Editorial: Health Insurance Companies Shouldn’t Have the Power to Destroy Lives

Last year, I decided to leave my soul-killing corporate job that I had been staying in solely for the health insurance benefits, to go out on my own as a consultant. I wasn’t downsized or let go. It was fully my choice to leave.

Some of my colleagues called me “brave.” Why? Not because I was leaving a “permanent” salary to go out on my own to a more precarious situation, although that is definitely something to be concerned about. It was all about the health insurance. I was electing to give up a job where my very good (and very expensive) health insurance was generously subsidized by my employer. Yes, some of my colleagues called me “brave,” but I’ll admit that at least one or two others called me “insane.”

I decided to take the COBRA option, at least through the end of the year, while I shopped around for an alternative. At $1600 a month, COBRA was a drain on my finances, but since I have a daughter with a chronic illness, maintaining good health care coverage is important to me.
I have to acknowledge now that maybe my co-workers weren’t entirely wrong about my “bravery,” although it may have been naivete disguised as bravery. I thought I’d have no trouble finding a good and affordable insurance plan on my state’s Health Connector, one of the statewide insurance clearinghouses set up under Obama’s Affordable Care Act (ACA, or “Obamacare”). Several years ago, I had been able to purchase a nice plan this way when I needed to.
I found, though, that the previous variety of plans and providers was no longer available on the Health Connector. Those that were left were pricey, had high deductibles, and, unless I was willing to pay the amount I had been paying under COBRA, had numerous restrictions.
I ended up purchasing a plan that I’m not entirely happy with, because the premium was the maximum I could comfortably afford each month.
This experience was an acute reminder that in the United States, the reason many people stay in unsatisfying, toxic, or underpaying jobs is that it’s the only way they have access to health insurance. And not all insurance plans are equal in the coverage they provide, the restrictions they have, or the portion of the premium that employees must pay. Even for those who have employer-subsidized health insurance, many will still be at risk of losing everything, should they or a family member have a serious, long, or expensive illness.
We’re told that hospitals will often “work with you” to pay medical bills. Several years ago, I worked in a hospital financial services office. Our patients had to prove that they were practically destitute and had exhausted all other resources before we would “work with them.” Many impoverished people, not to mention those who aren’t destitute but who are still struggling, fall through the cracks.
No one should have to exhaust all of their resources for the sake of their healthcare. No one’s life should be turned upside-down because of healthcare expenses.
It’s no wonder that in a recent Gallup poll (along with numerous other polls), healthcare was the top issue for voters, with 35 percent saying it was extremely important, and 81 percent saying it was “extremely to very important.”
Whether one has insurance through an employer, through a state Health Connector, or through a broker, the cost of treatment and medications (and often, the premium itself) is prohibitive. For those without access to affordable insurance, the cost is impossible. More and more Americans are coming to realize that there but for the grace of God or their employer, go they.
Despite the dearth of great health care options on my state’s Health Connector, I am a staunch supporter of the ACA. For all insurance consumers, not just those using “Obamacare,” it has given us benefits that we have now come to take for granted. It requires that annual checkups be fully covered; prevents insurers from denying us coverage if we have a pre-existing condition (which is important for my family — most families, if we’re honest); provides for a number of previously not well-covered services including those for addiction and mental health care; and requires health insurers to cover prenatal care, among many other benefits that previously, insurers could wiggle out of covering.
Our current president wants to take all of that away. Not because he wants to replace it with a plan that will better serve Americans. Certainly not because he wants more Americans to have access to decent healthcare. He wants to take it away simply because the ACA was Obama’s idea (and was shepherded by Trump’s current rival, Joe Biden). Trump wants to obliterate all things Obama — and we know how Trump feels about Joe Biden, as well.
There is much about the ACA that needs improvement. But it is an important first set of steps toward creating a healthcare system that works for the majority of people, and that could eventually work for all of us. Its guidelines are the best we’ve ever had as far as patient protections, and it’s the best we could hope to have under Donald Trump.
Our health is important, and our healthcare is important. Access to healthcare, however, should not be the force that drives so many of the other major decisions we make about our lives — where we work, how long we stay in an unbearable work situation, how many jobs we have to work, whether we can afford to go to the doctor, and, for many, which other bills to hold off paying in order to pay a medical bill, or even whether to declare bankruptcy.
As more people have experienced or witnessed firsthand what it’s like to have to make life-impacting sacrifices solely for the sake of their healthcare coverage (or because of non-coverage), more and more Americans are coming together on the position that healthcare is a right, not a privilege.
As of Thursday, March 5, the Democratic race for the presidential nominee has been whittled down to two men and one woman. Voters will place their faith in one of these candidates to heal the condition of healthcare in the U.S. Each has a different approach, but Democrat voters have high hopes that one of them will free us from the power that the private health insurance industry has to destroy our lives.

Sanders: The current healthcare system is ‘pathetic’ | CNN [2020-03-02]

Wall Street Focuses on Health Care in Election | Bloomberg Politics

Texas v. Azar: The End of the Affordable Care Act?

The attempts by Trump and his ilk to dismantle the Affordable Care Act (ACA, or “Obamacare”) continue, even as they are overshadowed by Congress’ impeachment inquiry. The next imminent threat to the Affordable Care Act may occur at some point in October, as judges in the 5th Circuit Court of Appeals rule on the Texas v. Azar lawsuit, argued in July.

Destroying the ACA was a hallmark and battle cry of Donald Trump’s 2016 campaign. On the day of Trump’s swearing in, he immediately signed an executive order “to waive, defer, grant exemptions from, or delay” portions of the Affordable Care Act. 

On December 15, 2018, a Texas federal district court judge found that the 2017 Tax Cuts and Jobs Act (TCJA), which nullified the tax penalties associated with the individual mandate portion of the ACA, rendered the individual mandate unconstitutional. Consequently, since the individual mandate is an “essential” part of the ACA, the entire ACA was unconstitutional, the judge ruled.

The state of Texas, along with the other plaintiffs, argued that with the tax penalty removed, the zero dollar fine now outlined in the ACA is a “naked, penalty-free command to buy insurance,” explains Nicholas Bagley, professor of law at the University of Michigan.

“…Congress doesn’t have the power to adopt a freestanding mandate,” he says. “It just has the power to impose a tax.”

Therefore, plaintiffs argued, “The naked mandate that remains in the Affordable Care Act must be unconstitutional.”

The fact that only two of the three judges in the case (both Republican-appointed) asked any questions when hearing the case in July is thought to bode poorly for the future of the Affordable Care Act. 

“I think we should be prepared for the worst — the invalidation of all or a significant part of the Affordable Care Act,” says Bagley.

If this is true, it doesn’t mean that the ACA will be immediately invalid. It is still the law. 

However, says Sabrina Corlette, director of the Center on Health Insurance Reforms at Georgetown University, “If that decision comes out before or during open enrollment (November 1 through December 15), it could lead to a lot of consumer confusion about the security of their coverage and may actually discourage people from enrolling, which I think would be a bad thing.”

The case will almost certainly go to the Supreme Court if the 5th Circuit Court declares the Affordable Care Act invalid, however. 

Here are some  other ways the Trump administration has hacked away at the Affordable Care Act:

  • Ending cost-sharing reduction subsidies to insurersThese federal payments to insurers were meant to motivate insurers to participate in the ACA insurance exchanges, and help keep premiums down. The Trump administration abruptly stopped paying these in 2017. 
  • Allowing states to add “work requirements” to Medicaid. The ACA expanded Medicaid so that more individuals and families were eligible. Under Trump’s new rules, states may choose to require potential Medicaid beneficiaries to provide documentation that they either go to school or work, in order to receive benefits.
  • Expanding access to short-term “skinny plans.” Under the ACA, these low-cost, low-coverage plans were meant only as a “bridge” for those between jobs or in school. These plans don’t tend to cover ACA-mandated items such as pre-existing conditions or “essential health benefits.” What’s more, their extremely high deductibles could place their holders in financial difficulty should they become seriously ill.
  • Reducing funds to facilitate signup for healthcare.gov insurance plans. Under the ACA, Navigator programs and a marketing budget were created to help people figure out how to sign up for health insurance on the exchanges. Trump’s reductions in funding for these services is a passive way to make it more difficult for disadvantaged people to sign up for ACA plans.

Experts have warned that dismantling the Affordable Care Act will cause great damage throughout the U.S. health care system. It is the Affordable Care Act, for example, that protects people with pre-existing conditions from being uninsurable, and mandates that “essential health benefits” such as a basic check-up, maternity care, and prescription drugs, are covered. 

“The Affordable Care Act is now part of the plumbing of our nation’s health care system,” says Bagley. “Ripping it out would cause untold damage and would create a whole lot of uncertainty.”

Could Texas v. Azar End the ACA? — Christopher Holt | American Action Forum (AAF) [2019-05-20]

Chairman Scott: Texas v. Azar Decision is “Frivolous” | House Committee on Education and Labor [2019-01-09]