Protestors file into Congressman Steve Knight's Santa Clarita offices on Feb. 23 to protest what they called "Trump care" with the United Here organization. Katharine Lotze/The Signal
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The Signal article “White House pulls Republican healthcare plan” left so much unsaid.

The only two people interviewed were pro-Obamacare while those who experience the Unaffordable Care Act were absent.

One local lady interviewed, a nurse, extolled the virtues of the ACA saying that “Nobody is saying that it’s cheap, but it’s available and more people than ever in this country are able to get health insurance. Certain healthcare rights are guaranteed.”

It’s very likely that the nurse has a good health policy provided via a union and for that sect there have been no struggles with the reality of the ACA.

“Availability” is at question in that people, who were satisfied with their health insurance and care prior to Obamacare, cannot find like-kind policies or prices. Yes, availability was realized for people who benefit from expanded Medicaid (free) and those receiving subsidies—subsidies financed by taxpayers and again by those who pay for coverage.

Perhaps no one said it would be cheap, but Americans were sold the snake oil that for the average family it would be cheap-er, by saving them $2,500 annually.

There’s an absence of the source for the claim that “certain healthcare rights are guaranteed”.

Another lady interviewed declared she’s gotten the best healthcare she’s had in decades. It would have been informative for readers to know the details of that.

Was there a pre-existing condition; is she receiving a subsidy; was a policy available but she could not afford it, or chose not to pay the price? “Affordability” is in the eyes of the one paying.

There was no challenge presented on the unsupported opinion expressed that the “Republican plan was bad for poor people, seniors and children and wanted to keep the ACA”.

It would have been beneficial and edifying to have a balance on this hot topic.

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  • Ron Bischof

    I too wish to see multiple perspectives in neutral reporting on contentious political issues, Ms. Arenson.

  • Jim de Bree

    Perhaps I can provide some enlightening information to put the Signal article in perspective.

    Betty stated: “Another lady interviewed declared she’s gotten the best healthcare she’s had in decades. It would have been informative for readers to know the details of that.”

    While I cannot speak to the details of the situation of the lady who was interviewed, I can provide numerous examples of people who I know whose quality of healthcare improved significantly after the enactment of the ACA. Virtually every one of them are chronically ill and do not have the ability to hold a permanent full-time job that would provide affordable insurance through an employer.

    Many of these folks have cystic fibrosis. Another was friend who suffers from Epstein Barr Syndrome. She had to quit her job and after her COBRA coverage ran out she could not obtain insurance that she could afford. Before Obamacare all of these people were unable to obtain private insurance either because of cost or some other disqualifying factor. After Obamacare, they were able to obtain subsidized insurance through the exchanges allowing them to get improved healthcare. By the way, these are the very people who are driving up the costs of the exchange coverage.

    Betty stated: “Was there a pre-existing condition; is she receiving a subsidy; was a policy available but she could not afford it, or chose not to pay the price? “Affordability” is in the eyes of the one paying.”

    Just to put this in perspective, when we shopped for insurance for my daughter, we found that a private individual policy that provides reasonable individual coverage for a chronically ill person costs about $500-$600 per month with deductibles/co-payments of $4,500. That is a lot of money for someone who is too sick to work full time. It also is substantially more than what a person covered by an employer sponsored plan would pay. Depending on the person’s income level, the ACA would subsidize 30% to 70% of that cost. That goes a long way toward making the insurance affordable for chronically ill people who cannot work full time.

    I suspect that the woman alluded to in the article was in similar circumstances.

    To present a balanced view, I will tell you that the ACA had precisely the opposite result for my daughter. My daughter suffers from cystic fibrosis. I was a partner with a Big 4 accounting firm that self-insured its medical expenses. The coverage was a super PPO, wherein every provider in the country was essentially in network and the plan covered many things not covered by most other plans. The plan covered all employees and partners, including retired partners. Prior to enactment of the ACA, I could cover my daughter in that plan as long as I participated in the plan and as long as my daughter was my dependent as defined by the plan. Unfortunately, when the ACA extended coverage for dependents to age 26, it required that coverage end when the dependent attained the age of 26. My daughter was on COBRA for three years and now she is covered by Obamacare, which is clearly inferior to her coverage before enactment of the ACA. We had a great plan, but we could not keep it. I loathe Obama for the “if you like your plan you can keep it” sales pitch. However, I will loathe the Republicans even more if their plan is passed. My daughter is one of the people who is likely to be devastated if the Republican bill is enacted. More on that in my next post.

    • Jim de Bree

      Betty stated: “There was no challenge presented on the unsupported opinion expressed that the “Republican plan was bad for poor people, seniors and children and wanted to keep the ACA”.

      I am not sure that a challenge was necessary to this point. Perhaps a further explanation was merited, but given the Signal’s constraints on article length, that was probably not feasible.

      It has been widely reported that the Republican plan will repeal the so called “Obamacare tax” on investment income earned by taxpayers having over $250,000 of income from all sources. The proceeds of the Obamacare tax are used exclusively to fund healthcare services under Medicaid. The Obamacare tax is the principal funding mechanism for Medicaid which provides healthcare services to people whose income is less than 138% of the poverty level. The repeal of the Obamacare tax is going to seriously reduce the available funding for Medicaid. Furthermore the Republicans’ plan changes the way Medicaid is funded by the federal government, placing a greater burden on the states. Based on what I have read, the Republicans have not offered a viable alternative to fund Medicaid other than shifting the burden to the states.

      Furthermore, under Section 112 of the proposed legislation, after 2019 it will be more difficult to qualify for Medicaid—you generally will have to be classified as being disabled by the Social Security Administration or not have a gap in your insurance coverage. What if you are too sick and miss a payment and your policy is cancelled? What if you are too sick to work and you don’t have the cash necessary to make a monthly payment? So when you consider all of these proposed changes, this bill likely puts poor people and their children in a worse position than they are currently under the ACA.

      Consider the case of my daughter if the Republican bill is enacted. She currently has a plan under the Covered California Exchange. In order to be eligible to participate in a Covered California Plan, she has to earn income greater than 138% of the federal poverty level. But what if she gets sick and cannot earn that amount in a given year after 2019? The Republican bill provides that she can be covered under Medicaid as long as there was no gap in her coverage. But here is the rub, in California Medi-cal can retroactively cancel her coverage in a covered California Plan if they have reason to believe that her income is insufficient to participate in that plan. That results in a gap in coverage. That also provides the state with a mechanism to deny coverage. If a state is strapped for Medicaid funds, it will have a strong financial incentive to engage in this type of activity. The poor lack the resources and the sick lack the energy to deal with the administrative heartaches. Unfortunately, the Republican bill does not provide protection to the patient in this circumstance. That is what happens when you rush the legislative process.

      Not only will the Obamacare tax on investment income be repealed, but the Medicare .9% surtax on earned income in excess of $200,000 will also be repealed, meaning that Medicare funding will be cut. Medicare is expected to exhaust its reserves by 2028. Cutting a source of Medicare funding is going to accelerate the time when the reserves are exhausted. This will definitely have a long term adverse effect on senior citizens. Interestingly, when the government considers the fiscal impact of legislation, they only have to look at a ten year window. The Medicare problem is eleven years away, so it can be conveniently ignored. That is one of the reasons why it is so important for Republicans to enact legislation this year. If the Medicare tax changes are postponed until next year, then the budget estimates, etc. all fall apart.

      As you can see, I am not sure that opinion stated in the article is unsupported.

      • Ron Bischof

        Ms. Arenson’s point was that only a single perspective was reported on in the article, Jim.

        “The Obamacare tax is the principal funding mechanism for Medicaid…”

        I’m unclear on this statement. Medicaid has been jointly funded by states and the Federal government for decades before Obamacare. Did you intend instead PPACA Medicaid expansion funding?

        https://www.medicaid.gov/medicaid/financing-and-reimbursement/

        The proposed Medicaid reforms are block grants that allow states flexibility in health care financing allocation. Can you advise why this is better managed from D.C. by Federal bureaucrats in HHS?