Friday, May 16, 2014

Obamacare... again

As I understood it, the Republicans were afraid that once Obamacare really got going, there would be no turning back.  Well, it has taken hold.  Clearly there have been problems and there are some folk, a small percentage in my understanding, who were truly impacted in a negative way by the program.  One might even argue that it was not the best solution for the problems or that some of the biggest problems in our healthcare system were not even addressed as directly as they could have been. 

Still, the ACA accomplished a number of things that I believe we as a nation needed to accomplish.  It removed pre-existing conditions as a barrier to getting health insurance.  It expanded the pool on which rates are based to include the entire community rather than a small slice or individual family.  It removed the lifetime cap that insurance would be responsible to cover.  It made insurance available and affordable to everyone (except in those states which have refused to expand Medicaid and continue to exclude the poorest folk from health insurance) and procvided health insurance to millions who did not have it before.  And it standardized what an insurance policy must cover.

My family were serious beneficiaries of the ACA.  For a whole variety of reasons my medical insurance, which was paid by my church, was insanely expensive.  It was one of the largest line items in the church budget and was getting to the point that it was becoming unaffordable.  A pre-existing condition made it impossible to get any other coverage at any price.  Under the ACA, the church was  able to get another policy with roughly the same coverage and save some $15K a year.  My 25 year old son, working at a just above minimum wage job,  had not had insurance for 4 years.  He has it again.  My daughter, son-in-law, and grandson were on an absolutely unaffordable COBRA plan after Christian lost his job, 2 months before the baby was expected.  They couldn't get any other plan because of a pre-existing condition - pregnancy.  To make things even more complicated, the company he had worked for changed their insurance 1 month before he lost his job.  Simply put, the ACA saved their butts and things would have been even better had it been available 6 months earlier.  I can tell multiple other stories of church members, friends, and acquaintances who were saved by the ACA.  I can also tell stories of folk who suffered significantly and some who even died because of lack of insurance. 

Of course there are the two big complaints... that everyone must purchase insurance and that some folk are having to purchase insurance for things they either will not use or even have some moral objection to using.  The entire system falls apart without those two criteria though... so it becomes a choice between the keeping the positives or disposing of the negatives.  As a country, I cannot see how we can morally even consider the latter.  Indeed, that will kill people.  I guess there are a small number of folk who actually do believe that poor people do not deserve health insurance and that the current system of going to the emergency room when things are dire is enough for them.  I don't think that viewpoint is even worth discussing it is so immoral.

Here's the surprise.  Over the past few weeks I've seen advertisements for two local politicians running for the House and promising to work to repeal Obamacare.  Invariably, they always back-pedal when asked and say they only want to repeal the mandate and the government requirements for what an insurance policy will cover... but given the current system, that literally cannot work.  Those two features cannot be removed without causing the rest to be unworkable. What they are really saying is that the poor need to be kicked off Medicaid, those with pre-existing conditions are on their own, and that any company can decide what it will or will not pay for via insurance for any reason they want and that if that happens to be the way you get your health insurance... too bad for you.  And we cannot forget that in '09 a study showed that 45,000 people died annually in the US due to lack of insurance.  I cannot imagine how anyone can think that is a good idea to repeal the ACA and I cannot imagine how anyone with a conscience would ever vote for a representative with that as a significant part of their agenda.

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