And, What Congress Should Do to Improve Access and Lower Costs.
For the past nine years, a group of politicians and talk shows have flooded the media with doom, gloom and blame for the “impending implosion” of Obamacare.
Ten Facts that your Congressional Representatives Doesn’t Want to Talk About:
1. US health insurance and health care is a $3 trillion-dollar industry with strong economic and political forces that focus on growing larger, increasing profits and having taxpayers assume their financial losses while they maintain control of their industry.
2. The industry is led by special interest groups, that spends over $100 million a year on lobbying and contributions to politicians, healthcare providers and advocacy groups, in exchange for their loyal support.
This comes at the expense of patients, employers, state and local governments who pay for the outrageously higher cost of insurance, health care and prescription drugs than the rest of the world.
3. There are only a handful of large national health insurance companies. These include United Healthcare, Anthem, Aetna, Humana & Cigna.
These insurers are very concentrated in populated areas of the country and this leads to less competition, higher premiums and greater conflicts with health care providers.
4. The major reasons why there are high cost and limited ACA Exchange insurance plans offered in some areas of the country (primarily in rural areas and less populated states) are:
(1) there has been no commitment by Congress to maintain the individual insurance mandate and provide ACA funding subsidies to insurers,
(2) insurers have no obligation to sell ACA health insurance policies for more than one year at a time and
(3) there is no public option insurance (like Medicare) to compete with private insurance for health care and prescription drugs that is available to adults under 65.
5. Individuals, employers, federal, state and local taxpayers pay for the cost of healthcare for people who are uninsured or don’t want to pay for their insurance.
Allowing people to refuse to buy health insurance, without a substantial late enrollment penalty (like Medicare) will result in an increase in medical services bad debts and an increase in the cost to taxpayers and the majority of individuals and employers who buy insurance. There is no free lunch.
6. Nineteen republican governors (primarily from sparsely populated western and southern states) have followed their party’s leadership in refusing to accept federal funding (since 2014) to expand Medicaid eligibility (with 90% federal funding) for their low-income, uninsured residents.
As a result, these states have substantially higher uninsured residents, higher costs and fewer insurers interested in selling plans in their states.
7. While the overall national uninsured population has been reduced from 20% in 2013 to 10% in 2016, republican governors that have refused to expand Medicaid have experienced substantially higher rates of uninsured residents.
These include; Texas, Oklahoma, Florida, Georgia, Mississippi and Idaho. Blocking people from receiving insurance results in higher premiums, medical expenses and taxes to cover the costs of services to people who are uninsured.