They Don’t Need To Do A Thing

They didn’t look 74. He was reading, sitting mostly in the shade, his skin dark and leathery.  And, he still had a full head of hair, though it appeared very white against his well-tanned face.  His wife was still working on her tan.  She wasn’t that far behind.  She was filling out a yellow bikini and, like Sally, frequently moving her beach chair to catch the best rays.  We talked for a few minutes before he asked my occupation.  Once I said health insurance he began to ask questions.

We just got back from a week in Mexico. (Feel free to insert your wall joke here!)  We talked with Europeans, Canadians, Mexicans, and lots and lots of US Citizens.  World affairs dominated our conversations with the Europeans.  Canadians wanted to know “What the Hell is going on?”  The Mexicans seemed to politely concentrate on their culture.  Americans immediately asked healthcare questions as soon as they learned that I was an agent.  Thank G-d for the NFL Draft.  It was my major break from shop talk.

I talked with business owners overwhelmed by changes in the group health insurance market. There were hospital workers worried about facility consolidations and closings.  Republicans sought reassurance.  “It is going to get better, right?”  Dems seemed worried about everything.  Cost? Coverage? Preexisting Conditions?  Americans, now accustomed to simple answers to complex questions, wanted to know what was going to change and when it was going to happen.

There are no simple answers.

I left for vacation as the Republicans struggled with their amended American Health Care Act (Trumpcare).  In a rush to accomplish something/anything within the first 100 days of this term, a stab was made at both healthcare and at the budget.  Neither got done.  Nothing changed while I was gone.  There was a lot of grandstanding in Washington and Harrisburg.  Lots of angst everywhere else.

There are Congressmen on TV declaring that the new, new, new plan still doesn’t protect their constituents with preexisting conditions. Other Congressmen are pooh-poohing the issue.  And the President is unclear, at best.  Worse, all of these elected officials are Republicans.  Somehow the Democrats have extricated themselves from this circular firing squad.  Would that the American people were so lucky.

Today is Wednesday, May 3rd.  The President and Vice-President are busy twisting arms and begging for votes.  They hope to have a vote tomorrow afternoon.  Why?  Surely it isn’t because they have a solution.  Trump needs a victory.  The Republican controlled Congress needs to prove that it can pass a bill.

The current sticking point appears to be preexisting conditions. The MacArthur Amendment appears to open the door to shuttling the sick to an insurance Siberia of underfunded high risk pools.  According to FamiliesUSA, there was a fund of $13 billion per year for ten years to help protect high risk individuals from higher premiums.  An additional $8 billion dollars was dumped in yesterday to help make the final push for approval.  That isn’t $8 billion per year.  No, that is $800,000 per year, essentially no change at all.

We have already seen what happens when you underfund high risk pools. Over 30 states tried one version or another prior to the Patient Protection and Affordable Care Act (Obamacare).  Even the PPACA had a high risk pool to help during the transition.  The $5 billion dollar fund quickly evaporated.

Conservatives James Capretta and Tom Miller tackled this issue in the Spring 2010 edition of National Affairs.  They lay out a compelling argument for high risk pools and a well-regulated insurance market.  They also call for reasonable funding – $15 – $20 billion per year.  That was in 2010.  The current bill calls for less money, not more.  It also calls for less regulation.  It is a recipe for disaster.

The elderly couple on the beach asked if they should finally purchase a Medicare Supplement. I took a few minutes to explain the basics of Medicare Part A and Part B, the drug benefits of Medicare Part D (Rx), and even Medicare Advantage Part C.  That’s when their faces lit up and they remembered that they had advantage plans through UnitedHealth Care.  I confirmed that their coverage was working for them and congratulated them on the choice.  They are lucky.  They don’t need to do a thing.

If you are under age 65, you aren’t that lucky.



Picture by David L. Cunix



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One Response to They Don’t Need To Do A Thing

  1. says:

    From our friend Ellen:

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