“You’re Not Invincible”: Young Adults Can’t Afford To Tune Out Obamacare Insurance Requirement
Before passage of the Affordable Care Act, becoming an adult meant getting kicked to the curb when it came to health coverage.
“Our gift when people turned 19 was to take away their health insurance,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “Turn 19 and we kick them out.”
If you were in college, you could usually stay on your parents’ insurance until you turned 22. But until health-care reform came about, young adults who didn’t find jobs with health coverage or qualified for government insurance were often left uninsured and vulnerable to massive medical bills.
Now there’s a present awaiting young adults.
Thanks to the ACA, commonly referred to as Obamacare, you may now be able to get insurance or continue to be covered under a parent’s plan up to the age of 26. And this coverage is available even if you’re married, not living at home, attending school or are financially independent. Starting next year, young adults up to 26 can stay on their parents’ employer plan even if they have another offer of coverage through an employer.
The downside for some parents is that they might have to pay extra to keep young adult children covered. But at least they will have insurance.
And, in just a few weeks, a new marketplace will open at www.healthcare.gov, giving young adults, particularly those older than 26, another option for obtaining health insurance. Trust me, this is one shopping trip that you need to go on.
There is concern that not enough young healthy adults will buy insurance, which will help offset the cost of those who are older and sicker and will need a lot of health-care services. Some experts believe these concerns are overstated. They note that insurance plans in the new marketplace will cover a core set of benefits such as hospitalization, maternity and newborn care, mental health and substance-use disorder services, and prescription drugs.
With the help of trained personnel called navigators, insurance shoppers will be able to compare plans based on factors including price and benefits. They’ll also be able to determine if they qualify for subsidies to help pay for the coverage.
When you’re young and healthy, you may think you can put off getting insurance. Maybe money is tight and you figure this is something you can delay until you get older, like contributing to a retirement plan.
“Health insurance is something at the moment I feel I can’t afford,” said Josh Nece, 29, a restaurant server in Oakland, Calif.
Nece, who suffers from severe eczema, says with rent, transportation, student loan payments and other expenses, he couldn’t afford the cost of insurance on his own. But he needs insurance to help pay for the medication and doctor visits when his eczema breaks out. He says he often goes without treatment or medication because he can’t afford it.
He plans to check out the marketplace in his state. I’m going to follow up with him to see if he does.
“I’m pretty sure I’m going to get health insurance,” he says. “Going into my 30s, I know it’s one of the adult things I need to do.”
In June, Kaiser asked young adults whether they wanted and valued health insurance. The answer was a resounding yes, contrary to the conventional wisdom about young adults feeling they are invincible.
Still, for those who think they can wait, here’s something to ponder: A tumble off a skateboard could end up costing you $20,000, as it did for Pollitz’s 22-year-old son, who works part time in a day-care center.
“He hit a rock, and the skateboard slid under him,” she said. “He broke his wrist.”
Pollitz said the bill was a “teachable moment.” Thankfully, he was covered on his parents’ plan. Otherwise, “that would have been a financial catastrophe for him.”
It is stories like hers that make Pollitz passionate about getting out the word to young adults to get health insurance. Although most young adults already have coverage, more than 19 million lack basic health insurance. In 2011, 27.9 percent of Americans ages 19 to 25 were uninsured. About the same percentage in the 25-to-34 age bracket also didn’t have insurance, according to Kaiser.
Some young adults might not get health insurance because the penalty for not buying it isn’t stiff enough. If the government determines that you are in the financial position to pay for coverage and you don’t fall under an exemption, you’ll have to pay a penalty for being uninsured when you file your federal income tax. The penalty starts next year at $95 annually for an individual and can go up to $285 for a family, or 1 percent of a family’s household income, depending on which is higher.
I like to believe millennials are smart enough to recognize they can’t afford not to get health insurance. It’s a gift that can keep them not only healthy, but out of medical debt.
By: Michelle Singletary, Columnist, The Washington Post, September 13, 2013
“The Grand Case Against Obamacare”: The Republican Old, Stale, Non-Compeling, Non-Argument
You’d think with the resources he commands as de facto leader of the conservative movement at the Heritage Foundation, rightwing warhorse Jim DeMint would be able to come up with a fresh and compelling argument for why he wants to shut down the federal government and maybe risk a global economic meltdown in order to stop the implementation of a health reform law based largely on a blueprint first devised by his own think tank. But DeMint’s latest ukase on the subject for the Fox News site is as tired as an uninsured diabetic in South Carolina working two shifts at minimum wage.
I won’t quote DeMint directly, but his five big reasons for killing Obamacare are the usual woofers: it may force people in the individual market to change insurance policies (for better ones, with premium subsidies available for those of modest means); it may cause some consumers to choose between the policies and providers they want (just like private insurance policies today); the Medicaid expansion is a fraud because Medicaid’s worse than no insurance at all (tell that to the many millions receiving Medicaid now); Obamacare will slash and maybe kill Medicare (the usual confusion of cost reductions and provider cuts with benefit cuts); and of course, the whole thing will blow up budget deficits (not what the nonpartisan CBO says at all).
But what’s most remarkable is that DeMint doesn’t even mention the tens of millions of people with preexisting conditions who will obtain health insurance they just cannot get right now, and also cannot get under any GOP alternative (though DeMint doesn’t bother to mention any) known to mankind, at least since the GOP abandoned Stuart Butler’s plan hatched at Heritage.
I don’t know why DeMint and his wordsmiths even bother with such “persuasion” efforts, particularly for Fox News readers. Anyone buying his premises has already bought the conclusion.
By: Ed Kilgore, Contributing Writer, Washington MOnthly Politica Animal, September 10, 2013
“Working Together To Screw People Over”: The Republican Team Effort On Obamacare Obstruction
When it comes to the Affordable Care Act, you have to give Republicans credit for sheer sticktoitiveness. They tried to defeat the law, but it passed. They tried to get the Supreme Court to declare it unconstitutional, but that didn’t work. So now, as the open-enrollment period for the exchanges approaches on October 1, they’re thinking creatively to find new ways to sabotage the law. Sure, at this point that means screwing over people who need insurance, but sometimes there’s unavoidable collateral damage when you’re fighting a war.
Their latest target is the Obamacare “navigators.” Because not just the law but the insurance market itself can be pretty complicated, the ACA included money to train and support people whose job it would be to help people get through this new system, answering consumers’ questions and guiding them through the process. Grants have been given to hospitals, community groups, charities like the United Way, churches, and the like in the 34 states that are relying on the federal government to operate their exchanges in whole or in part. You can see the problem: If there are folks out there helping people get health coverage, that will mean that people will get health coverage. And that won’t do.
So Republicans are implementing a joint federal-state subversion campaign. On the federal level, Republicans on the House Energy and Commerce Committee have sent threatening letters to recipients of the navigator grants, demanding copious documentation on everything they’ve done having anything to do with the program (Jonathan Cohn explains here). Not because there’s been any suggestion of fraud or incompetence—don’t forget, at this point all the navigators have been doing is getting ready for open enrollment when they’ll have to start helping people—but on the apparent theory that if you can harass them enough, it’ll keep them from doing their jobs.
Meanwhile, on the state level, Republicans are finding whatever ways they can to get in the navigators’ way. Just get a load of this despicable toad: http://youtu.be/0fm-2J4F4v4
That’s Georgia Insurance Commissioner Ralph Hudgens, a former chemical company salesman and Republican state legislator, who I guess ran for insurance commissioner because he cares so much about people. He explains how when it comes to Obamacare, he’s doing “everything in our power to be an obstructionist.” He then explains, to the laughs and cheers of this Republican crowd, how a new law requires the navigators to get licensed by his department, with the clear implication that they’ll make it as difficult as possible.
In fact, 16 Republican-controlled states have passed laws imposing requirements on the navigators over and above what the federal government is already requiring. And guess who’s writing these laws? Lobbyists for insurance agents and brokers, who worry they’ll lose business if people can just call up a toll-free number and have somebody explain to them how to get insurance on their state’s exchange.
Remember, what they’re trying to do here is make it as hard as possible for people to get insurance. It’s as simple as that. The more people they can keep from getting insurance, in this case by keeping them from getting the information they need to buy insurance on the exchanges, the easier it will be for them to argue that the Affordable Care Act is a failure. And what about the human suffering that will cause if they’re successful? The diseases that go undiagnosed because people avoid going to the doctor, the uninsured families bankrupted when struck with an accident or illness? Too bad. Because screw you, Obama.
By: Paul Waldman, Contributing Editor, The American Prospect, September 4, 2013
“A Thuggish Abuse Of Power”: Republicans’ Devious Plan To Slow Down Obamacare Enrollment
Republican lawmakers who had criticized the Internal Revenue Service (IRS) for improperly targeting conservative nonprofits for additional scrutiny kicked off an investigation last week into community-based groups who received Navigator grants to help uninsured people enroll in the exchanges established by the Affordable Care Act, demanding that the organizations answer detailed questions and produce thousands of reams of documents.
Fifteen Republican members of the House Committee on Energy and Commerce, including Chairman Fred Upton (R-MI), are requesting detailed responses and thousands of pages of documents from approximately 60 percent of Navigator-recipients across the country by Sep. 13.
The tactic is reminiscent of the kind of practices Republicans had condemned over the summer, after news broke that the IRS subjected certain groups applying for 501 C4 nonprofit tax status to long, intrusive, questionnaires about their filings. Upton personally called such tactics a “thuggish abuse of power” and “simply un-American.”
But according to the GOP-backed letter, groups scrambling to begin enrolling individuals in coverage on Oct. 1, will have just two weeks to provide detailed written descriptions of their employees and activities, interactions with the Department of Health and Human Services, and “all documentation and communication related to your grant.”
Last month, the Obama administration distributed $67 million in federal grants to more than 100 hospitals, universities, Indian tribes, patient advocacy groups and local food banks “to help people sign up for coverage in new online health insurance marketplaces.”
The effort is just the latest attempt by Republicans to undermine enrollment in the Affordable Care Act. Republicans on the Energy and Commerce Committee have previously sent letters seeking information to entities tasked with educating the public about the law, opened investigations into public relations companies that had been contracted to promote the law on popular television shows, and warned the National Football League (NFL) and National Basketball Association (NBA) against encouraging enrollment in the law.
An HHS spokesperson strongly condemned the committee’s request to Politico, noting, “This is a blatant and shameful attempt to intimidate groups who will be working to inform Americans about their new health insurance options and help them enroll in coverage, just like Medicare counselors have been doing for years.”
By: Igor Volsky, Think Progress, September 3, 2013
“An Important Milestone”: In Michigan, A Defeat For The Tea Party And Victory For Common Sense
Obamacare took a big step forward on Tuesday night, when the Michigan Senate approved an expansion of the state’s Medicaid program. The state House is likely to back the same measure, as early as next week. And while the program requires a special federal waiver, the Obama Administration is likely to grant it. Assuming all of that happens, Michigan will become the twenty-fifth state to expand Medicaid as part of the Affordable Care Act. As a result, a few hundred thousand residents are likely to get insurance—and the state will get a much-appreciated infusion of federal funds, while putting up a much smaller share of state money.
For the advocates of making health insurance available to all Americans, it’s a huge victory. But the victory did not come easy—or without some last-minute drama.
Tuesday’s vote was the product of a long, sustained campaign by Democrats, moderate Republicans, progressive organizers and business leaders. For months, they have made the case for expansion—citing the likely financial and health benefits for Michigan’s uninsured citizens, and the expected boost to Michigan’s economy. The federal government is picking up most of the expansion’s costs, they have argued, and hospitals need the revenue to make up for money they lost on charity care and declining reimbursement from other sources.
Among those assessing the statistical impact were Marianne Udow-Phillips, director at the Center for Healthcare Research and Transformation and a lecturer at the University of Michigan School of Public Health. As she told me on Wednesday,
if you look at all the facts—the fact that the majority of physicians in the state are ready to serve this population; the positive impact on the state budget, on the state’s economy at large, on hospitals, on businesses, on all those who are currently insured (by reducing cost shifting) – not to mention the half a million people who will directly benefit by getting health insurance coverage in a program that has the highest satisfaction of any insurance coverage type in the state – you have to draw the conclusion that the Medicaid expansion is the right thing to do for the state.
Governor Rick Snyder and the state Chamber of Commerce have been among the strongest proponents of expansion. The state’s health care industry, naturally, has lobbied furiously. But Tea Party Republicans and their allies have been dead set againt it, arguing that Medicaid is a wasteful, expensive program that subsidizes the indolent—and that the size of the federal subsidies masked the true impact on the state, which would actually be negative.
Writing this week in the Detroit Free Press, Joseph G. Lehman and Clifford W. Taylor from the Mackinac Center for Public Policy warned that
The state’s main incentive to expand Medicaid is a federal promise to transfer to Michigan $2 billion (increasing to $3 billion) annually for three years if we add 320,000 Michiganders earning up to 138 percent of the poverty level to Medicaid rolls.
After three years our federal subsidy would shrink by $300 million per year, meaning either Michigan taxes increase by that much or lawmakers kick 320,000 people off Medicaid, which seems unlikely.
Expansion supporters have responded that, even after the reduction, the federal government would still be picking up 90 percent of the new cost. They have also tried to accommodate concerns about Medicaid efficiency, by, among other things, proposing that some Medicaid recipients pay a portion of their own costs. The compromises changed a few votes, and in June the state House approved its version of the expansion. But the Senate in June surprised everybody, including the governor, by rejecting the measure. One likely reason: Tea Party groups, and their financial backers, were threatening to support primary challenges to Republicans who voted yes.
The expansion’s supporters spent the remainder of the summer making their case, rallying the public, and lobbying individual members. As of Tuesday morning, they were confident they had 19 senators willing to vote yes. That would produce a tie in the 38-member chamber, with the lieutenant governor prepared to vote yes and break the tie. But when the Senate first voted in early afternoon, only 18 said yes. The chamber quickly voted to reconsider and, after a feverish few hours of lobbying and meeting, tried one more time. This time, the bill passed 20 to 18.
Progressives aren’t thrilled about some of the compromises, particularly those asking Medicaid recipients to pay a larger share of their costs. (Sarah Kliff has more of the details if you want them.) And it’s not out of the question that the federal government will raise objections, because the federal Medicaid law limits the ability of states to change the program. But given political resistance to any expansion, supporters are mostly elated at Tuesday’s outcome. “It’s not perfect, but it’s going to help nearly half a million Michiganders,” Amy Lynn Smith wrote at Electablog, a progressive website based in Michigan.
Michigan’s decision is an important milestone in the effort to make Medicaid available to all low-income Americans—an endeavor that has proven far more difficult than most experts anticipated. Last summer, when the Supreme Court made it easier for states to reject Obamacare’s planned expansion of Medicaid, many of us assumed the vast majority of states would participate anyway. The need for coverage was too great, and the allure of federal money too tempting, for even most Republicans to reject. Quite obviously we were wrong. Conservatives serving either as governor or state legislators have successfully blocked expansion across a wide swath of the country, including the huge states of Florida and Texas, where a few million people would be eligible.
But the Medicaid expansion has gotten support from several other Republican governors, including Jan Brewer in Arizona (where the expansion is already going forward) as well as Rick Scott in Florida and John Kasich in Ohio. Florida looks hopeless, at least for the time being, given the grip extreme conservatives have over the legislature. Ohio is another story: The politics there look a lot like the politics in Michigan. The same goes for Pennsylvania, although that state’s Republican governor, Tom Corbett, doesn’t yet support expansion.
Obamacare’s Medicaid component, in other words, is moving ahead. But progress is taking place in fits and starts, with frequent setbacks, thanks mostly to political opposition that’s strongest in the most conservative parts of the country.
Yeah, you should get used to that pattern.
By: Jonathan Cohn, Sebior Editor, The New Republic,
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