Insight News

Feb 12th

Obamacare: At what price?

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Reforming health care in America is proving complicated.  Until now, every attempt to provide Americans universal health coverage, as most other leading nations already do, has failed.  Each of the 200 countries on our planet devises its own arrangements for keeping people healthy, treating the sick, and protecting families against financial ruin from medical costs.  America has been the lone exception among 32 of the 33 developed nations that have universal health care.

It may not be “world-class”, but American lawmakers can now say Heath Care Reform is “a done deal”.  Congress and Obama Administration officials say Americans will now get health reform “based on shared responsibility that asks businesses, insurers, providers and individuals to do their part to make health care more affordable and our people and our economy healthier”.  While many Black Americans are elated over what is deemed as a political victory for Obama, they’d be native not to note the role health, hospital and insurance companies and organizations played as the legislation was taking place.  Major “Pay for Play” was on display: insurance-related companies and organizations employed 4,500 lobbyists to influence the bill.

After the final legislation is signed, in six months insurance companies will be banned from unpopular practices such as: rescinding coverage when policyholders get sick, imposing lifetime financial caps on coverage or denying coverage for children with pre-existing conditions.  These companies will be required to allow parents to keep children up to age 26 on health care policies, unless the offspring get employer-backed coverage.  In coming years, the government can offer a $250 rebate to Medicare beneficiaries to help pay their prescription drug costs when they hit the “doughnut hole” – an existing coverage gap.  Two years out, Medicare beneficiaries will see a 50 percent discount on brand-name drugs.

Unless waylaid by lawsuits from the states, within 90 days, a temporary high-risk pool will be created for those uninsured because of pre-existing medical conditions, allowing them to immediately buy insurance.  Other provisions 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 133 and 400 percent of poverty level - about $30,000 and $80,000 annually.

• Separate exchanges are to be created by 2014  for small businesses to purchase coverage.

• The funding that is supposed to be available to states to establish exchanges is to be provided within one year of enactment.

Every American, beginning in 2014, may be required to buy insurance or pay a penalty.  Subsidies will be offered to help those making less than $44,000 or $88,000 for a family of four, afford insurance.  Fines would be $95 in 2014, gradually rising to $695 by 2016.  By January 1, 2014, companies with more than 50 workers would be required to provide health care for them or face a penalty of $2,000 per worker.  Up to $40 billion in tax credits will be offered to help companies buy insurance for workers.  It will cost $940 billion over 10 years and provide coverage to 32 million uninsured Americans.  When fully phased in, 95 percent of eligible Americans will have coverage, compared with 83 percent today.

Among rich nations, America has the highest level of poverty and income inequality.  This structural racial inequity significantly affects Blacks.  Forty percent of Black Americans were uninsured for some portion of 2007-2008, compared to 1 in 4 whites.  Calling it “a moral imperative”, most of the Congressional Black Caucus (CBC) voted for the bill.  CBC Chair Barbara Lee of California, said: "The president’s plan will give American families and small-business owners more control over their own health care."  Although Blacks have suffered the most inequities in health care, Alabama Congressman Artur Davis, a CBC member who represents the only majority Black congressional district in the state, voted against the bill.  Davis is running a “mainstream platform” in his campaign for Alabama governor against the state’s Agriculture Commissioner Ron Sparks.  Sparks, a white man, accuses Davis of “selling out his constituents by opposing health care reform to satisfy conservative big business interests”.

(William Reed –

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