Nel's New Day

August 11, 2015

‘Obamacare’ Good for the Country

Another federal ruling has come down on the Affordable Care Act, and we can only hope that this one is the last. After the Supreme Court once again decided in favor of the ACA, the entire Circuit Court of Appeals for D.C. refused to rehear Sissel v. Department of Health and Human Services. Over a year ago, a three-judge panel had turned down a lawsuit that attempt to strike down the ACA based on a procedural issue that the law should have originated in the House rather than the Senate. Judge Brett Kavanaugh disagreed. That loss led Sissel to ask for the entire court to hear the case. He lost in a unanimous decision.

The D.C. circuit court is split between seven Democrat-appointed judges and four of the most conservative judges nominated by Republican presidents. Sissel might have expected to get a ruling in his favor at least from the conservative judges because the release of a decision took a long time. Instead, the lengthy time before a ruling came from a disagreement about why the court wouldn’t hear the case. Judges disagreed only on academic grounds.

It is unlikely that the Supreme Court will take up Sissel’s case, and the conservative nature of the judges ruling in favor of the ACA may discourage other people from going to court. For example, Judge Janice Rogers Brown, who ruled against Sissel, called the New Deal a “socialist revolution” and claimed that Social Security is a kind of intergenerational cannibalism because of all the “free stuff” that “the political system will permit [Social Security recipients] to extract.”

As time goes one, the ACA continues to get stronger.

A Forbes report by Bruce Japsen, who has covered healthcare and healthcare policies for over 20 years, indicates that unpaid hospital bills drastically declined, both in number and cost, after ACA went completely into effect. Steve Filton, CEO of Universal Health Services (UHS), said that uncompensated care in the company’s hospitals has been on the decline for six quarters. The company’s cost for “doubtful accounts” declined some 17 percent over the first six months of 2015, compared to the same time period in 2014. In 2015, UHS acute care hospitals have seen a “decrease in the aggregate of charity care, uninsured discounts and provision of doubtful accounts as a percentage of gross charges.”

Filton reported something that is obvious to everyone except Republicans. Of the six states with UHC acute care hospitals, two of them—California and Nevada—show a greater participation in Medicaid expansion. The other four states are Florida, Oklahoma, South Carolina, and Texas. A bonus of the ACA is that healthcare stocks are going up, with a surge after the Supreme Court issued its positive ruling in June.

Florida, one of the states that refused Medicaid expansion, denies health insurance to almost one million working poor people. Senate Republicans were in favor of accepting the expansion because the funding would come from the federal government, but Gov. Rick Scott persuaded the House to vote against the working poor. Legislators do understand, however, how important health insurance is: they also voted to keep their own low-cost health insurance. Almost 30,000 state workers, including Scott and Attorney General Pam Bondi (who sued the government over the Affordable Care Act), each pay just $8.34 a month for individual coverage or $30 a month for family coverage. Members of the House, Senate and rank-and-file state employees pay $50 a month for themselves or $180 for family coverage. Their insurance rates are frozen through 2016.

Another Forbes report shows that the ACA has added almost one million jobs in health-related fields through June 2014. The first of over 67 attempts to repeal ACA was called “Repealing the Job-Killing Health Care Law Act.”

A new report in The Journal of the American Medical Association shows that the ACA is a great success especially for minorities previously without healthcare. Over the first two enrollment periods, 10.2 million Americans have received private coverage through Obamacare, and another 12.2 million have been covered by Medicaid and the Children’s Health Program. Costs for Medicaid have dramatically dropped, and the program is fully funded for the next thirty years.

Six measures were used in the survey: self-reported rates of being uninsured, no personal physician, difficult access to medications, inability to afford needed care, overall health status, and health-related activity limitations. Five of these measures improved after people were able to purchase insurance on ACA exchanges; only days limited by poor health didn’t improve.

The study concluded:

“As states continue to debate whether to expand Medicaid under the ACA, these results add to the growing body of research indicating that such expansions are associated with significant benefits for low-income populations.”

An ACA provision mandating that insurers must pay 80 percent of the premiums on health care saved individuals or their employers $5 billion in rebates or premium adjustments for 2011 and 2012. Unlike dire predictions, few—if any—insurers went out of business.

Despite the overwhelmingly positive news about the ACA, the GOP continues to waste its time trying to repeal the law—the last time at the end of July. Majority Leader Mitch McConnell says that he is prepared to hold another vote “to bring an end to the nightmare of Obamacare.” This is a dream that patients, investors, and healthcare companies want to preserve.

In mid-June, the nonpartisan Congressional Budget Office reported that a ACA repeal would “probably increase budget deficits with or without considering the effects of macroeconomic feedback.” The deficit could increase up to $353 billion over a decade. The repeal would also add 19 million people to those uninsured by 2016 and grow by several million in the following years.

Media and candidates are constantly criticizing Donald Trump for not having specifics in carrying out his ideas, but Republicans have the same problem with healthcare reform. After five years of claiming that they will have a plan, it still doesn’t exist. At this time, their only plan is to add billions to the deficit while denying health care to millions of people.

Each state is allowed to set the income level at which people can no longer get Medicaid. In Texas, for example, a family of four must make less than 20 percent of the poverty level to qualify. That’s $4,531 in total annual income. If the family makes $4,532, then they can’t get Medicaid. In Alabama, the cutoff is $4,293. In a Catch-22 a family of four that makes over one-fourth the poverty level in Texas can’t get subsidies for health insurance until it hits 100 percent of the poverty level–$18,128 a year. In addition, childless adults cannot get any Medicaid in all the 19 states without expansion except for Wisconsin.

Two years after ACA became the law of the land, only one state has a rate of uninsured citizens over 20 percent—Texas with 21 percent of its residents lacking health insurance. Before ACA, 14 states were 20 percent or above. California halved its uninsured rate, and both Arkansas and Kentucky dropped their rates from 20 percent to 9 percent in these two years. The national average went from 20 percent uninsured to 13.2 percent with the highest rates for states with Republican governors. New England has insured 95 percent of its population; Rhode Island has only 2.7 percent uninsured.

As of now, 31 states have accepted the Medicaid expansion and its accompanying federal funding, an increase from 26 states a year ago. Time is gradually changing perspectives as more people demand health care and people continue to die without health insurance. In the same year, approval of the ACA has gone up 10 points while disapproval has gone down 12 points. The 47-percent approval is almost triple the 17-percent approval rate of Congress.


During the first GOP presidential candidate debate, Ohio Gov. John Kasich said that the state’s Medicaid expansion cut down the prison population. He said, “Eighty percent of the people in our prisons have addictions or problems,” Kasich added. “We now treat them in the prisons, release them in the community and the recidivism rate is 10 percent….” The average rate in the United State is 52 percent. Ohio is one of 31 states saving money and keeping people alive with Medicaid expansion.


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