When The Goal Is FAILURE

The answer was, “NO”.  I hate to say, “No”, and I hate to disappoint a perspective client.  And yes, I hate to fail.  Joseph (name changed) has had a lot of disappointing news lately.  Joe has worked for the same employer for over ten years.  He and his family are covered by the employer’s group health insurance policy.  The employer has always paid a portion of both Joe’s (employee) premium and also part of the family’s (dependent coverage) cost.  Now, as of June 1st, the employer will only pay part of the employee premium.  Joe is left to pay all of his wife and son’s premium.  The cost is prohibitive.  Here are options we could pursue:

  • Were it not for the Family Glitch, discussed in my last post, we might be able to get a tax credit subsidy to help him pay for his spouse and son’s coverage through healthcare.gov.
  • If Joseph’s spouse and child didn’t have any preexisting conditions, we could move them to short term major medical coverage. Short term policies are less expensive because they are not guaranteed issue.  The application is underwritten.  You can be declined.  Preexisting conditions are NOT covered.  This is not a good option for them.

Joseph and his family can not be without insurance coverage.  He does not want to look for a new job.  They will be forced to cut back and find the money for the premiums for the rest of 2022.  We can only hope that the Biden administration’s plan to fix the Family Glitch will be in place by this year’s Open Enrollment Period that begins November 1st.  My goal is to view this  as a set-back, not a failure.

But what if the goal is failure?  What if you have spent the last ten years or so working every day to make it harder, not easier, for Americans to access and pay for health care?  And that brings us to Senator Pat Toomey (R-PA).  You probably don’t think about Senator Toomey when you are thinking about health care legislation.  He has spent most of the last decade decrying the introduction of the Patient Protection and Affordable Care Act (Obamacare), voting for the repeal of the law without any replacement, and still talks about the debunked theory that everything will be fine if we could only purchase health insurance across state lines.  Now in the waning moments of his last term (like Rob Portman (R-OH) he beat the electorate to the punch and chose to not seek re-election), Mr. Toomey has decided to make a last attempt for both relevance and to gain the attention of some future employer.  Mr. Toomey is too committed to the failure of Obamacare to suddenly want to help Americans afford their health care.  Instead, on May 11, 2022 he and fellow consumer advocate, Senator Richard Burr (R-NC) have attacked the Biden administration’s attempt to fix the Family Glitch.

This is the link to the Toomey / Burr press release.

The opening sentence dispels any possibility that this is a good-faith effort by Senator Toomey to help Americans access and pay for health care.

“This action would further the reach of the federal government into Americans’ daily lives, placing more federal red tape between patients and their doctors.”

Helping American workers pay for their health insurance does not insert the government between the patient and the doctor.  People like Joseph will have a choice.  He will be able to keep his employer’s coverage for his family if he can afford it and if it serves his family’s best interest.  Or, he might be better off purchasing a policy through the government’s exchange, possibly with a tax credit subsidy.  Joseph is not alone.  According to the Kansas Health Institute, a nonprofit, nonpartisan educational organization based in Topeka, approximately “40,000 Kansans are not eligible to receive premium tax credits due to what is known as the ‘family glitch’.”  The Kaiser Family Foundation estimates that over 5 million Americans are affected by this across our country.

As I noted last month, members of the National Association of Health Underwriters (NAHU) go to Washington every year to fight FOR our clients.  We have asked Congressmen and Senators to address this issue for over 10 years.  We know how the laws passed by Congress and regulated by the various agencies impact our clients.  It is that information that we bring to our elected representatives.  We are so close to making life easier for our clients.  This doesn’t solve everything.  It doesn’t make Obamacare anywhere near perfect, just a little better.

Our efforts have been focused on helping Joseph and millions of Americans like him.  That was our goal.  Once again we have been reminded that for some, the goal is failure.



Picture – When Failure Is Inevitable – David L Cunix


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3 Responses to When The Goal Is FAILURE

  1. Michael J. Saltzman says:

    There are Toomey Republicans in Congress. Vote them out.

  2. […] with Senator Pat Toomey’s (R-PA) effort to prevent the Biden administration from resolving the Family Glitch, a problem within the Patient Protection and Affordable Care Act (Obamacare).  My research led me […]

  3. […] interpersonal relationships, may be the only area they don’t wish to regulate.  My other blog, Health Insurance Issues With Dave, has discussed the government’s overreach into the payment and delivery of healthcare.  Another […]

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