Having It Both Ways

The most cynical man in Washington was, once again, counting on the American public to believe his words and to ignore his actions. “Everybody I know in the Senate, everybody is in favor of maintaining coverage for preexisting conditions…There is no difference in opinion whatsoever”, said Senate Majority Leader Mitch McConnell last week. Senator McConnell feverishly tried to block the passage and implementation of the Patient Protection and Affordable Care Act (Obamacare), and he has spent the last eight years trying to repeal it without a workable alternative, but please believe him when he says that he is concerned about your access to health care. Worse, a certain percentage of the American public are prepared to dry Mitch’s crocodile tears.

This blog has discussed the political strategy of Republican-led states to sue the federal government over Obamacare. The Justice Department recently decided that it will no longer defend such provisions as the Individual Mandate and preexisting conditions in a district court case brought by Texas and a group of nineteen states.

Actions speak louder than words. We have eight years sabotage and poison pills (see the abortion provision placed in last year’s Alexander / Murray negotiations). Senator McConnell tells us that he is 100% in favor of protecting access to health insurance for the 52 million Americans under age 65 who have preexisting conditions, while simultaneously touting the Trump Administration’s new moves towards Association Health Plans and the destruction of the guarantees of the PPACA. Mitch thinks that he can have it both ways.

There are, of course, responsible American leaders fighting Senator McConnell and Donald Trump. It is easy to point to Senator Sherrod Brown (D-OH) who recently said, “Families in Ohio will likely face higher premiums next year because of the actions taken by President Trump and Republicans in Congress. Instead of working in a bipartisan way with Democrats to lower costs and expand access to care, we’ve seen this administration create instability in our health care system and it is hurting millions of hardworking families.” Easy, but the truth is that Senator Brown is running for reelection and too many will dismiss his comments, even though factual, as purely partisan. We also need to hear from members of both parties who have shown as much interest in solving problems as scoring political points.

We need to hear from the governors.

A statement was released on Monday, June 18, 2018, from a bipartisan group of governors. And yes two of them, John W. Hickenlooper (D-CO) and John R. Kasich (R-OH), seem to relish the opportunity to appear on the top of any bipartisan press release, but the other governors are new to this club of problem solvers. The following statement was also signed by Bill Walker (I-AK), Tom Wolf (D-PA), Brian Sandoval (R-NV), Roy Cooper (D-NC), Steve Bullock (D-MY), Jay Inslee (D-WA), and Larry Hogan (R-MD).

Everyone in this country deserves access to affordable, quality health insurance. The Administration’s disappointing decision to no longer defend this provision of federal law threatens health care coverage for many in our states with preexisting conditions and adds uncertainty and higher costs for Americans who purchase their own health insurance.

Helping our neighbors get health insurance even though they have a preexisting condition is something Americans support and the Administration’s actions will hurt families in our states. This is not right. We’re asking the Administration to reverse their decision and instead work with Congress and Governors on bipartisan solutions to protect coverage and lower health care costs for all Americans, all while protecting those with preexisting conditions.

Governors Kasich and Hickenlooper have been consistent in their efforts to make health insurance, our system of accessing and paying for health care, work for all Americans. They were fighting for sensible reforms last summer while Congress was attempting to dismantle the PPACA. Where was Mitch McConnell last August while Kasich and Hickenlooper were discussing solutions? By all accounts he was in his office licking his wounds after the defeat of his fictitiously named Better Care Reconciliation Act of 2017.

Joining the governors in this fight are business leaders, insurance executives, and any number of representatives of the doctors and hospital associations from around the country. Andrew Dreyfus, CEO of the non-profit Blue Cross Blue Shield of Massachusetts, is in Washington this week to discuss the importance of the consumer protections built into the PPACA. According to the Boston Globe, Mr. Dreyfus will be pressing his case with a variety of congressional leaders. I’m willing to bet money that he won’t get a chance to talk to Mitch.

And that is the question. Are Kasich, Hickenlooper, and Dreyfus simply spitting into the wind? Is there a serious interest in Washington to help Americans to better afford and access health care? That is an honest question in 2018. And we won’t get any solutions as long as Congress and this President try to have it both ways.

DAVE

www.cunixinsurance.com

Picture - Clip Art

 

Sunset Of The American Dream

The United States is often called a nation of immigrants. Many of our families made the choice to leave their homes and make the arduous journey to a land that promised a better life, if not for them then at least for future generations. A better life for some meant the right to practice their religion without government interference. The American Dream included food for the hungry, prosperity for the impoverished, and freedom, a concept so alien that most could not define it, for all.

The American Dream is under attack.

 

Security. The American Dream is dependent on us feeling secure. Secure in our faith in the rule of law. Secure financially with a stable economy. Secure with access to quality health care paid, for the most part, by someone else. Yes, someone else. Most Americans have private self-paid health insurance, employer sponsored group coverage, Medicaid for the poor and working poor, Medicare for the disabled and elderly, or some combination of a couple of those. This is hardly a perfect system, but it is ours. Tampering with our process of compensating medical providers should only be done with the goal of improving the system. Someone needs to explain that to the Trump administration.

The Trump Justice Department is actively trying to sabotage the Patient Protection and Affordable Care Act (Obamacare). A main feature of the PPACA is the protection the law provides for those of us (about 52 million Americans under age 65 according to the Kaiser Family Foundation) who have preexisting conditions. Unsatisfied with the destabilizing impact of removing the penalty associated with the Individual Mandate, the Justice Department has upped the ante and asked a district court to open the door to medical underwriting. Donald Trump believes that we should return to the days when unhealthy people were charged more for their health insurance. Denying coverage can’t be far behind.

This blog predates the PPACA by over a year. The Patient Protection and Affordable Care Act was a compromise bill created by Republican and Democratic lawmakers. It both suffers and benefits from those compromises. But it was still being drafted right up to the vote and this blog has been clear that the PPACA was poorly written and much, too much, was left in the hands of the regulators. This blog is neither defending the law nor the process. But, our system was working to adjust to the changes initiated by the law.

There have been two types of Republicans since the passage of the PPACA, those who understand the nature of the law and cynically campaign and fundraise against it, and those who really don’t understand our health care system. There was never been a comprehensive Republican alternative to Obamacare. But the Republican tax bill that eliminated the penalty, as of next year, for failing to carry insurance, Trump’s decision to eliminate funding for the Cost Sharing Reduction, and this new effort to reduce access for Americans with ongoing health issues, usher in the era of Trumpcare.



Trumpcare                                                                              Obamacare 

Erase a legacy                    Goal                                      Access to care

Destabilize                         Markets                                Adjusted in time

Price based on health         Underwriting                   Community pooling

Short term politics              Vision                                    Focused, if flawed

Guaranteed to fail               Success                                  Needed to evolve



Some states are trying to stave off the disaster of Trumpcare. Governor Phil Murphy (D-NJ) and Governor Phil Scott (R-VT) have recently signed legislation that will codify the Individual Mandate in their states. New Jersey has also passed legislation that will take the money raised by the penalty to form a reinsurance fund to further help stabilize the market. Several other states are reviewing similar actions. Ohio, this being an election year, is marching in the opposite direction.

I cannot sit silently and watch the American Dream being attacked. How much worse it is when that attack is from within?

DAVE

www.cunixinsurance.com

Picture – David L Cunix – Sunset Of The American Dream