Richard Kirsch from the Roosevelt Institute untangles the enormous mess that is the Affordable Care Act,
which will not only not remediate the problems of some of the poor who can't afford health care, it will cost them more money -- and still leave them uninsured! Look, there were some improvements in this bill (especially if you're in the middle class) but on the whole, this is going to be an enormous clusterfuck for the working poor. Read on:
The debate over fast food chains and their workers is revealing one of the biggest flaws in the Affordable Care Act. Many low-wage workers will be put in a very difficult position: pay a big chunk of their limited wages for health insurance that is costly to use, or pay a fine for the privilege of remaining uninsured. This is an example of how the debate around Obamacare is about to take a huge turn. Instead of partisan opponents fearmongering about the theoretical impact of the law, the new struggle will be around the actual experience of those Americans whom the law was written to protect: people who are uninsured because they can not afford coverage or are locked out of the system because they have a pre-existing health condition.
Yep. That's because so many of the Beltway insiders still believe (despite the original study that pushed the idea being debunked again and again) that the problem with health care costs is that people use it frivolously! "It's such a lovely day, let's all go to the doctors and demand MRIs -- because we can!" Hence, the infuriating guiding principle of "skin in the game." If we make it expensive enough, people will only go to the doctors when they need it. Hah.
Talk about "skin in the game" -- literally. I'm at high risk for skin cancer because of my coloring and that fact that I had several serious sunburns as a child. I've already had ten or so moles and skin growths removed, most of which came back as precancerous. The deductible under the Obamacare coverage I have was $30 or so -- but that was last year. I just got the bill for a growth I had removed in January. The new deductible? $544. So I've canceled the rest of the removals, because I just can't afford it.
And you know, it doesn't make sense. It's a lot cheaper to remove these things now than to pay for chemotherapy and radiation later. But this is what passes for intelligent public policy these days. Remember: It's not really health care if you can't afford to use it. It's the illusion of health care -- just like before.
Come January 2014, millions of people will get affordable health coverage for the first time. These will mostly be working people who do not get insurance on the job now but will become newly eligible for Medicaid or income-based tax-credits to buy insurance in the new health insurance marketplaces (“exchanges”). This will also include those who will no longer be turned down because of a pre-existing condition. The expansion of Medicaid – in states that give that the green light – and the income-based subsidies will create a huge new constituency for Obamacare that will oppose any attempts to roll back the law.