Health Insurance Under Threat

by JC Dufresne
for the “Progressive Views” column, Boerne Star, December 28, 2018

Medicine capsule on a five-dollar bill
“E Pluribus” by David Goehring is licensed under CC-BY 2.0

Well over one million Texans stand to lose their health insurance due to a federal court decision, here in Texas, striking down the Affordable Care Act in its entirety a week ago today. The lawsuit was brought by the Attorneys General of 18 Republican-controlled states. Interestingly the suit was brought in the Northern District of Texas where U.S. District Court Judge Reed O’Connor, a George W. Bush appointee, is the only active judge so it has the appearance of judge shopping.

O’Connor held off on handing down the decision on this case for months as it was argued in his court in the Spring. Whether he did it for political reasons or not is hard to say but it sure seems odd that he waited until a month after elections were over before rendering the decision given that this issue would have been fodder for the O’Rourke and Cruz senate campaigns.

In addition to those losing health insurance they previously got through the Marketplace with subsidies there are others who will be affected by the ruling. By striking down the entire bill, limits on how much more older people can be charged for coverage compared to younger people are also eliminated so those of us 50 to 65 may find our health insurance premiums suddenly take a big jump.

The ruling also eliminates the ban on annual and lifetime caps on how much your insurance will cover so if a member of your family comes down with cancer it will be possible for your insurer to stop paying for life saving medicine and treatment after paying $1 million.

In addition the judge’s ruling means that children over 18 no longer are allowed to stay on their parents’ health insurance until age 26. The same ruling means that a host of preventive care services previously mandated to be provided with no co-pay are no longer required.

Then there are those like my wife who have Medicare Part D covering their prescription drugs; under the Affordable Care Act the donut hole, which is the amount of out of pocket money spent on prescriptions, was substantially reduced. If O’Connor’s decision stands she and others like her will go start spending thousands more for their medications.

There are other less well known parts of the law such as the requirement for background checks on all nursing home staff that are also eliminated by striking down the law.

Many in the legal community were surprised by the ruling and believe it will be overturned since the Affordable Care Act has survived 70 other attacks including twice in the Supreme Court, especially since Congress just had an opportunity to repeal the law and instead chose to eliminate only the individual mandate to purchase insurance. If they’re right we’ll have dodged a bullet aimed squarely at those of us least able to afford the cost of recovering.

Regardless of whether or not Judge O’Connor’s decision is overturned it’s quite clear that there is still a long way to go to truly become the equitable society that this nation aspires to be.

It’s past time for the United States to convert to a single-payer system like that proposed in the “Medicare for All” bill supported by most Democrats. Claims that “Medicare for All” is unaffordable are ridiculous given that nearly every other industrialized nation in the world has used such a system for decades.

This January Medicare for All should be part of the Democrats agenda in Washington. Look for a similar bill in the Texas legislature as well.

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