Los Angeles Times health reporter Noam Levey, in a report that appeared in various Tronc (formerly Tribune Publishing) newspapers, filed “Equal Access to Coverage at Risk” on Sunday, an aggressive attack on Trump and Congressional Republicans as dishonest Medicaid slashers who pine for a return to a "medical gulag," while portraying Obamacare as a savior.
President Trump and congressional Republicans, despite repeated pledges to preserve sick Americans’ access to health coverage, are poised to scrap this core insurance protection in their campaign to roll back the Affordable Care Act.
Both the House GOP bill that passed in May and the revised Senate GOP bill unveiled last week effectively eliminate the coverage guarantee by allowing health insurers to once again sell skimpier plans and charge more to people with preexisting health conditions who need more-comprehensive coverage.
At the same time, the House and Senate bills dramatically scale back financial aid to low- and moderate-income consumers, and slash funding for Medicaid, the government safety-net plan that has helped millions of sick and poor Americans gain coverage.
(Once again: Medicaid is not being “slashed." Spending on the program will actually rise over a ten-year period.)
There was little or no attempt at balance:
That combination -- looser insurance requirements and less financial assistance for patients -- will once again put health plans out of reach for millions of sick Americans, according to numerous analyses.
(Fellow Tronc paper Orlando Sentinel ran the article and took the opportunity to print a charged photo of a protest alongside it. The largef photo “put attention on affordable health care” with mock tombstones showing reasons for death like “Pre-existing condition” and “Hit Lifetime Cap.”)
“The legislation ensures that every American with preexisting conditions has access to the coverage and care they need, no exceptions,” Vice President Mike Pence told a meeting of the National Governors Assn. in Rhode Island on Friday.
But that assurance has been contradicted by nearly every independent evaluation of the Republican healthcare bills, including two lengthy reports by the nonpartisan Congressional Budget Office.
Pence’s claims are also at odds of with the assessment of health insurers themselves.
Levey went to insurance companies (which surely have no dog in the fight) to attack the GOP plan.
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On Friday, the heads of the industry’s two leading advocacy groups -- America’s Health Insurance Plans and the Blue Cross Blue Shield Assn. -- called the Senate bill “simply unworkable,” warning it “would undermine protections for those with preexisting medical conditions.”
Similarly, in a letter to Senate leaders this month, the American Academy of Actuaries warned that provisions of the Senate GOP bill “could erode preexisting condition protections” and “make it more difficult for high-cost individuals and groups to obtain coverage.”
Nearly every major patient advocacy organization has reached the same conclusion.
Health coverage has long been very far from perfect in America, but Levey’s tone is one of hell on earth, no less than a “medical gulag" before President Obama saved the day.
The kind of deregulated insurance markets envisioned by the House and Senate bills would mark a return to what health insurance looked like before the current healthcare law was enacted in 2010.
Before Obamacare, most insurance companies worked aggressively to exclude sick customers, either denying coverage altogether or charging unaffordable prices to people with preexisting conditions such as cancer, diabetes, even acne.
That left tens of millions of Americans with next to no options for coverage.
“It was a medical gulag,” said Richard Figueroa, former enrollment director of California’s plan, which had a long waiting list because demand always outstripped money available for coverage.
Obamacare fundamentally equalized how health insurance treats patients. Insurers were not only forbidden to deny coverage to sick consumers, they had to provide a basic set of benefits.
Obamacare protected Americans from their own stupidity:
That standardization ensured that sick Americans were not forced to pay more for health insurance than healthy Americans, who might be tempted to buy skimpier plans that did not offer some benefits, such as prescription drugs or mental health and substance-abuse therapy.
This meant higher costs for some consumers, particularly those who enjoyed lower premiums before the law, when insurers were allowed to exclude the sick.
But uniform standards are necessary to ensure equal access to coverage, said Manatt Health managing director Joel Ario, a former insurance commissioner in Oregon and Pennsylvania. “It doesn’t work unless everyone participates on the same terms.”
To date, more than 20 million Americans have gained coverage through the law and many more depend on its protections.
Sen. Bill Cassidy (R-La.) famously pledged that he wouldn’t vote for a bill that didn’t pass what he called the “Jimmy Kimmel test,” in a reference to the late-night host’s emotional explanation of how important it had been that his baby son was not shut out of insurance coverage after being born with congenital heart disease.
More loaded language and scare quotes.
Conservative Republicans led by Texas Sen. Ted Cruz, who insists on the insurance deregulation, have said they will not support the Obamacare repeal bill without Cruz’s amendment.
But offering this kind of “choice” -- even with additional money to help sick consumers -- would effectively end the coverage guarantee, the two health insurance groups said.