ACA 2.0 [View all]

[McCamy Taylor]

Reasons we need to retake Congress in 2016 so that the Affordable Care Act can be improved:

1. To put the Affordable back in Affordable Care: Too many plans tack the whole annual out of pocket onto the start of the insurance as massive deductibles, $3000 to $5000 a person. Since these are the plans that the poorest people pick (because they are the only plans they can afford) they do not use their new insurance, except in an emergencies---and sometimes not even then. I see too many people in the office who refuse to get necessary care at the hospital. "I can't afford that $3000 deductible. You'll have to give me something for my ____ (insert stroke, heart attack, concussion) in the office or I am going home without treatment." High deductibles kill. More often, people put off necessary tests---like breast biopsies, because they do not have the cash up front to schedule "elective" procedures. Meaning when they finally get so sick that they have to bite the bullet and go to the hospital, their disease has progressed.

2. To Put the Care back in Affordable Care : Too many insurers have found a sneaky way around the "No exclusion for pre-existing conditions". They refuse to pay for necessary treatments for the most costly pre-existing conditions---in effect denying care to those who need it most. AIDs patients suddenly find that they can not get their meds. Cancer patients can not continue their chemotherapy. The same insurers make most medications available for a reasonable copayment. When insurers choose not to cover the treatments which the sickest people need, they do so in order to discourage the sickest people from signing up for their plans. For those who say "Some insurance is better than none", AIDs patients on Medicaid get good drug coverage. If we force them onto private plans that do not cover their meds, they will not be able to afford their meds.

3. To Force Red States to Act on Affordable Care: The Supreme Court found a nasty loophole. States could choose not to accept billions in federal funds earmarked for their poorest citizens. In effect, some states could decide to let their poorest citizens die---just because. The result has been the closure of rural hospitals in Red States, causing everyone, even those with insurance to be at risk for preventable death. This is a public health disaster. If the states won't take the money, then the feds need to write a new law creating a new program which is federally managed to insure the poor.

Universal health care is a work in progress. The job is not done. To make any progress, Dems will need to control both houses again.