It’s still complicated

To those in our Government that stood up against the repeal/replacement of the Affordable Care Act, I thank you. Even if it was for a reason I do not support. The work to save our system is far from over.

I’m not quite sure why you thought this would be easy, any of you that are for or against the Affordable Care Act.  Let me debunk a few myths:

Myth #1: Obamacare/ACA is in no way affordable. Not for the working poor, the truly poor, the middle or even the upper class. It’s probably affordable for the private jet class, and them only. The ACA has increased premiums and deductible for all of us.  I went to the ER and not only did I have an almost $100 copay, a month later I received a bill for my deductible ($250).  For five stitches it cost me almost $400.  I have a knee that I really hurt falling down a mountain. I refuse to go to the doctor because it’s just not affordable.

Myth #2: Medicare is an entitlement.  Um, nope. Since 1965, our grandparents/parents/ourselves and our children have been paying into the Medicare system. It was our loan to the Government. In return for our loan, the government promised to provide health insurance to us after our 65th birthday regardless of income or health status.  How many seniors do you know that only have Medicare as their only insurance? My parents pay out of pocket every month for a supplement to handle every thing that Medicare does not, which is the majority of their medications and office visits.

Myth #3 All Disabled persons receive Medicaid free of charge.  Some do, but Medicaid is dependent on the State in which you live.  In the case of a child, if the parent(s) is working that may make them automatically ineligible for Medicaid.  In some States it depends on income. In other States (like mine) the Medicaid bill is prorated based on income.

There are many more myths about ACA, but for the purpose of this post I’m trying to keep it as uncomplicated as possible. Let’s face it, we can use a health care system that is less complicated and more effective.  Here are a few suggestions:

Include in the bill the following provisions

  1. As of 2019, every  US Federal and State Employee, Federal and State Representative and Senator will receive the same health coverage as those on Medicaid. (See bullet point #4)
  2. As of 2017, anyone who has paid into the Medicare system will receive 75% health insurance coverage as of their 65th birthday.
  3. As of 2018, anyone who is 63 years of age or older and paid into the Medicare system will receive 90% coverage.
  4. As of 2019, Medicaid is Universal.  The coverage in Maine will be the same as in California. Take the best of what every State offers and make sure every disabled person receives the same benefits. (FYI this will stop disabled persons from flooding States with optimum coverage leaving States with less-than desirable coverage in the clear).
  5. As of 2017, anyone who has served our country receives 100% health coverage, for life. Their spouses and children included. They did their part for our country, we must do our part for them.
  6. As of 2018, regulate the Health Insurance industry.  The FAA, the Electric, the Deep Sea industries are regulated. Yet the industry that comprises almost 20% of the US GDP is not regulated by the Government. In 2015, in the middle of a recession, the health care industry had a jump of over 5%. How is this one industry that impacts over 30 million people is not regulated, is mind-boggling.
  7. As of 2020, your health insurance coverage must be sliding scale dependent on your income and family size. Similar to the poverty threshold for food stamps. This might seem like a Universal coverage option (something to think about) but if the health care industry is truly regulated it will allow the option for families of all incomes to access the same are.
  8. As of 2019, remove the provision of parents keeping children on their policy until they are 26. Tell the kids to get a full-time job that provides insurance. Modify the provision until age 22, with enrollment in a full-time college program.  Allow a 6-month variance between college graduation and when employer coverage begins. We should not be paying our children’s healthcare while they explore a gap-year.
  9. As of 2019, all employers (regardless of size) must provide health insurance to all employees, regardless of hours worked (to stymie employers who hire employees 1-hour under any mandate) at an 70% cost/share.

As far as the undocumented workers, I’m not an expert on immigration but my ideas would be (**this is not a stance on immigration, rather a fair way to make sure our healthcare stays solvent):

  1. As of 2017, if you do not have legal USA Citizenship you will pay 100% of your health care.
  2. If you are here on a work visa, you will pay 50% of any healthcare you receive while in the country (unless you purchase private insurance, obviously) and we will bill your Country or private insurance for the balance.
  3. If you are traveling (with a valid entry) in our country, you will pay 60% of any healthcare you receive and we will bill your Country/insurance for the balance.

This is healthcare, in a nutshell. Cover everyone in a manner that is equitable.  It is how to make it equitable that makes it complicated.  Here are my ideas:

  1. Create a Healthcare committee that comprises of up to 24 people, so there can not be a tie.
  2. The committee includes, but should not be limited to: (1) Republican and (1) Democratic Senator, (1) Republican and (1) Democratic Representative, (1) Constitutional Lawyer, (1) Director of Health and Human Services, (1) Union Representative, (1) Doctor, (1) Nurse, (1) Rehabilitation therapist, (2) Certified Public Accountants (not Government employees) to keep the finances in focus, (2) parents of children with disabilities, (2) parents of typical children, (2) adults with disabilities, (2) Fortune 500 CEO’s, (2) Small-business owners and (2) Veterans.
  3. There will be no Insurance company or Lobbyist on the committee.
  4. The committee has clear (non-partisan) mission and vision statement and a strategic plan for implementation.
  5. The committee commits to doing for the People, by the People and further understands that their actions or non-actions have real impact on every person in this Country.

Let’s face it, Healthcare is complicated. But not funding the ACA has real impact, on every person–even if you are healthy and never go to the doctor. We need real solutions by those who are impacted by whatever decision in made.

I’m willing to add my voice and opinion, are you?

Contact your State Representative and Senator by clicking the links below. I have called my State Senators and Representatives offering to testify, will you?  They need to hear from all of us, not just those who make decisions in a bubble.

http://www.house.gov/representatives/find/

https://www.senate.gov/general/contact_information/senators_cfm.cfm

https://www.usa.gov/state-governor

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