When Barack Obama was crisscrossing the country in 2008 and 2009 “selling” Obamacare to the masses, one of his oft-repeated claims was that as a result of his signature legislation, health insurance rates would decrease by $2,500 a year:
That claim, along with several others Obama has made regarding the Affordable Care Act, has, of course, proven false. Did the president lie? Well, you be the judge.
But one of the other selling points that Obama and his Democratic Party made regarding Obamacare was that it would be a boon to America’s poor and downtrodden; after all, they would finally be able to have health insurance coverage, and it would be subsidized to boot, mostly by the evil rich, now defined as any couple making $150,000 a year.
Still, as millions of Americans are now discovering, “subsidized,” in many cases, doesn’t mean “free,” and that is especially true of the nation’s working poor, many of whom are near the end of their working lives (or should be). Nobody told them that even a small stipend for health insurance, which is required now, per Supreme Court-sanctioned government mandate, would prove to be more than they could afford.
Take Barbara Garnaus. Prior to Obamacare’s insurance mandate, the 63-year-old was living a tight balancing act, financially speaking, according to the Los Angeles Times:
For nearly two decades, Barbara Garnaus maintained a modest, delicate life balance: keeping her part-time Orange County school district job and juggling her bills and credit card debt. …
She works 20 hours a week ordering pencils and testing materials, earning $22,480 annually before taxes, and isn’t eligible for the district’s health insurance coverage. She’s tried unsuccessfully to get full-time work at the district and elsewhere, she said, but felt it was best to hold on to what she had when the recession hit.
Her monthly take-home paycheck is about $1,750. With her $1,180 rent, about $150 on gasoline and $100 on utilities, she’s left with less than $320 each month for food and any other expenses, including medical bills.
In March of 2013 Garnaus was diagnosed with a rare but aggressive uterine cancer. Obamacare’s mandate that insurance companies (and taxpayers, through subsidies) must cover preexisting conditions meant that Garnaus was able to get the care she needed, but the added expense of the Obamacare-mandated coverage has pushed her financial resources to the brink. High co-pays and even higher deductibles under her “very basic” plan mean that while she has “coverage,” per se, she still has out-of-pocket expenses that are, at times, still too much for her to pay for.
She is, like millions of others, on the margins economically, and while Obamacare offered the promise of coverage for the kind of catastrophic illness she developed, the manner in which it was sold still is not living up to its hype – or the president’s promises – because it simply was never designed to do so.
Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation, a healthcare research group, said that previously uninsured patients living on the cusp of poverty and now required to buy insurance may struggle with the new financial obligations but should focus on the upside.
“These individuals will pay more,” she said, “but they will get better benefits.”
It is this kind of arrogant dismissiveness that continues to cloud the real problems behind the construct of Obamacare: What’s the point of getting “better benefits” if it breaks you in the process? And really, haven’t the law’s backers, including the president, continually sold Obamacare as “affordable”?
Republicans in Red States have taken a lot of heat from liberals for not creating state Obamacare exchanges and expanding Medicaid coverage under provisions of the law, but even in solid Blue States like California, where Garnaus lives, some counties have cut their welfare benefits as well, meaning fewer poor – and especially working poor – now qualify for extra assistance. The reason is simple: Obamacare coverage is going to be increasingly expensive, and prohibitively so, for tens of millions more people who earn much more than people like Garnaus, without substantial reform or replacement of the existing Obamacare statutes.
And this is where the GOP has the upper hand.
For one, under a plan offered by a trio of GOP senators – Orrin Hatch, of Utah; Tom Coburn, of Oklahoma; and Richard Burr, of North Carolina – the mandate to buy insurance would be repealed. Right away, the marginalized working poor would no longer have to spend their remaining disposable income on coverage.
In addition, their bill offers tax savings to earners so they can still buy coverage they need, but without having to spend their last dime. Also, their measure would keep the current Obamacare preexisting condition requirement, which means that people like Garnaus could have still purchased coverage for her cancer treatments.
There are other proposals from Republicans as well for Obamacare alternatives. Perhaps the most constitutional of those plans, which is offered by Rep. Paul Broun, R-GA., a physician who is also running for a U.S. Senate seat this cycle, it calls for no new tax hikes (another extra expense that the working poor like Garnaus must endure – Obamacare imposes a host of new taxes, on not just on “the rich”), medical savings accounts, block Medicaid grants to the states, and – a big one – increased tax deductibility.
A plan offered by Louisiana Gov. Bobby Jindal, a potential 2016 presidential contender, does more of the same, albeit with a few mandates. Like Broun’s plan, Jindal reforms Medicare and Medicaid, through Broun’s plan is bolder because he would make Medicare a choice, not a mandate, and would severely trim the bureaucracy.
All plans offer some tax equity, which is crucial to ensure that working poor like Garnaus can still afford coverage (if they want to buy it at all).
“Equal tax treatment is crucial to reducing health care costs and the ranks of the uninsured,” notes Dean Clancy at The Federalist.
Finally, a newly-released plan by the Republican Study Committee, a caucus of House conservatives, called The American Health Care Reform Act would:
- Fully repeal Obamacare, “eliminating billions in taxes and thousands of pages of unworkable regulations and mandates that are driving up health care costs;”
- Spur “competition to lower health care costs by allowing Americans to purchase health insurance across state lines and enabling small businesses to pool together and get the same buying power as large corporations;”
- Implement medical malpractice reform “in a commonsense way that limits trial lawyer fees and non-economic damages while maintaining strong protections for patients;”
- Provide “tax reform that allows families and individuals to deduct health care costs, just like companies, leveling the playing field and providing all Americans with a standard deduction for health insurance;”
- Widen access to Health Savings Accounts, “increasing the amount of pre-tax dollars individuals can deposit into portable savings accounts to be used for health care expenses;”
- Allow for those with pre-existing conditions to apply for coverage without being discriminated against.
Democrats and a few Republicans won’t admit it, but health care, prior to the 2,700-page Affordable Care Act, was already one of the most regulated industries in the country. The additional regulatory burdens imposed by Obamacare are more than just onerous, they are simply unworkable – and there is reason believe that the Democrats may have wanted that all along:
How quaint the days when your doctor came to your house or, heaven forbid, you went to the doctor’s office and eschewed seven different forms for “guarantee of payment” and just wrote the receptionist a $40 check for your care. Truth be told, health insurance should really just cover the high-dollar cost of certain procedures and hospitalization from sickness, disease and accidents – not the ordinary or routine. But because the industry is so heavily regulated, and because the health insurance and hospital industries are so driven by all of the wrong things (profit is not bad but profiting on the backs of only those who pay premiums has been a disaster – same for hospitals).
Any plan that lessens government involvement and lightens onerous government-imposed burdens on both the health care and insurance industries would result in less overall costs, higher efficiency, better outcomes and improved doctor-to-patient relations – all things Obamacare was promised to produce but hasn’t. And won’t.
Some of the GOP plans will produce these results. And in the end, those living on the economic margin won’t have to sacrifice their last dime for mandated coverage that costs more than it may ultimately be worth.