The Republican Party was sweep into control of the U.S. House of Representatives in the 2010, and large part of their campaign was their vow to “repeal and replace what they call “Obamacare”, the Patient Protection and Affordable Care Act. Now that the U.S. Supreme Court has upheld the constitutionality of the law, they seem to have completely forgotten the “replace” part and are hellbent only on repealing the law. GOP Presidential candidate Mitt Romney vows to repeal “Obamacare” on his first day in office as President. Never mind that Presidents don’t get to repeal laws, only Congress can do that. House Speaker John Boehner says “Today’s ruling underscores the urgency of repealing today’s harmful law in its entirety”. He has scheduled another meaningless vote to repeal the law on July 11. Meaningless because if they vote to repeal it will go nowhere in the Democratic led Senate, and even if it did President Obama would veto it. But if Republicans sweep this November’s election, they would be in position to repeal and replace nothing. Let’s take a look at what the Republicans want to repeal if you vote them into power this November:
Benefits in Effect Now:
- Expanded coverage for preventive care and screenings
Seniors who have Medicare Part B as well as those covered by many individual and employer-sponsored health plans are eligible for free (no co-pay payment) preventive and wellness benefits, such as annual health exams, immunizations, mammograms and other screenings for diseases including diabetes and certain cancers Learn more at HealthCare.gov. Vote Republican and bring back cancer and other screenings only for those who can afford to pay for it!
- New options for people with pre-existing conditions
Adults whom private insurers consider to be “high-risk” due to prior or current health problems — and who have been uninsured for at least six months — are eligible to buy insurance through the federal Pre-Existing Condition Insurance Plan (PCIP) in their state. Learn more at PCIP.gov. Vote Republican and bring back health insurance only for the healthy!
- Lowered costs for people in the Medicare Part D “Doughnut Hole”
People with Medicare Part D who fall into the prescription drug coverage gap will automatically receive a 50 percent discount on most brand-name prescriptions and biologic drugs, as well as a discount on generic drugs. For 2012, the generic drug discount is 14 percent. Vote Republican and bring back full priced Part D prescriptions! The drug companies will thank you!
- Greater consumer protections against insurance cancellations
A common practice among insurers seeking to deny payments for costly medical care has been to re-examine customers’ initial applications and cancel or “rescind” policies. Now, due to the health care law, as long as you pay your premiums, your health insurance is guaranteed. The health care law prohibits insurers from rescinding coverage because of unintentional mistakes or minor omissions on an application.Vote Republican and bring back the insurance companies using any excuse possible to cancel your policy if actually try to use it!
- An end to lifetime limits on health insurance coverage, and higher annual limits
Insurers can no longer limit how much they will pay out in essential medical services over a person’s lifetime. This benefit is now automatically in effect on all insurance policies. Most insurance plans must now cover medical expenses up to at least $1.25 million per year. Vote Republican and bring back “so sorry, you got too sick and now you’re out of luck, and coverage”!
- Expanded coverage for adult children up to age 26
Young adults who don’t have access to an employer health plan can now stay on a parent’s health insurance policy until they turn 26, even if they are married or don’t live at home. Previously, most insurance plans kicked young adults off family policies when they turned 18 or, if the young adult was in college, soon after graduation.Vote Republican and bring back “over 18 and not in college? You’re on your own”!
- Insurance supports for early retirees
If you have retiree health coverage through your work and are between 55 and 64, funding from the new Early Retirees Reinsurance Program can help your former employer maintain your health benefit until you reach Medicare age.Vote Republican and bring back “work ’til you drop because you need that insurance coverage”!
There many other benefits of the ACA already in effect:
- Greater protections for children with pre-existing conditions
- Free wellness care for babies and children
- Easy-to-use resources for finding affordable insurance
- Easier access to specialty care
- Expanded rights of appeal
- Insurance supports for small-business employers
All of those benefits are in effect now, but will be gone in a heartbeat if the Republicans get their way with Repeal and not replace a single thing. And there are many more benefits when the law comes into full effect in 2014.
Benefits Still to Come:
- An end to denials and expensive premiums due to gender or pre-existing conditions
As of Jan. 1, 2014, insurance companies will no longer be able to deny adults health coverage because of pre-existing conditions, or charge higher premiums due to gender or gender-specific medical needs, such as childbearing.
Actually, there’s a lot in the ACA that directly benefits women, who have been at a severe disadvantage in dealing with health insurance companies. Under a current practice known as “gender rating,” insurers can charge women higher premiums than men—in fact, women now pay up to 150% more than men each year for identical health plans in the individual market. This becomes illegal under the ACA in 2014. Also in the current individual insurance market, coverage for maternity care is routinely excluded. Only 12 percent of plans sold in the individual market offer maternity coverage, which is frequently inadequate because of long waiting periods and deductibles that can be as high as the cost of the birth itself. This will end under the ACA.It’s also common in today’s market for insurers to refuse to cover women because of gender-based “preexisting conditions.” These conditions can include issues such as having had breast cancer or a Caesarean section or having been a victim of domestic violence or sexual assault. This practice, too, will be outlawed 2014 – unless the Republicans get to Repeal and Replace with nothing.
- The creation of health insurance exchanges
People without employer or other group coverage will be able to purchase insurance more affordably through state-based health insurance exchanges. Premium subsidies will be available for individuals and families with limited incomes.
- Expanded mental health and substance abuse services
While many group insurance plans today do include mental health and addiction services, by 2014 most individual and small group insurance plans will be required to do the same.
NOTE: The excellent article “The Health Care Law: What’s in Effect, What’s Still to Come” at AARP.org was the source for much of this information.
Of course, all this comes at a cost – the dreaded Individual Mandate. It’s no secret that insurance companies manage to stay in business and even make a profit by taking in more money in premiums than they pay out in benefits. To be able to afford all these new benefits they need to increase their pool of healthy individuals paying premiums. But the intent of the ACA is not to “make” people buy health insurance, the intent is to persuade people to buy health insurance, by making it more affordable through insurance exchanges and subsidies to lower income families, and by making the benefits better for those covered. And contrary to what some extreme Republicans would have you believe, the feds aren’t going to come hunt you down and start breaking your fingers one by one until you yell Uncle and agree to buy a policy. No, if you still aren’t persuaded to buy more affordable policies with better benefits, all that happens is that the government sends you a bill, a tax bill. How big a tax bill? Well here, let Chief Justice John Roberts tell you:
For most Americans the amount due will be far less than the price of insurance, and, by statute, it can never be more. The penalty was not intended to be a criminal fine, because those who choose to pay it, rather than honor the mandate to obtain health insurance, would be in full compliance with the law.
Politifact.org has a very good article on the penalty tax for not being covered by a health insurance policy.
The minimum amount — per person — will be $695 once the tax is fully phased in. But it will be less to start. The minimum penalty per person will start at $95 in 2014, the first year that the law will require individuals to obtain coverage. And it will rise to $325 the following year.
Starting in 2017, the minimum tax per person will rise each year with inflation. And for children 18 and under, the minimum per-person tax is half of that for adults.
$95 in 2014 for not having health insurance? A pack a day smoker pays that much in tobacco taxes in a month, a moderate drinker pays that much in alcohol taxes in a couple months. And many people are exempted completely from any penalty tax. Taxpayers who earn less than the minimum income required to file a federal tax return (currently $9500 for an individual) are completely exempt from any penalty for not having health insurance. If an employer offers coverage that would cost the employee more than 8 percent of his or her household income (for self-only coverage) that individual is exempt from the tax. The Secretary of Health and Human Services is empowered to exempt others that she or he determines to “have suffered a hardship with respect to the capability to obtain coverage”. Members of Indian tribes, persons with only brief gaps in coverage (such as changing jobs and there is a wait period for coverage with the new employer) are also exempt from any penalty, as are members of certain religious groups currently exempt from Social Security taxes such as Mennonite, Amish or Hutterite. Also, unlike income taxes, the law prohibits the IRS from seeking to put anybody in jail or seizing their property for simple refusal to pay the penalty tax for not having health insurance. The law says specifically that taxpayers “shall not be subject to any criminal prosecution or penalty” for failure to pay, and also that the IRS cannot file a tax lien (a legal claim against property such as homes & cars, or against wages and bank accounts) or a “levy” (seizure of property or bank accounts).
The Patient Protection and Affordable Care Act pleased almost no one. As it is often the case in a compromise in Congress you don’t get the best of both worlds, you get the best of what can get a majority vote. Those on the left wanted a single payer provision, an expansion of Medicare. Those on the right don’t like the idea of the “guvmint” telling anyone what to do, and on the extreme right many feel if one can can’t afford their own healthcare, then “let them die”. But the good far outweighs any negatives. Republicans want to Repeal and Replace with nothing out of pure demagoguery, out of their dislike for President Obama. Or is it maybe they just don’t like someone stealing their ideas? After all, the ACA is based on the law signed by Gov. Romney in Massachusetts, and which he advocated be adopted nationwide – until it was passed by the Democratic Congress in 2010.
The largest single reason for personal bankruptcy filings in this country is people who have incurred medical bills beyond their ability to pay because they didn’t have health insurance coverage, or they had insurance but their insurance company dropped them, denied coverage, or the expenses exceeded their policy maximum payouts. That is a national disgrace. The ACA directly addresses this. It is not a perfect law, there is room for strengthening and improvement. And a single payer option can be added – but that will never happen with a Republican controlled Congress. Don’t let the Republicans pull the wool over your eyes and bring back the days of pre-existing conditions, denial of coverage, and coverage inequality for women.