The Republicans have come out with an alternative to the Affordable Care Act (ACA) also known as “Obamacare.” The Patient Choice, Affordability, Responsibility and Empowerment Act (Patient CARE Act). Catchy anagram isn’t it? But what does it really involve?
The GOP’s ‘Patient CARE Act is a band aid.
Well, for starters, it’s basically the same thing. But there are a few glaring differences. Keep in mind that the ACA is a hybrid of originally Republican ideas. If Democrats and liberals had their way we would be talking about single payer. A simple, proven way to provide healthcare to a country’s citizenry. But nothing in Congress is done because it’s simple or proven. The Patient CARE Act is no different.
10. Exclusion of coverage for those who just signed up.
In my opinion, Think Progress put it best.
“Right off the bat, the Patient CARE Act would repeal Obamacare in its entirety, meaning that the three million Americans who have already enrolled in new plans through the law’s state and federal marketplaces and the millions more deemed newly eligible for Medicaid coverage in states that expanded the program would lose their health coverage.”
But that’s not all. The Patient CARE Act would also change Medicaid as we know it. You had to know that was coming. Medicaid funding would suffer an imposition of a “per capita cap”. More simply stated a block grant. Which would only cover a selective group of people. Pregnant women, women with children and the disabled. Plus a few others. The majority of the working class, regardless of how poor they are would be required to purchase more expensive private insurance.
9. Fewer subsidies.
You’ll like this one too. Instead of the sliding scale subsidies in the ACA, the Patient CARE has flat subsidies. Where Obamacare covers the needs of people up to four times the poverty rate, the Patient CARE Act only goes to three times the poverty rate. And as I mentioned the subsidies are flat. So whether you’re below $ 11,000 a year or closer to $50k with a family, you get the same amount. When you figure out how that levels the playing field and makes things more inclusive for coverage you let me know. I’m still scratching my head on that one.
8. Annual limit caps.
The Patient CARE Act does not have lifetime limits on coverage. In that way it is identical to the ACA.
BUT, what it does have are annual limits. Say for example you have a catastrophic incident or illness during the course of a single year. When your insurance’s annual limit is reached you are stuck with paying the entire remaining balance. So either way they gotcha. If you don’t get sick they get your money. If you get really sick they don’t cover you entirely and they get your money. You may not have a lifetime limit but if that means that you only have one or two incidents in your lifetime you could still go bankrupt in under a year. And THAT with full coverage. Nice huh?
7. Removing consumer protections.
Oh but it doesn’t end with annual limits. All those consumer protections that come with the ACA are dismantled, divided or eliminated altogether. For example, you may be the most religious, sexually repressed right-wing radical on the planet but if your kid happens to rebel against your teaching Obamacare will cover the cost of your testing and/or contraception. Not so with the Patient CARE Act. If you didn’t feel the need for that type of coverage when you purchased your health care plan or your employer didn’t see fit to include it in theirs, you’re out of pocket. Better yet, before it gets to that point you have availability to mental health care and the prescription drugs that come with it. So the whole family has the ability to live a healthier lifestyle. Sanity included. Damn that Obamacare!
6. No free preventative maintenance.
Under the ACA, all sorts of preventative testing and health maintenance services are totally free of charge. It is one of the foundations that Obamacare is built upon. By providing easy, cheap or free access to services and testing that can diagnose or prevent more serious health issues early the entire risk pool achieves lower costs across the board. Oh, and we are all just a little healthier because of it.
The Patient CARE Act has determined those tests should be included in only the best healthcare plans. And, of course, those plans are the most expensive. The rich get healthcare to identify serious medical issues before they become potentially catastrophic. Those who cannot afford the very best insurance will not receive the very best care.
5. A gaping loophole for pre-existing conditions.
If you have a pre-existing health condition you can get coverage with the Patient CARE Act with one stipulation. You must maintain continuous coverage. If you do not have coverage then insurance companies can refuse to cover you. If for example you leave a job and your insurance lapses, you can be refused for any reason. The Republicans say they support covering pre-existing conditions. The Patient CARE Act shows their true colors. High risk means low profits and that is not acceptable in the Republican world of healthcare.
4. Higher premiums for sick and elderly
Inside the Patient CARE Act the premiums for younger customers are cheaper. They don’t have the health issues of older people. Therefore the likelihood of them actually using their insurance is lower. Sounds fair right? Except that if they don’t use those premiums then the insurance companies are really being paid for nothing. But instead of making policies the same and spreading the costs across every citizen the Elderly and Sick will actually pay more. It is true that the Patient CARE Act provides higher subsidies for older people but that, in and of itself, isn’t legal in all states. New York is a prime example. Chuck Todd asked Orrin Hatch about this very thing.
Chuck Todd – “How do you prevent a spike for older Americans who, maybe just by default of genetics, are starting with a lot of health care problems, and because of that, end up getting charged more?”
Orrin Hatch – “Well, we have a formula in there that it can’t go beyond a certain position. But the fact of the matter is, somebody has to pay for these things.”
So, the older you get, the more difficult and expensive healthcare is going to be. Period. The attitude is not that the country will take care of it’s own. The attitude is if you can’t pay you go bankrupt and then you die.
3. Higher costs for women.
No need for equal coverage that is spread across the risk pool. The Patient CARE Act is more than comfortable charging women for the things that are specific to their gender. Mammograms, maternity care, birth control, abortion coverage are all back in the dark ages of healthcare. The equality between men and women is over. Republican men don’t need these things in their healthcare coverage so women will pay for these services themselves. And the additional $1 billion in healthcare costs that women exclusively use is theirs to exclusively purchase. Like it or not, the Republicans are bound and determined to continue discriminating against women. At this point, I don’t believe they even know when or how they do it anymore. Discriminatory practices comes so naturally to them.
2. Higher costs for ALL.
As I mentioned before the Patient CARE Act does have lower premiums for younger buyers. But here’s where the Republicans flip-flop on their ever present “no taxes” mantra. The Patient CARE Act increases taxes on employee healthcare plans. You will pay taxes on 35% of the premium. That’s a tax hike for 150 MILLION Americans. Currently, employer based plans are paid for with pre-tax dollars. Under the Patient CARE Act that would be capped at 65% of the premium. You pick up the tab for the rest of it.
Additionally, the Patient CARE Act is designed to sell plans that are less expensive. And, of course, those plans provide far less coverage. The mandate for quality of coverage has been removed. Buyer beware.
1. More people can be denied coverage.
This whole thing comes down to denial of coverage. The way the Patient CARE Act is structured, medical coverage is no longer a right. It’s back to letting insurance companies control the market. It’s medicine for profit at all costs. Dismantling and repealing Obamacare is what The Patient CARE Act is about. It’s just in prettier packaging. There are some things that would stay the same. There are some things that may, in fact, work out better in the end. But unless and until Republicans stand for the health and well-being of the people before that of corporate interests any plan they put forward will contain these caveats. The Patient CARE Act is not an olive branch of peace and bi-partisanship. The Patient CARE Act is the same old approach with little compromise. And none of the things the American people truly want in their healthcare.