Response to Sue Carroll
Sue Carroll’s letter (Carriage Towne News, July 25, 2013) is evidence of the confusion surrounding Obamacare and Medicaid Expansion. Ms. Carroll is entitled to express her views and it is up to each reader to decide whether or not to research further before arriving at a judgment. In an effort to facilitate a more rational assessment, I offer the following information:
Healthcare costs have been rising faster than the GDP for over thirty years. The system was broken and too costly long before Obamacare was deemed constitutional by a majority of justices in a conservative leaning Supreme Court.
Obamacare is not by any reasonable definition a “government takeover” of the healthcare system. That would require the elimination of private ownership of insurance companies, the delivery system for patient treatment, and medical device and pharmaceutical manufacturing, none of which is taking place.
There are no provisions in Obamacare that put the government in a position to decide whether or not a patient gets a specific treatment. In fact, private insurers do exactly that right now and have a history of canceling coverage when someone is too expensive to cover. Obamacare makes this illegal and also eliminates lifetime caps on payments. Obamacare also prevents someone from being denied coverage due to pre-existing conditions.
The individual mandate, which Ms. Carroll describes as a tyrannical requirement to purchase a product against one’s will, was originally developed and promoted by the arch-conservative Heritage Foundation during the Clinton administration’s failed attempts at healthcare reform. They argued that without a mandate, many people would game the system and wait until they were sick to buy insurance. A fair point with a good solution proposed.
Requiring insurance companies to offer women access to reproductive healthcare is not as Ms. Carroll portrays it, forcing Christians to pay for abortions against their conscience. However, not including this coverage or banning abortion would arguably constitute the imposition of her religious views on those who don’t share them. That has already been deemed unconstitutional.
Rejecting Medicaid expansion would be equivalent to giving tax money we already paid to other states. This would leave NH as the largest tax revenue ‘donor’ state in the country. Further, accepting it does not obligate NH to continue the program if government reimbursements (100% for the first three years and no less than 90% thereafter) should cease for any reason.
Suggesting that Medicaid Expansion will create a stampede of folks abandoning their private coverage in favor of Medicaid is over the top. For the bulk of participants, eligibility is limited to 138% of the Federal Poverty Level (FPL). In 2013, that is $32,499 ($23,550 x 138%) for a family of four. Ms. Carroll might characterize those folks as scammers, but I suggest that helping struggling families of four living on $23,550 have just a few more dollars to spend in an improving economy is a good thing.
Ms. Carroll, what might you do instead? You didn’t really say.