Fall 2013 Part 3



The Affordable Care Act


The Affordable Care Act is one of the most controversial laws in the early 21st century. It has been watered down and the reactionaries hate it. It has strengths and weaknesses. We all know the weaknesses of the law. I will reveal that in more depth later in the words. I still believe that a single payer system is superior to the ACA. Now, there are strengths of the law. Here are some of them. Many human beings in America are receiving lifesaving preventative care. There are 2.5 million young adults that can now remain on their parents' insurance until the age of 26. 50,000 people with preexisting conditions now have coverage. Millions of women now have access to mammograms and other care with no cost sharing. The health care law does have important regulations on the insurance companies like preventing them from rejecting people because of preexisting health conditions. Yet, these new rules have been compromised and qualified half to death. There is still a situation now where the health care industry's profits are maintained at the expense of some. The logic of the ACA is that increased coverage for many, though not all, of the uninsured must come along with cutbacks in access to care for others--as Harry Reid says, everyone has to have "skin in the game." Ironically back in 2003, President Barack Obama desired a single payer universal health care system. Obviously, the ACA is not that, because Corporate America refuses to endorse such a plan. At the end of the day, the elites helped to create the ACA. Some companies are using the "Walmart loophole"--to avoid ACA fines for not insuring workers by making sure employees make so little that they qualify for Medicaid. One strategy for employers to avoid the Cadillac tax is to offer plans with lower premiums, but higher deductibles before insurance begins to pay for care. More than a third of workers covered by insurance are now in plans with annual deductibles of $1,000 or more, and 14 percent have deductibles of more than $2,000. "The lower premiums comply with the Obamacare requirement that less than 9.5 percent of your income go to premiums," explained Brown. "But the law doesn't take into account how much you spend on deductibles and co-pays in employer-provided insurance, creating pressure to get less care." The ACA was a product of compromise and bargaining with the financial elite and the medical, pharmaceutical, and insurance complex. The ACA is not true universal health care. Some folks will have health care and some human beings will improve their lives. That is inevitable. Still, millions will not have true universal health care at all. We need to take out the profit motive out of providing access to quality health care. Many of the aspects of the ACA are similar to the proposals made by the Heritage Foundation over 20 years ago. The ACA was written by the health insurance companies and the members of Congress. The President is the front man of it when he did not originate this agenda at all. So, the ACA must be radically improved upon or replaced with a single payer system. Some unions are criticizing the law for its usage of undermining the workers' living standards. No worker should be told that they have too much health care. Health care is a human right. Medicines, treatments, facilities, and health care resources are legitimate.

The Affordable Care Act is here. There is a website that deals with healthcare exchanges in the marketplace. There has been years of promotion, lobbying, and political wrangling on this issue. The law was open for business on October 1, 2013. Coverage for enrollees is set to begin in January 1, 2014. The insurance exchanges are real. The catch is that billions of dollars are going to be sent into the coffers of the private health insurers. Still, the system will leave tens of millions insured and others with vastly deteriorated medical services. The health care law was originally meant to allow no insurer to be allowed to deny coverage to a sick child or an individual with a preexisting condition, no family would go bankrupt or hungry due to health care costs, and that insurance companies would be held to account. Now, we see an imperfect law called the Affordable Care Act. Many progressive parts of the legislation has been stripped or dominated by other error filled parts of the law. We should fight for the improvement of the medical care of all Americans. Now, we see a heavily class based system of health care delivery. Some believe that Medicare was harmed by the establishment of this law. The public option is not in the law. There were concessions to the law made to big business. Only companies with 50 or more employees would have to provide insurance, only those working 30 hours or more had to be covered. Bare-bones, “skinny” plans—without hospitalization and surgery coverage—would be considered “adequate” employee-sponsored plans. Those businesses that do not comply would face minimal penalties. Human beings without coverage via their employer or from a government program (like Medicare and Medicaid) would make up a fresh pool of captive, cash paying customers who must fend for themselves on the insurance exchanges. Today, those browsing the offering of the new marketplace will confront a confusing array of plans. There is one common feature of it. The least expensive plans offer the lowest levels of coverage with limited choices and the highest out of pocket costs. There is not real oversight over what the insurance companies can charge for coverage. If there is an insufficient number of young, healthy people sign up, the insurers can be expected to jack up premiums even higher to gain their cash flow. According to the Congressional Budget Office, the health care overhaul will leave an estimated 31 million people—about a tenth of the US population—uninsured by 2023. Undocumented workers and their families are barred from purchasing coverage on the exchanges. Due to a “family glitch” in the law, businesses are only required to provide “affordable” insurance to their employees, not to their employees’ families, so those family members will not receive subsidies to purchase coverage on the exchanges. Some of the poorest will be ineligible in some states. Some states have struck down expanding Medicaid expansion in 21 states. Some companies and municipalities are dumping folks into the exchanges. Private insurance exchanges dominate the ACA. Health care is a human right in society. The ACA is heavily influenced by the Heritage Foundation and other corporate interests.



The debacle of the HealthCare.gov is something else. The website is not fully working and it is a shame. The White House is facing more pressure to fix the technical problems of the website. The site wants to sell insurance via the Affordable Care Act or the ACA. Even some Democrats have criticized the website as dysfunctional. Health and Human Services Secretary Kathleen Sebelius said that the government is still working to fix the hundreds of problems with the federal health insurance website.

The White House has apologized for the errors found in the website and the cancellation notices from health insurers due to the Affordable Care Act or the ACA.  In a White House interview Thursday, NBC’s Chuck Todd asked the president to speak on “the most quoted thing or requited thing you have said in your presidency, ‘If you like your health care plan, you can keep it.’” The White House has experienced much criticism for the controversies behind the ACA. We know that Big Pharma and the elite helped to create the law in the first place. What we have is neo-colonialism here. The President now is the spokesman for this 1 percent agenda. He is the scapegoat for the policies of white supremacy. So, it is like the white supremacy power structure uses some black human beings as a means to continue with the status quo. That is why much of the policies of the Obama administration are nothing more than a continuation of the policies from the previous Bush administration. In recent weeks, hundreds of thousands of individuals and families who buy their own health insurance—those not insured through their employers or a government program such as Medicare or Medicaid—have received cancellation notices from their insurers. Many have found that premiums for replacement policies cost much more. The White House claims that such actions were done to improve the quality and accessibility of health care for the American people (and replacing bad plans with good plans that have standards).


So, the President made an error by saying that if you like your health care, then you should keep it. As early as June 2010, less than three months after the passage of the health care bill, written ACA regulations included an estimate that “40 to 67 percent” of the 11 million to 14 million people insured through the individual market would not be able to keep their coverage, and that the figure might be even higher. Private insurers were going to dump these people. The new law needs new, cash paying customers to get insurance exchanges. They must buy insurance or face a penalty. Many are being forced onto ACA exchanges as a means to increase the pool of customers. Second, the ACA requires that people with preexisting conditions cannot be denied coverage, and it sets out 10 “essential” services, such as preventive and maternity care, that must be covered by insurance policies. But it does not require the private insurers to foot the bill for these changes in coverage. Many of the people being dropped by their insurers have policies that do not cover these “essential” services. When these policies are rewritten to include them, the increased costs are being passed on to the customers. Obama alluded to this when he commented Thursday: “A lot of these plans are subpar plans. And we put in a clause in the law that said if you had one of those plans, even if it was subpar—when the law was passed, you could keep it. But there’s enough churn in the market that folks since then have bought subpar plans. And now that may be all they can afford.” The one “fix” suggested by Obama for the people being dropped from coverage would be to allow their “subpar” plans to be grandfathered as well. So, these plans were in risk of being dropped if they were purchased after March of 2010. We know that the ACA was about reform not radical solutions to the profit driven health care system in America.  A single payer plan—similar to many other industrialized countries, where health care is sponsored by the state—was never on the table. Even a token “government-run option” on the insurance exchange was dismissed out of hand early on in the congressional debate. The ACA law was created to increase the profits of the private insurers and many of its costs are shifted to working families and the poor. Even the least expensive Bronze plans may offer the “essential” services, but they carry the highest out-of-pocket costs, and limit choices of doctors and hospitals. Most folks will not have access to the website until the end of November. So, the ACA will give many humans health care, but not all. It was a watered down law that is not single payer health care. Single payer health care is superior to the ACA.


The wealth and technology does exist now that we can provide affordable, universal, and quality health care to every American.

By Timothy