Health Care Reform as I Understand It

With everyone so eager to share their opinion on the historic health care bill that just passed, I figured I’d throw my two cents into the ring. Rather than provide you with an opinion on how I think this is going to play out, I’m simply going to lay out the provisions of this bill (as best as I understand them from a survey of articles that range from The New York Times to Fox News to Feministing.) I couldn’t resist throwing in a little opinion though… which is why the provisions are categorized into Good, Bad, and Questionable. I hope this helps make this whole debate just a little bit more comprehensible.

– The Good:
Most awesomely, this bill will expand insurance coverage to thirty-two million uninsured Americans. This will be accomplished, in part, through insurance exchanges. These exchanges would allow small business owners, and uninsured individuals to buy insurance through state-based exchanges that include subsidies for people who make from 100 to 400 percent of the federal poverty level.

The bill also puts strict regulations in place that will (hopefully) ban insurance companies from charging higher premiums or even denying coverage of people with preexisting conditions, as well as ban companies from charging higher premiums for women. It would also require insurance companies to provide maternity care.

This bill will also expand Medicaid so that people who make up to 133 percent of the federal poverty level will be covered, and close the Medicare “donut hole” which is a costly gap that vastly pumps up the price of prescription drug coverage for senior citizens.

The bill will allow parent’s insurance to cover their children through the age of twenty-six.

– The Questionable:
With a few exceptions, this bill would require all U.S. citizens to purchase insurance or pay a $695 annual fine, and require businesses with fifty plus employees to provide them with insurance or pay a two-thousand dollar fine per employee every year if any employee receives federal subsidies for purchasing insurance. (However, the employer mandate has been removed by the Senate.)

– The Bad:
Essentially, women’s health was thrown under the bus in order to pass this bill. Obama’s executive order that all abortion funds must be kept separate from any federal funds used in supplying health insurance will essentially cause all insurance companies to drop abortion coverage altogether; the alternative for the companies (maintaining records that separate out special ‘abortion funds’ from money that the policy-holder pays directly without government aid) is a record-keeping logistical nightmare.

This article
by Jon Walker says it best:

“The system of exchanges and affordability tax credits could easily be modified to ensure federal funds are not used to pay for abortions, while still not taking away the ability of women and small businesses to buy insurance packages that cover abortion. Having an individual mandate that forces women to buy insurance, but also a law that prevents them from getting insurance that covers a legal medical procedure, is a disgusting abuse of women’s rights.”

The other major fail in this bill concerns immigration. This bill as it stands would not allow undocumented immigrants to buy insurance on soon to be established exchanges, even if they are willing to pay the full cost out of pocket, with no government aid. Not only is this policy cruel, it also makes no sense fiscally. Walker explains it well:

“The more undocumented immigrants that pay for their own health care, the more taxpayers save by not being forced to pick up the cost of undocumented immigrants’ uncompensated care when they use the emergency rooms.”

[UPDATE] The bill also re-instates funding for the failed abstinence-only education initiative that is commonly referred to as Title V. The reputable studies out there all point to comprehensive sex education (that includes discussions about celibacy) is the most effective way to prevent pregnancy and the spread of STIs. Abstinence only does not work – it does not stop teenagers from having sex, and when they do have sex students who have only received abstinence education tend to use less (if any) protection. Again, I understand compromises have to be made but really now? Between the abortion strike-down and this you’d think our government wants more women to become dis-empowered mothers-without-a-choice*. That is not okay with me.

What Comes Next? Recognizing that, for the most part, this was a big step in the right direction is integral; but that’s all it is, a step. Now its time to bring the focus squarely onto reproductive rights (including access to safe, legal abortions for people of all income levels) and push to get some pro-choice legislature through as soon as possible. Another push to make it so illegal immigrants can purchase insurance will hopefully happen as well, since denying them coverage, even when they can afford it, is detrimental to both the health of our country and the health of the people we are refusing to cover.

Crossposted @ Amplify.

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* I am not implying that anyone is dis-empowered because they are a mother. What I am saying is that being forced to choose motherhood (because you were not given the information to prevent pregnancy, nor did you have access to a means of ending your pregnancy)  is dis-empowering. Shouldn’t we be working towards a country where every child is wanted and every parent wants to be one?

2 thoughts on “Health Care Reform as I Understand It

  1. I agree with you in principle, but there was no way in hell this was going to pass unless the Stupak crowd got what they wanted. Hopefully, this can be modified in the future.
    But as to women’s health, it makes it illegal to charge women higher rates than men, removes spousal abuse from the category of pre-existing conditions, and biggest of all, it gives the millions of women who don’t have health-care the opportunity to get it.
    I know it’s far from perfect, but as you say, it’s a step in the right direction.

  2. Believe me, I know. That’s why I am happy that this passed as is, because it is a great step, but I am also sad that Reproductive Rights had to get thrown under the bus in order for it to pass.

    It made a few HUGE steps forward for women, but it also made huge steps back. I think it’s really important to be able to recognize both of those things – as you did – and keep from getting complacent about the bad, while still praising the good.

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