Monday, July 31, 2017
Oliver really wanted to talk with me. I hadn’t heard from him since he took a job at a major law firm about ten years ago. But NOW he wanted to talk. I checked my email late Wednesday evening. There were two emails, a Linked In message, a friend request on Facebook, and a message left on the office phone. I scheduled a phone appointment for 9 o’clock Thursday morning.
Oliver (name changed) wants to open his own office. We discussed where he would set up shop and the areas of law he would practice. I guessed that he was targeting the first of the year and wondered about the urgency to connect. And that is when he asked to purchase coverage for August 1st.
Now? Oliver had decided to quit his job right now while he could still purchase a health insurance policy under the Patient Protection and Affordable Care Act (Obamacare). The Senate was debating repeal and seemed unconcerned about people like him, people with preexisting conditions. We had a heck of a time getting him insurance last time. Oliver didn’t want to take a chance.
The Better Care Reconciliation Act of 2017 (BCRA) was released on June 22nd. I printed it, read it, and had an analysis posted by the next day. I’ve also printed and read Senator McConnell’s subsequent attempts. There is a good chance that I have dedicated more time and paper to these half-baked plans than most of his fellow senators. The question was never whether any of this could become law, but which senators would be forced to stop this charade. In the end it was Senators Lisa Murkowski (R-AK), John McCain (R-AZ), and Susan Collins (R-ME). One has to wonder if our Republican senator would have voted NO if the bill was actually going to pass.
But Oliver and millions of Americans just like him didn’t know what the Senate was going to do. Will this game of chicken continue until someone forgets to blink? Will President Trump goad the Senate into another vote, and another, until someone screws up? Will Trump further destabilize the health insurance market? Will there be health insurance coverage available?
It is way too early for Oliver to quit his job. He’s not ready. We reviewed the steps necessary to successfully create a business. I assured him that we will find him health insurance coverage the day he actually needs it.
We focus so much on the big picture. We know that this debate is about nearly 20% of our economy. We know that we are talking about the way Americans access health care. But we too often forget that there are real people impacted by these political decisions. Oliver. Your friends. Your parents. Maybe even you. It is time for Washington to see us.
Friday, July 21, 2017
Today’s Health Insurance Issues With Dave is a short quiz. Grading is Pass/Fail.
You find that you are going the wrong way on Gates Mills Boulevard. Do you
A. Turn around in the first available driveway
B. Turn at the first intersection or median cut-through
C. Push the Detonate button and blow-up your car
D. A or B whichever comes first
If you chose A, B, or D, please forward your copy of this quiz to your Congressional representative. The subject line should be Healthcare. If you chose C, you may already work in Washington.
Monday, July 10, 2017
Need a surgeon? Would you consult Dr, Jack the Ripper? Would you hire Godzilla for your next construction project? And yet, we have entrusted our healthcare system to Paul Ryan, Mitch McConnell, and Donald Trump. What could go wrong?
The U.S. Senate is about to return from their latest vacation. The push is on. Senate Majority Leader Mitch McConnell is determined to get his legislation, the Better Care Reconciliation Act of 2017 (BCRA), passed before their next vacation, the August recess. Faster legislation, but not necessarily good legislation.
Health insurance is regulated on both the federal and state level. Our elected officials in Washington and Columbus have been very busy. Some of their focus has been on tax cuts, election nullification, and sabotage. And every once in a while, when they have nothing better to do, they put some effort towards solving problems.
A key element of the Patient Protection and Affordable Care Act (Obamacare) is the Individual Mandate, the requirement to purchase insurance. This blog and numerous other published articles have noted that the Individual Mandate traces its roots to the conservative Heritage Foundation over twenty-five years ago. The logic is simple – If we are going to offer health insurance to all Americans and cover preexisting conditions, we must have everyone participate.
You can’t fund a healthcare system if only the sick and the responsible are participating.President Trump and Congress are actively sabotaging the system. As previously discussed, Mr. Trump’s first Executive Order directed federal agencies to “waive, defer, grant exemptions from or delay the implementation of the Act…” And with that the IRS stopped holding tax returns that didn’t include proof of insurance coverage. Enforcement became optional. But that isn’t enough for Congress.
The New York Times recently reported that a bill is moving through Congress that would prevent the IRS from enforcing the Individual Mandate. Why leave anything to chance? With the replacement bill floundering and Obamacare, by default, looking better every day, it is important to the Republicans to harm PPACA any way they can. Every healthy person that chooses to not purchase coverage is a future rate increase for everyone else.
* * * * *I’ve left the message on our system. Every comment on this blog is appreciated. He had given his response a lot of time and thought, so much that he wasn’t able to call my office until 10:30 on a Saturday night. He was careful to mask his number to evade the caller ID but, oddly enough, forgot to leave his name. My reader wanted me to know how much he respected President Trump and that my opinion wasn’t appreciated, though he didn’t use those exact words.
Monday, July 3, 2017
At some point we have to ask, “Where the Hell are we going?” Seriously, we have a couple hundred Congressmen and 50-60 Senators gambling with 20% of our economy and people’s lives in an effort to negate the 2008 and 2012 elections. And leading the charge is a guy so obsessed with his predecessor that he would sign a bill mandating daily doses of arsenic if he was told that it would reverse an Obama achievement.
The Patient Protection and Affordable Care Act (Obamacare) was passed in 2010 after months of Congressional hearings, public meetings, and debate. The final law borrowed heavily from Republican plans pushed by The Heritage Foundation, Newt Gingrich, and Mitt Romney. It was not the traditional Democratic plan focused on either a Single Payer or Public Option. Like all compromises, there was plenty to love and lots to hate in the PPACA. But the legislation’s intention was to give every American access to affordable healthcare.
Obamacare fell short of its goal.
What is the goal of the American Health Care Act (AHCA)? What is the goal of the Better Care Reconciliation Act (BCRA)?
Both the House and the Senate bills are focused on tax cuts, Medicaid reduction, and defunding Planned Parenthood. Neither has a single provision to lower the cost of healthcare. Neither provides access for a single American. Both bill would eliminate health insurance coverage for over 20 million Americans over the next ten years.
The AHCA and the BCRA are both championed and denigrated by President Trump. It just depends on the hour. The reason is simply. He doesn’t care. He just wants a win.
On Friday Senator Ben Sasse (R-NE) revisited a different Republican option, Repeal Now – Replace Later. His website features his newly found relevance since President Trump has reversed himself and is now embracing this idea. This simplistic concept features a triumphant Republican controlled Congress repealing OBAMAcare and then, now with a clean slate, the Republicans invite the Democrats to join them to create a similar system. Yes, this is exactly like an arsonist burning down his own home and then demanding that you help him rebuild it.
There are, of course, other options. Steven Brill, author of America’s Bitter Pill, published an article last week in the Washington Post. Nine ways to really fix Obamacare is a short list of common sense solutions that advance the goals of access and affordability. There are Republican and Democratic ideas incorporated into these nine changes. It is a short article. Click here to read it.
I don’t know that there is a road to an insurance nirvana. But if there is, it certainly isn’t paved with bad intentions.