Blair Horner: The Health Care Reform Battle Gets Worse


It has been an article of faith among those opposed to the federal health care reform law that it must be repealed.  You see it all the time: “repeal Obamacare.”  But what does that mean?  Do they really mean repeal everything?  It turns out that the answer is “yes.”

The law is extensive.  It covers lots of issues.

For example, under the federal law parents can keep their adult children on their health care plan until the age of 26.  This provision helps reduce the number of uninsured since one of the age groups with the highest uninsurance rate is young people under the age of 30.  Should that provision be repealed?

Another provision eventually closes the so-called “donut hole” in Medicare prescription drug coverage.  Until the new federal health reform law was passed, Medicare provided subsidies in circumstances when the patient’s annual prescription costs were relatively low and when they were catastrophically high.  In 2009, for example, seniors had to pay for their prescriptions if their annual costs exceeded $2,700 and were lower than $6,100 (in addition to copays).  The costs in between created the “donut hole.” 

The new federal law immediately provided a $250 subsidy to help offset the costs of the “donut hole,” and by the year 2020 the “donut hole” will be completely phased out.  Should this senior subsidy be repealed?

Another provision phases out the ability of insurance companies to deny coverage to those with pre-existing medical conditions.  Pre-existing conditions are things like having had cancer.

For some people with serious illnesses, the new federal law offers help right away.  A recent report found that nearly 62,000 ‘uninsurable’ patients could lose coverage if the health care law is repealed.  These individuals – people with serious health conditions that make it nearly impossible to obtain affordable coverage – are able to get insurance through a little-known program for people who have been turned away by insurance companies because of their pre-existing medical conditions. 

A government report this year found that the top five diagnoses for people in the pre-existing condition plan are cancer, heart disease, degenerative bone diseases, organ failure requiring a transplant and hemophilia.

Should those individuals have their protections taken away?

Those provisions, as well as others that are designed to help reduce the number of uninsured and provide new protections for those in need, are popular.  The main public debate over the federal health care law has focused on the so-called individual mandate, which is the law’s requirement that nearly all Americans purchase health insurance.

Yet for the most ardent opponents of the law, stopping the individual mandate is not enough.  They want the whole law repealed. 

A fight erupted among opponents came when it was reported that Speaker John Boehner was considering offering an alternative health care plan that would include some of the non-controversial items in the federal health care law, such as keeping children on their parents’ health care until 26, providing coverage to those with pre-existing conditions and keeping the “donut hole” closed.

The reaction from the most ideological on this issue was fast and furious.  Within hours, the Speaker had to publicly state that he supported full repeal of the federal health care law.  These ideologues oppose the earlier-mentioned provisions.  According to one, covering pre-existing conditions “would destroy the private insurance market.”   Another said that the Medicare “donut hole” should be kept since it prevents “wasteful drug spending.”

Really?  Fixed-income seniors will behave “wastefully” if the “donut hole” is eliminated?  I doubt it; it’s more likely that those seniors will be forced to decide whether they want to eat or to remain healthy.

When you hear the words “repeal Obamacare” remember what that means – eliminating a host of programs that help the sick and needy.

Blair Horner is the Vice President for Advocacy for the American Cancer Society, Eastern Division.  His commentary does not necessarily reflect the views of the American Cancer Society.

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