Look, I'm as thrilled as everyone that the House reached agreement on a health care reform plan that will ensure medical coverage for 96% of Americans. This is a milestone, and a landmark piece of legislation which will make it through voting process next week.
But, here's my concern. In the proposal, there are numerous references to employers, as well as what happens to those who lose their jobs, but what about those who are unemployed? What about the indigent? I'm not clear on whether the requirements for eligibility for Medicaid will change, or whether that will be left up to the states. Right now, in the state of California, one has to be eligible for welfare in order to get on Medicaid. Those who hover around the poverty line, the so-called working poor, are often ineligible for government programs like food stamps, and Medicaid. Will that change?
Also, this legislation sets up what is called an "exchange," or salad bar of health care options, but what happens to those who come to the table with an appetite, and not the wherewithal to pay? Indeed, they fall into the 4% who are uncovered, the chronically forgotten. 4% certainly sounds like a small enough number, but it works out to be something like 9 million people. When was the last time you made a turkey dinner for 9 million people? That's a lot of stuffing.
In the interest of fairness, just as the bill calls for 2.5% of annual income penalty for those who refuse to get coverage, income eligibility for Medicare must change so that the needs of more unemployed, and unemployed Americans are reflected.
The way the public option measure is worded is such that it comes across as part of the exchange, hence leading one to think that there may only be a marginal difference in cost between the so-called public option and an HMO like Kaiser.
And, what is an affordability "credit?" Is it like a tax credit for carrying insurance? If so, where does that leave the unemployed, and/or the underemployed? Also, what does the below clause mean?
"All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income, subject to a hardship exemption.
The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing."
Don't get me wrong. Given that approximately 41 million, or one in every nine Americans have no health insurance now, this plan is a first step, and a good one. But, it is every American's and every member of Congress's duty to read the fine print, and ask the hard questions now. After all, it took more than two hundred years to get this far, and it may take another two hundred to reform the reform.