Many Americans without health insurance coverage look forward to the coming weeks and months. Starting Oct. 1, they’ll be able to enroll for coverage under the Affordable Care Act, President Obama’s signature health care initiative. Folks who don’t make much money – strangely and sadly, those who make too little may still be out of luck — will be eligible for federal subsidies when the coverage begins on New Year’s Day.
Just think – millions of people who finally will be able to go to the doctor or hospital and have a way to meet the costs. Many others already are benefitting from the new law’s protections such as its requirement that health insurance cannot be denied because of pre-existing conditions.
No wonder the law’s diehard opponents are desperate!
Yes, from the standpoint of those politicians whose dislike of the president fuels their dedication to the failure of “Obamacare,” the prospect that it might succeed amounts to an all-hands-on-deck emergency.
There’s no getting around the fact that the law is complex – more complex than a comprehensive, effective solution to America’s health insurance dilemma needs to be. However, much of that complexity is due to the virulently partisan and financially self-serving opposition that reformers had to overcome in enacting the country’s first major health coverage overhaul since Medicare almost 50 years ago.
Those seeking to derail the law now hope to entangle it in a fog of confusion that could cause supporters to lose their bearings.
Capitol Hill Broadside
Not surprisingly, a case in point involves the U.S. House, where the tea party movement has its center of gravity and where majority Republicans depict Obamacare as the work of deluded socialists if not Satan himself. (For some of them, that would be the Satan in the Oval Office.)
The House Energy and Commerce Committee recently took aim at the unfolding effort to explain enrollment options to potential ACA beneficiaries and to get them signed up. That effort will feature special “navigators” supported by federal grants.
The committee is demanding that groups receiving the grants supply a boatload of detailed information, including how the navigators will be trained and supervised, what specific work they’ll do and how they’ll safeguard any personal data – a responsibility the groups already have been directed to plan for.
If this were purely in the spirit of thorough congressional oversight, perhaps it would be OK. But given the heavy burden of complying with the requests at the same time the enrollment period is about to begin, amid an implementation schedule that has been extremely tight all along, oversight clearly is crossing the line into obstructionism.
U.S. Rep. Renee Ellmers, the first-term Republican from Dunn who is a member of the Energy and Commerce panel, has hardly pulled her punches in conveying her disdain for the Affordable Care Act.
A Sept. 8 article in The News & Observer of Raleigh quoted Ellmers as calling the law a “complete and total disaster.” Referring to the committee’s demand for information about the navigator program, the former nurse said: “If this ended up resulting in a delay, I wouldn’t be unhappy about it.”
Maybe she wouldn’t be unhappy. Maybe she’d be thrilled. But what about the many Americans, doubtless including many constituents of hers, eagerly awaiting a chance to obtain health insurance that until now has been out of reach? Delay for them means prolonging the time when a medical emergency could easily become a financial emergency – or when people already paying for health insurance will end up footing the person’s medical bills as costs are shifted across the health care system.
Inform and Enroll
Spreading the word about how and why to enroll for coverage under the ACA is a high priority for many organizations that believe Americans should not be at risk of going without health care because they can’t afford it.
The N.C. Council of Churches, for example, is posting information on our website and encouraging congregations to make sure members take advantage of their new options. For the program to work as intended, it’s important that people who could benefit – folks without employer-based health coverage, people who haven’t reached Medicare age, those denied coverage because of pre-existing conditions – go ahead and enroll. That way, the health insurance mechanism can function properly, with the premiums paid by healthy people helping to cover the costs of those who are sick.
Some premiums may sound high, based on data released so far by Blue Cross and Blue Shield of North Carolina and Coventry Health Care, the companies that will offer policies here. But subsidies flowing to lower-income people are geared to make the coverage affordable – at least, for people who earn enough money to make them eligible for the taxpayer-funded help.
Unfortunately, North Carolina’s Republican-controlled legislature has mirrored the U.S. House’s hostility to the Affordable Care Act by declining to establish a state-run “exchange” where people could shop for coverage. That job was left to the feds.
No Medicaid For You
In a display of both callousness and illogic, legislators also declined to expand the state’s Medicaid program, as envisioned by the law but then made optional by the U.S. Supreme Court. A Medicaid expansion would have meant health insurance coverage for some 500,000 of North Carolina’s poorest residents. These are people who don’t earn enough to qualify for the subsidies that would help them buy insurance from Blue Cross or Coventry, or who would fall into categories not eligible for Medicaid, such as many adults with no children at home. And the federal government (yes, Tar Heel taxpayers help fund the government, but so do taxpayers in every other state) would have fully paid for the expansion for the first three years.
Politicians such as Rep. Ellmers apparently hope to use every delaying tactic to frustrate what they call a “terrible law,” to use her words. What’s really terrible, though, is that if those politicians succeed, millions of their fellow Americans will continue doing without the health coverage that so many others – including members of Congress – take almost for granted.
That translates directly into more expenses loaded onto the overall health care system as people put off seeking treatment until they’re desperate, or seek it through costly hospital emergency rooms. And it translates into more suffering. There’s no better reason to hope that the navigators now poised to help get the law up and running are effective.
— Steve Ford, Volunteer Program Associate