Thursday, March 2, 2017

The Thing About Health Care

First of all, let me just say that “health care” and “health insurance” are two different things.  But somewhere along the way, we have started to call health insurance, health care.

I remember the days when a health insurance plan did not necessarily provide a person with health care.  There were abominable deductibles and co-pays, and lots and lots of health care that just wasn’t covered.  Remember that?  It wasn’t so long ago.

And then, to republicans’ great consternation, Obamacare required minimum standards that were actually standards and not rip-offs.  The complaint from the right-wing was not at all about quality of care, it was about… freedom of choice.  That’s right.  The government was telling you that you would no longer be allowed to buy a sub-standard health insurance plan.

Shortly after the ACA became a real thing, I heard a guy at the optometrist’s office complaining to the receptionist about his Obamacare.  “I do get more stuff covered,” he admitted, grudgingly.

But now the good old days are coming back.  We consumers will once again have freedom of choice, by which I mean freedom to choose health insurance that you can afford even if it doesn’t really provide adequate health care, and even the freedom to be uninsured.  "Boy howdy!" as Rachel Maddow would exclaim.

And then there is the current big debate among the majority lawmakers over tax credits.  What tax credits mean is that when you pay your taxes, you will get a credit for a certain amount to go towards payment for health insurance.  So, if your health insurance costs $3,000 a year, you would have to pay $3,000 less in taxes.  Sounds good, right?

But suppose your income is so low that you only owe $1,000 in taxes?  What happens to that other $2,000 of health insurance cost?  That, friend, is what our lawmakers are bickering about.  The less evil among them believe the government should pick up the other $2,000, while the Ted Cruzes and Paul Ryans -- we know who you are -- believe we should just go suck eggs.

Until the ACA came along, Medicaid covered low-income seniors, children and the disabled.  If you were an adult working, say, at McDonald's, and you were most likely not earning a living wage, you most likely couldn't afford health insurance and you did not qualify for Medicaid.  For much of the country, Obama's Medicaid expansion changed that, providing federal dollars to cover those whose earnings put them somewhere between a rock and a hard place.

Republicans saw the injustice in providing health insurance to the working poor, however, and got the Supremes to agree that governors could decide whether or not they would take the free money.  And some of those anti-tax governors just could not go along with taking tax dollars, especially if they weren't going to benefit big corporations.  Here in South Carolina, where Nikki Haley refused to accept the Medicaid expansion, that meant you qualified if you earned less than $12,000 a year, and had less than $7,300 in savings.  So I am thinking (and this whole thing is about as clear as earwax) that if you are a low-income worker in SC, the good news is you may be no worse off after Congress and Trump get done with health insurance.

Sadly, that will be true for a whole lot more Americans.  And for those of us whose income qualified them for health insurance through the ACA, tax credits will mean a lot more of us will be falling through the cracks.  The good news about this, though, is that those fools will probably also repeal the mandate, so if you can't afford health insurance, you won't get fined for not being able to buy it.

The republican congress did not show up much in the eight years of Obama's presidency.  Mostly they were there to block any proposals made by the president and congressional Democrats.  That meant filling their time with lots of votes to repeal Obamacare.  These days I have heard more than once that they are like the dog that caught the car.  And I am really proud to say that, beginning with the Woman's March on January 21, we have been a big part of their problem.

We have shown up at town halls, made phone calls, protested, marched, written letters to the editor, and pretty much kept legislators awake nights wondering how they can sneak this travesty by us while we are watching their every move.

Apparently, even the Americans who voted R have finally woken up to see that something they need badly is being snatched out of their hands.

There is a lot of crap flying these days.  We are trying to fight as much of it as we can.  There are bad things that will happen.  For awhile, corporations will be having a big party, overindulging and then throwing up all over our country.  The rich will get richer and the poor will get poorer, until those of us who have been buying the stuff that make the plutocrats fat can't afford it anymore.  It happened in 2008.

But this time we anticipated it, and we didn't just let it get reported in the news.  We took to the streets, and we are fighting it.  I don't know if the republicans are going to be able to turn health care into the tragedy it was before the ACA, or if they will just mangle it beyond recognition.  I do know that their decision will take them down.

And then we get to build it again.


  1. Agnes, your cogent comments continue to inspire me. I had given Mark Sanford a break from calling since his town hall, but I'll be back on it today. Thee cornerstone of Paul/Sanford "replacement" plan are Health Savings Accts and Tax Credits. For most people who NEED ACA standards care, they have no savings to set aside and they make less income than tax write offs can help. Oh, and they will cherry pick healthy younger people who will be prized insureds to be traded across state lines. You know how well SC behemoth State Govt does in competing with the other 50 states--Normally DEAD LAST. Keep up the drum beat of your beautiful and necessary alarms!