

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