How Low Can You Go?

How Low Can You Go?


Some of us remember learning and mostly failing at the limbo in our younger and suppler years. President Trump and the Freedom Caucus in the House are engaged in the same dance moves. The consequence is not whether you embarrass yourself and fall on your ass (inevitable at some point), but rather how little coverage you will have left when you get sick (also inevitable at some point with dire financial consequences if you are uninsured or underinsured).

The ten essential health benefits guaranteed to all Americans under the Affordable Care Act apply to employers, to individuals and to government programs. They include: hospitals, doctors, prescription drugs, preventive care, emergency care, maternity care, mental health care, substance abuse treatments, habilitative and rehabilitative services, and childhood pediatric (including child dental care). What are habilitative and rehabilitative services? For example if you lose your legs or break your back in an accident, they include the wheelchairs or the prosthetic legs you may need; they include learning to re-use your limbs after a stroke. Habilitative refers to the same types of services for people who are born with birth defects.

The Freedom Caucus and President Trump would like to return to the days when insurers sold limited benefit policies – hospital care only or no mental health, no maternity, no prescriptions, and no prevention. They believe this will allow insurers to sell cheaper policies, which will be more popular with the American public. They believe that the solution to the affordability problem is to take away the guaranteed ten essential benefits from the American citizens.

Rather than tackle the very real problems of inflated drug prices or inflated hospital charges in their legislation, they are choosing to give back to insurers the authority to take away maternity benefits from young families, to take away mental health from the mentally ill or wheelchairs from the disabled or restorative services from stroke victims. You may say “well I’m healthy, I take care of my health and I don’t need this coverage – never been sick a day in my life” and that is true until you or your spouse or your children or your grandchildren get sick or injured. You may say “I’m 60 and I’m not getting pregnant or having any more kids”, that may be true but you’re at increased risk of heart attack, cancer or stroke while the new family down the street may well want to have coverage for another child, but is at very low risk of the diseases more common with aging that are covered in both your policies under the ACA.

Just encourage your Congressman to say “no” and tell them to start over again, hold real, meaningful and transparent hearings and build bi-partisan consensus on what coverage Americans need, want and are willing to pay for.

Prepared by: Lucien Wulsin

Dated: 3/24/17




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