The House approved President Barack Obama’s latest iteration of “health care reform” Sunday on a vote of 219 to 212. Democratic leaders are claiming victory. Republican leaders are pontificating about “pork.” Commentators are discussing the ramifications of the bill’s passage on the fall elections.
Meanwhile, anybody who doesn’t draw a paycheck based on the approval or defeat of the health care legislation – and such involvement has become the only growth industry in the nation – either do not understand it or do not care about it. With good reason.
The New York Times referred to the measure as an “overhaul the nation’s health care system” that achieves “a goal sought by presidents and progressives for more than a half-century.” That is news to most progressives, much less presidents.
For all the hue and cry and gnashing of teeth over this so-called “landmark reform,” there is very little in it that is either a landmark or a reform. In fact, the bill approved Saturday will have little or no affect on the vast majority of U.S. citizens.
None of the sweeping changes the President spoke of as a candidate were included. Calling the legislation “health care reform” is a misnomer. What the bill achieved was minor meddling with health insurance.
Further, whatever it is the legislation will do will not occur for four or five years, if that.
One has to wonder how many of the 32 million currently uninsured Americans will still be alive in five years. Of those who live that long, they do not have too much about which to look forward.
Some of the “major” provisions of the health bill include:
• Uninsured and self-employed individuals will be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level. That is between about $30,000 and $80,000 annually. After taxes, food, clothing, day care and other necessities of life, the “subsidy” received will not likely cover the hike in insurance rates that is certain to occur.
• Separate exchanges are to be created for small businesses to purchase coverage in 2014. Small businesses that can survive 14 years and generate the excess capital to afford it will have the opportunity to purchase outrageously priced coverage.
• The funding that is supposed to be available to states to establish exchanges is to be provided within one year of enactment and until January 1, 2015. The most well-known of these “state exchanges” already exists in Massachusetts. It works so poorly that an unknown Republican with a room temperature IQ defeated an overwhelmingly favored Democrat to fill Ted Kennedy’s Senate seat by stumbling over it as an issue.
California is looking at a $20 billion shortfall in the coming year’s budget, so no one knows how much of the heath care exchange money will actually reach those who need it. Of those who qualify and want to purchase their own health insurance from a state exchange, they cannot be eligible for Medicare, Medicaid, or covered by an employer. Those restrictions reduce those who qualify to even attempt to obtain a subsidy to buy astronomically priced heath insurance to an almost negligible number.
How the government is to pay for this golden opportunity borders on fiction. Starting in 2012, the Medicare Payroll Tax is to be expanded to include unearned income. That will be a 3.8 percent tax on investment income for individuals making more than $200,000 and families making more than $250,000 per year. Those are the rich folks who are treated unfairly. Additionally, in 18 years, insurance companies are to pay a 40 percent excise tax on insurance plans worth over $27,500 for families ($10,200 for individuals), as though they will not otherwise be able to afford it.
The bill also digs for pennies at the expense of baby boomers and Hollywood by imposing a 10 percent excise tax on indoor tanning services. Actually, that tax could raise a decent amount of money, especially here in California.
Now that we know what the uninsured are supposed to get and how the government is supposed to pay for it, let see what onerous steps the big, rich insurance companies are to take to make it all worthwhile.
• Six months after the bill becomes law, the insurance companies can no longer deny children coverage based on a pre-existing condition.
• In 14 years, insurance companies will not be able to deny coverage to anyone with pre-existing conditions.
• Insurance companies must allow children to stay on their parent’s insurance plans through age 26.
Good thing the Republicans fought the bill so hard. Those extensive changes could cripple the insurance industry. At least they have health insurance.
Then there are the Republicans commonly referred to as conservative Democrats. Democratic leaders (and the term is used quite loosely) caved to these latter day Dixiecrats by agreeing to drop abortions from those procedures covered. This will likely assure that no safe abortions will exist any longer, as no health care plan will be required to offer abortion coverage and no federal funds will be permitted for abortions except for the obligatory case of rape, incest, or health of the mother.
Of course, undocumented workers will not be permitted to purchase health insurance from the state exchanges even if they pay entirely with their own money. This was included because immigrants are probably the only ones who would pay for heath insurance from their own pockets if allowed, which would perplex anti-immigrant activists.
Then there is $695 annual fine that everyone will be forced to pay if they choose or not, to buy health insurance. Yes, a fine for not buying health insurance. Be assured, however, that the insurance industry had absolutely nothing to do with this provision.
That’s it. Not much else of note is included. Congress members may lose their jobs for voting for what cannot even pass as a bandage on what is truly a crisis in this country. Perhaps they should lose their jobs for having the unmitigated gall to claim that the action taken is “health care reform.”
Chris Crotty is a San Diego-based political campaign, communications, and public relations consultant who has worked with political candidates, labor unions, non-profit agencies, businesses, trade associations, and community organizations throughout the U.S. since 1989. Crotty has run statewide ballot initiative campaigns in California since 1990.