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Health care: Let’s not go backward!

Published: Wednesday, July 12, 2017 9:36 a.m. CST

We are being told our pre-existing conditions will be covered under Trump Care (the current Senate bill coming up for vote) without caps — i..e. limits — just like under the ACA/Obama Care.

Sounds good until we look at the fine print and consider two aspects of the bill. The first is that the states will be allowed to seek a waiver from coverage of various parts of the Essential Health Benefits currently required under the ACA/Obama Care. EHB’s are outpatient care; ER; Hospitalization; maternity and new born care; mental health and substance abuse services, prescription drugs; rehab services and devices; lab services; preventative services or chronic disease management and pediatric services, including oral and vision. Given that Iowa has terrible budget problems, why wouldn’t Iowa seek waivers of EHB’s?

The chances are some of the benefits no longer being covered will be things like mental health care, substance abuse care and maternity care or cancer care or heart disease care. All of the drugs necessary to treat these conditions may not be covered either. Imagine the surprise to find out that the pre-existing condition is covered but that the expensive drugs needed are not! These “skinny plans” result from companies being able to pick and chose the coverage they offer.

Then the second aspect kicks in — the cap on annual out of pocket expenses as well as on lifetime coverage. The Brookings Institute found that states exercising the waiver of EHB’s can lead to insurance companies and employers reinstating annual and life time caps on coverage—taking us back to life before the ACA/Obama Care.

Even if the EHBs are covered, if a person can pick and chose insurance coverage, they will only most likely select those EHBs they need now, not in the future. Healthy young people will be less likely to sign up for cancer coverage, preferring to stay on the “skinny “ bare bones plans but other folks needing coverage for cancer, for example, or heart disease, will be facing much steeper costs for coverage, along with heart breaking caps on coverage. 

Why in the world do we as a society want to go back to this kind of “non-health care?” We were sold on the idea of repeal/replace Obama Care in order to reduce premiums. That clearly is not going to happen under Trump Care/ Senate Bill. In fact, the CBO report is for rising premiums for several years. In general, this will result in an “age tax” as older people will face significantly steeper premiums. The projection is up to five times the premium being paid now by older people. In addition, there will be many more bankruptcies as this bill simply busts people. 

The current bill’s purpose is openly and plainly to provide big tax breaks to the wealthy. Remember that Rose Garden celebration over the passage of the House version of this bill? Lots of talk about all the different tax breaks the wealthy would be getting, some even retroactive. But that will not help us, the average American. We need real affordable health care, for all of us.

Bev Clark


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