The face of ACA
Stonewalling on Obamacare and expansion of Medicaid isn’t saving any money or lives.
Mark could fix anything. Light switch out, call Mark. Roof leaking, call Mark. Refrigerator broken, bathroom need remodeling, sprinkler system out of whack, call Mark. He would appear in a flash and fix it. No fuss, no muss, keys jangling on his belt, ponytail neatly tied back. What he couldn’t fix was his health. Mark suffered from Hepatitis C. Recent advances in treatment could cure him, but they are outrageously expensive: $84,000 for a course of one such drug, more than Mark could pay. He had no insurance. He could not get insurance at any price because he had a pre-existing condition. The Affordable Care Act took effect just in time to treat the liver cancer that was a direct result of his untreated Hep C. But not in time to save Mark’s life. He died for lack of insurance. He was 58.
This page doesn’t often use anecdotal tales to make its point. But a recent report from Blue Cross and Blue Shield Association paints a statistical picture of its post-Affordable-Care-Act policyholders, and those statistics need a face — a hardworking, honest, loving father and grandfather face like Mark’s. According to Blue Cross, its newly insured customers are sicker than their neighbors who were lucky enough to have had consistent and adequate health care. They have higher rates and more advanced cases of diabetes, HIV, high blood pressure, cardiovascular disease, depression, Hep C, and their care is more costly. As a result, Blue Cross plans in many states are raising premiums.
Republicans in Congress and on the campaign trail beat their chests and declared they had been right all along about the impending economic catastrophe created by Obamacare. But health policy experts weren’t surprised that there were a lot of sick people with pent-up demand. These are the same patients who were treated in emergency rooms at much greater expense to taxpayers and health-care systems. In setting up the ACA marketplaces, some insurance companies underestimated the scale of these demands and are raising their premiums now to cover the increase in claims. Some companies are pulling out of the ACA marketplace altogether. But these are adjustments expected in a new program, the experts say, and Blue Cross also reported that its programs will get its new customers healthier quickly and keep them healthy, which should moderate costs over time. The flood of expensive, very sick patients will ebb as the country’s health improves. The real catastrophe is the millions of Americans in need of medical care who couldn’t get it before the ACA.
If the Republicans in Congress continue their crusade to repeal the Affordable Care Act, they should explain in detail their version of a health-care plan that would offer coverage for pre-existing conditions, provide for young adults supported by their parents, prevent insurance companies from canceling a policy whenever a claim is made, and deal with the 1.2 million Texans who now have access to the state’s world-class medical system but would lose it if the ACA is repealed.
And the Texas Legislature should move to expand Medicaid coverage. Refusing to do so has already cost the state about $18 billion in federal subsidies and kept Texas at the top of the infamous list of states with the most uninsured citizens — 5 million at last count.
While we believe providing adequate health care is an ethical obligation, the financial argument is also a powerful one. All of us pay for the uninsured through higher hospital costs, higher insurance premiums and higher property taxes. The Legislature’s hyperpartisan stonewalling on the ACA and Medicaid expansion isn’t saving any money for Texas taxpayers, and it certainly isn’t saving lives. Mark worked hard. He raised his family. He paid his taxes. He should not have died from a disease that could be treated. He deserved better. We all deserve better.