Republican Alternative To The ACA Lands With A Thud

After seven years of promising a “market based” alternative to the Affordable Care Act or Obamacare, the Republican Party finally delivered. However their plan is a disaster and would cause more problems that it would solve. When the American Hospital Association, the American Medical Association, AARP and the CEO of the Cleveland Clinic, Toby Cosgrove oppose this proposal; you have to realize that this is a real stinker of a bill. No matter how much they dress this up and spin it, no matter how much make up they put on this pig; it is still a pig and a very bad bill that should be soundly defeated.

Last month Corbin Luna wrote a column critical of my columns. In his column he states that the ACA only benefits a few people, yet hurts 99% of Americans. But there is no basis in fact for that statement. Contrary to his statement of only 1% of Americans benefitting from the ACA, the truth is that most Americans do benefit from the ACA. Let me illustrate.

For every American; the ACA mandates no cost preventative care. This means that preventative medical care is available to everyone with no deductible or co-payments. This includes an annual wellness exam for adults and annual well child exams for children. It also includes cancer screening tests such as mammograms and PAP tests for women as well as prostate cancer screening tests for men. It includes colorectal cancer screening tests such as stool tests and colonoscopies. It includes tests to discover heart disease. This could make a large difference in lowering the cost of health care as well as improving the health care of Americans since diseases detected in their early stages are easier and more successfully treated.

For those on Medicare; the ACA helps by gradually closing the prescription drug coverage gap or “donut hole”. This year for anyone who falls into the coverage gap, 60% of the cost of name brand drugs are covered and 49% of generic drug costs are covered. The coverage gap will gradually close until 2020 when it will close with 75% of all drug costs being covered in the “donut hole”. For people with serious illnesses who use a lot of prescription drugs, this could be a life saver.

As far as the expansion of Medicaid that is part of the ACA; this has been a life saver for many people. An example is a woman I met a few years ago in her early 50s. She was forced to leave her job (and health insurance) to care for a husband with terminal cancer and an elderly father. Thanks to the ACA she was able to qualify for Medicaid under the expansion due to the ACA. Because of that she was able to get a PAP test that revealed cancerous cells on her cervix. Without the no cost preventative care and Medicaid expansion, she would not have gotten that test and delayed seeing a doctor about it until there was severe bleeding indicating serious cancer

There are countless stories of others like her whose life and health were saved because of the passage of the ACA. In Ohio alone, more than 700,000 Ohio residents have been able to qualify for Medicaid because of the expansion under the ACA. That is 700,000 people who would be uninsured with most of them being students, part time workers and full time workers whose income just isn’t enough. Nationally it is estimated according to the Kaiser Family Foundation that as many as ten million people have qualified for Medicaid under the expansion as part of the ACA.

In addition to the Medicaid expansion, the health insurance exchanges have enrolled many more Americans. Thanks to premium subsidies that are paid directly to the health insurance companies, many more Americans now have health insurance where they would not be able to afford it previously. Again according to the Kaiser Family Foundation, more than 20 million Americans have enrolled in health insurance through the exchanges with 84% of those qualifying for a premium subsidy.

Yes, there are problems with the ACA that have been well documented. Not enough young and healthy people are enrolling and choosing to be uninsured. This is causing adverse selection and increasing premiums. However this is because the penalty for not getting covered is way too low so it is cheaper to pay the penalty than to get insured. The Republican alternative eliminates this penalty entirely. If anything, the penalty should be increased so it is more expensive to be uninsured by choice.

But the real problem is that here in the United States, we have never thought of health care as a basic right of citizenship. Instead we have treated health care as it is some commodity that could be bought and sold like a television set or car. But the first thing that I learned in a course in health economics is that health care does not operate under traditional economic rules and markets. Everyone is going to need or use health care at some time in their life. One can easily live without a television set, but no one can live without access to health care. It is long past the time for the United States to become like every other developed nation on earth and realize that health care should be a basic right of citizenship.

What is more important than the health of our citizens and the health of the nation? A healthy nation is a productive nation and a productive nation is a prosperous nation.

Lee Kamps

Lee has been working with Medicare, Medicaid and private health insurance since he began working at the Erie County Welfare Department in January 1973 where a major part of his job was determining eligibility for Medicaid. He went into the private insurance business in 1977 with Prudential Insurance Company and within a short time had become one of the company’s top sales agents. In 1982, he was promoted into management where he managed two field offices and as many as thirteen sales agents. After leaving Prudential in 1986, Lee decided to become more focused on health insurance and employee benefits. He has advised many local employers on how to have a more cost effective employee benefit program as well as conducted employee benefit meetings and enrollments for many area employers. The companies Lee has worked with ranged from small “mom and pop” businesses to local operations of large national companies. Lee received his B.S. degree from Kent State University where he has been active in the local alumni association. He has completed seven of the ten courses toward the Certified Employee Benefit Specialist designation. He has taught courses in employee benefits and insurance at Cleveland State University and local community colleges. In addition, Lee is an experienced and accomplished public speaker. He has been a member of Toastmasters International where he achieved the designation of “Able Toastmaster – Silver” in 1994. He has also served as a club president, Area Governor and District Public Relations Officer in Toastmasters as well as winning local speech contests. Lee has also been a member of the Greater Cleveland Growth Association’s Speaker’s Bureau where he was designated as one of the “official spokespeople for the Rock and Roll Hall of Fame” prior to the hall’s opening in 1995. He has given talks and presentations before many audiences including civic organizations, AARP chapters and many other community groups. With the implementation of the Medicare Modernization Act (Medicare drug bill) in 2006, Lee has shifted his focus to Medicare and helping Medicare beneficiaries navigate the often confusing array of choices and plans available. As an independent representative, Lee is not bound to any one specific company or plan, but he can offer a plan that suits an individual person’s needs and budget. In addition, Lee is well versed in the requirements and availability of various programs for assistance with Medicare part D as well as Medicaid. While he cannot make one eligible, he can assist in the process and steer one to where they may be able to receive assistance.

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Volume 9, Issue 4, Posted 10:17 PM, 04.02.2017