THE VIEW FROM HERE-That important date is coming up! What should we do? What choices should we make? How do I know what will benefit me (and my family)? What if I make a mistake? Yes, October 1, 2013, that very important date, is just around the corner!
There seems to be a lot of confusion throughout the country with regard to what this law entails and how it affects each and every one of us. My purpose through this article is to dispel many of the fabrications, misconceptions, and misrepresentations that have been advanced over time and to explain, instead, how we shall all benefit from its provisions.
To start out somewhat before the beginning, I believe (as many do) that the healthcare bill should have been introduced as Medicare for all—but that was not to be. Despite people from the right accusing this president of being a socialist, everyone seems to love their Social Security and the Medicare coverage for the elderly that goes with it. Medicare for all would essentially be the same thing as universal health care but would not have carried the baggage that the title “Obamacare” does. Perhaps someday.
The Patient Protection and Affordable Care Act, signed March 2010 (ACA)—otherwise known as Obamacare (because Obama cares!)--was designed with a slow roll-out. Interestingly enough, our Congressmember will no longer have their own special health policies but will have to apply for the ACA coverage just as the rest of us will have to do.
Already patients cannot be declined by insurance companies for pre-existing illnesses. Said companies cannot place a cap on the amount of coverage a patient may need (particularly when a catastrophic illness or injury is involved). Children, up to the 26th birthday, can be carried on their parents’ policies if these young people, still attending or just emerging from school, are without coverage of their own.
To help illustrate just how traumatic and harrowing a lack of medical coverage can be, I shall never forget the story of a child who had a tooth ache. His mother took him to the dentist but had no insurance. The boy was not treated. A major infection soon ensued. He was hospitalized (at a major cost to the taxpayers) and later died because treatment came too late! Had he been treated immediately, he would still be alive and the cost would have been minimal. Do we want to live in a society in which such nightmarish stories are allowed to occur?!
Years ago, before the final form of this Act was signed into law, there was significant discussion around the public option. Regrettably, that option is not to be—for now. This was to be a government insurance program that would have competed with current health insurance companies. The Public Option would have had two ways to go: It would have shared Medicare’s pricing power, thereby saving enormous sums of money, or an option by which there would be a government-run health insurer would have saved less money.
Before our present health care law was enacted, insurance companies were not competitive with each other, thus premiums could remain high and even rise based upon profitability standards (lacking pricing controls); the benefits were fewer; the administrative operations were inefficient. According to Ezra Klein on March 22, 2013, the Congressional Budget Office (CBO) stated that the Public Option would have saved the taxpayers $100 billion over a 10-year period. Lamentably however, Congress, in its inimitable way, could not agree upon a more reasonable plan.
What is in the present law, however, is far and above what we had before. It took some 60 years since the creation of Medicare for a reluctant, recalcitrant, and oppositional Congress to pass into law the current mandated health care provisions. New rubrics will cover the uninsured--those who previously could not qualify under the old rules and/or could not afford the premiums. It is not a perfect law. Many presidents have tried and failed to get such a law enacted, but only President Obama, undaunted by resistance from both sides of the aisle, was able to see it through to fruition.
In California, always a leader for the rest of the country, Sheila Kuehl (now running to succeed Supervisor Zev Yaroslavsky for a seat on the LA Board of Supervisors) worked tirelessly both in the State Assembly and then in the State Senate to pass a law to mandate a universal health care law for all Californians. SB 840 (the California Universal Health Care Act) passed both houses in 2006 and 2008 but was vetoed by then Governor Arnold Schwarzenegger.
It was written to initiate a single-payer plan which would have drastically reduced premiums and costs and dramatically increased benefits because of the large pool of insurees it would have created. Many of her ideas are found in today’s Affordable Health Care Plan.
Because so many people are confused or have been given misinformation, it is important to debunk the myths, the distortions, the untruths and to explain the actual facts around this issue:
1. There will be no death panels—an idea that was introduced by the Right to scare people from accepting what is truly in their best interests. The Right balanced the bottom line against the health and longevity of the citizen populace.
2. Premium costs have already been reduced in states where some form of this new program has been introduced and is projected to do so in the remaining states. Overall, the costs will be lower for the insured.
3. With more money in the pockets of the insured (based upon lower premiums), there will be more money to spend, more money to stimulate the economy, greater purchasing power, more manufacturing to keep up with that increased demand--something which will lead to growth and expansion of existing companies and creation of new ones.
For those who complain that they should be allowed to purchase insurance across state lines, the problem is that if one can purchase such a policy elsewhere, the cost may be less but so might the benefits. Different states have different regulations, so that what one might purchase in a Southern “cheaper” state like Alabama may not rise to the higher standards in a state like California. The insurance pools in respective states will be affected so the economies in those states can rise or fall due to how many insured are gained or lost for those pools.
Another concern is the effect on small businesses. There are tax credits in place to help small businesses defray some of their insurance costs, and companies like Trader Joe’s can opt to have their part-time workers covered under the exchange program instead of its own. In my humble opinion (and I don’t mean to sound insensitive), if a business opens without enough capital to sustain itself (for a period of many months or even years) and, at the same time, chooses not pay its employees a decent living wage with reasonable benefits, that company is just not ready to do business! Consider the fast-food workers who have been demonstrating across the country for better pay!
It is said that larger companies like Walmart can pay their employees a wage of about $12.50 an hour ( instead of $8 and change) and pass on the cost to the customer at an average cost of only $48 per year. Walmart is notorious for putting its employees on the Federal dole, making taxpayers cover their employee health care needs.
On the other hand, companies like Starbucks, under the guidance of Howard Schultz, are taking a leadership role. Schultz is promoting the ACA not only for Starbucks but is encouraging other companies to join the program as well. He recognizes that through partnership in this health plan, there can be both a bottom-line fiduciary benefit for his shareholders and an overall social and economic justice application. A healthier workforce, working under fair conditions, is a happier one and a more productive one. Thus, when a company pays its workers a living wage with basic health benefits, we all gain.
Not to sound too preachy, but Biblical sources do support this point: To paraphrase, What good will it be if humans gain the whole world, yet forfeit their own souls? Thus a person who concentrates only on self will lose the essence of life. It is a simple fact that transformative policies support social, economic, and health care parity—something for which the American Creed has long stood.
4. And what about those who simply don’t want to buy any insurance (think of the myopic young people who believe they will never need it because they will never get sick). And the unintended consequence of not buying insurance? If we do not have large enough insurance pools, our premium costs could very well increase.
Before making such a counter-productive choice, they should consider the real costs to them: There will be a penalty fee for non-compliance of $95 per year which will rise to $695 per year before the end of the decade. That is just the fee! Should they become seriously ill or suffer from a catastrophic (or even minor) accident, they would have to foot the cost of the entire bill!
There are provisions, however, for the low income persons who simply cannot afford any fee. They and others with exceptional circumstance will still qualify for coverage under the new income limits for Medicaid, despite their inability to pay.
5. The undocumented can become part of this program through a documented spouse or can continue to use the public health care clinics throughout the county.
6. If you already have health care coverage that you like, you may keep it without filling out any further paperwork. You still, though, have the opportunity to “shop and compare.” Additionally, there is portability regarding your present coverage. If you change jobs, you may carry the coverage with you from the last company’s coverage.
7. Regarding prescription drug coverage, the “donut hole” will continue to narrow through 2017, thus continuing to make prescription drugs more affordable.
8. People presently under Medicare and Medicaid will not lose their present coverage.
Indeed, Uncle Sam needs you (to join the Affordable Health Plan), and Obama cares that you do!
Once again, that important date is coming up: Open registration begins on October 1, 2013, and draws to a close on March 31, 2014. Should applicants not sign up by then, they will have to wait until the following enrollment period (and, in the meantime, go uninsured).
Incidentally, I want to praise Cong. Tony Cárdenas (CD 29) for holding a very informative Health Care Forum last Saturday at Panorama City High School. For more information, please contact his office at 818-504-0090 (district) or 202-225-6131 (Washington, D. C.) or contact your own Congress member.
Below is information you will need to know to help you make the critical decisions for you (and your family) regarding this program:
Between now and the deadline, there are various websites, such as healthcare.gov, [[hotlink]] from which you can get assistance in getting questions answered. There are videos to view to take you through the procedures. Family Planning National Training Centers have been placed across the country for free tutorials and guidance to get applicants through the application process.
Covered California is the state’s exchange program which can be seen online at coveredcalifornia.com. There, you will find comparison charts from which you can select the insurer (from a list of 12) which offers the package (benefits and premium costs) that will best serve your needs. The Los Angeles County Department of Health Services (DHS) at ladhs.org is another good source for information.
(Rosemary Jenkins is a Democratic activist and chair of the Northeast Valley Green Coalition. She also writes for CityWatch.)
-cw
CityWatch
Vol 11 Issue 76
Pub: Sept 20, 2013