Ahead of next week’s Supreme Court decision on the Affordable Care Act, it’s important to remember the legislation is providing benefits and help to people right now, and billions of dollars in coverage expansions and aid to providers is already being used. If SCOTUS strikes the law down, all of that could instantly go away in places like Peekskill, NY.
In this small city about an hour from Manhattan, pregnant teenagers, laid-off professionals and day laborers without insurance receive care at a community health center that has been part of the social fabric here for nearly four decades.
Because of the sweeping federal health care law passed two years ago, the center, part of the Hudson River HealthCare network, received a $4.5 million grant last month to expand. It plans to add six more medical and seven more dental exam rooms, allowing it to see as many as 5,000 additional patients, many of whom are without insurance, on Medicaid or have limited coverage. An additional 730 community centers or so like it are to be renovated or built across the country in the next two years for patients like that.
Unless the Supreme Court says otherwise.
And you’d better believe Republicans will take health care away from millions to give tax cuts to Mitt Romney and his friends.
Critics of the law, particularly Congressional Republicans, argue that much of the spending already allocated and authorized is wasteful. They have been particularly concerned over the Prevention and Public Health Fund, whose funds have already been cut by a third as lawmakers sought to find money for other programs.
“Instead of helping Americans prevent health problems, the president’s new law actually uses this so-called prevention fund as a Washington slush fund,” Senator John Barrasso, a Republican from Wyoming, said last month.
Barrasso is calling the Hudson River HealthCare network liars and a slush fund. Of course, he gets free health care being a Senator. Do you?
As a result, people like Linda Ellis, 64, are now insured. Ms. Ellis could not find a private insurance company to cover her when she lost her employer-sponsored plan after being laid off. Her husband is already enrolled in the federal Medicare program, so she had to try to find coverage on her own. She was not eligible for the state Medicaid program. Because of a shoulder condition and minor ailments like sinusitis, no one would offer her a policy when she scrambled to find coverage.
“People don’t realize you can get rejected in the private market even if it’s not life-threatening,” said Ms. Ellis, who now pays $428 a month for insurance from a federally financed state program in Ohio. Ms. Ellis had contacted Families USA, a consumer advocacy group that provided her contact information to The New York Times.
But Ms. Ellis said she had no idea whether she would continue to be covered if the Supreme Court declared the entire law unconstitutional. When she asked the office of her United States senator, she was told no one could say, and federal officials declined to comment on what might happen to any program now financed under the law. “Obviously I’m concerned,” she said.
She should be. Five guys with free health care for the rest of their lives could take affordable health coverage from people like Linda here as early as Monday. Folks, the Affordable Care Act is doing good things now and I damn well bet it’s doing good things for some of the people who are reading this right now. I know personally my stake in seeing the Affordable Care Act stay in place is pretty huge, because I work in medical IT, much of which got a major boost from the legislation. The electronic medical records and accuracy/accountability/compliance standards part of the ACA for clinic networks like the one in Peekskill? That’s literally my job and my livelihood right now.
All that could vanish next week. Doesn’t that bother anyone?
c u n d gulag
No, it shouldn’t bother anyone who’s wealthy, healthy, and immortal.
Unfortunately, some wealthy amoral and immoral people are determined to increase other people’s mortality.
And all for their own, and their cronies, fun, power, and profits.
To paraphrase the great Charles Pierce – “This is your America, folks. Cherish it.”
Me?
If I could get a job outside of this soon-to-be Theocratic Fascist Banana Republic, or afford to leave on my own, I’d get out in a feckin’ nano-second.
NotMax
Congress has access to a variety of health care insurance plans, many of which are tippy-top drawer indeed.
But free? Not yet, anyway.
Salaries and Benefits of US Congress Members
Lawmakers get ‘generous’ health plans
Health Care for Members of Congress
Mike Goetz
I think what will happen is that literally only the mandate will be struck down; everything else, including the penalty for not buying insurance, will remain. So it will go from “You must buy insurance, and here is your penalty if you don’t.” to “You can either buy insurance, or you can pay the penalty – your call.”
It will work exactly the same, except without the mandatory language. Kennedy gets to scratch his libertarian philosophical itch, without causing utter chaos.
I’ll bet the delay in the opinion is the Court working all this out, and I bet there are last minute switchers and re-writes going on right now.
Keith
Uhh, yeah, it probably bothers 95% of the people who read this site. You’re preaching to the choir.
Zandar
@Mike Goetz: Considering the rulings just this week, I’m not inclined to believe that SCOTUS is going to make such a narrow, surgical ruling when ERMAHGERD NOOKULER CHAIRNSAW is much more “fun”.
NotMax
@Mike Goetz
The ‘penalty’ is, for all intents and purposes, toothless and virtually uncollectible.
dp
Hey, they’re just calling balls and strikes. Of course, on some pitches, you have to call all the baserunners out and forfeit the occasional half-inning ….
Ash Can
Even though the headline on that NYT article only mentions the money involved (thanks, editor, you asshole), it’s good to see the benefits of the ACA getting exposure. The more people realize what’s at stake, the better.
Odie Hugh Manatee
While overturning part or all of it would bother me, I don’t think I will be surprised if they do so. I feel like I’m sitting in the cheap seats at the last show.
That show being The Rise and Fall of America.
The Supremes have the lead roles and the main cast is comprised of sellout politicians. When the show is all over, I hear that we get to kill each other.
The Final Second Amendment Solution.
superdestroyer
@Mike Goetz:
Under Affordable Care Act, insurance will no longer exist as insurance but as just a health care cost sharing and pre-payment program.
And there is nothing affordable about increasing benefits to people who will pay little or nothing for the care. The real future of healthcare is using the queue and the lack of access to lower cost as providers get out of the business and/or stop providing services.
When a program refuses to use a single actuarial, it should not be called insurance.
Ronzoni Rigatoni
@NotMax: I thought the Congerscritters shared the same health plans as us other Feds. Free? Nope. But relatively cheap and pretty good. BC/BS FEP (Federal Employee Program) family plan costs me $430/month. Co-pays and deductibles are a pain inna buttox, but doable. Given all the disasteropus medical problems we’ve had over the past 5 years, I’d say we got our money’s worth. And it’d be even cheaper for me after the divorce LOL
DW
@superdestroyer: Um, insurance is by definition a cost sharing program. You get a bunch of people to throw money into a pool for healthcare that they can draw on. The “winners” of the bet draw on the pool for major medical expenses. All insurance is a way of spreading out rare but large costs. And the ACA very explicitly was designed to make sure everyone could afford health care by making almost everyone part of the system. All universal health care systems do this one way or another.
Ron
@superdestroyer: Employer-sponsored health “insurance” already does what you are dooming and glooming about now. It works just fine. Unless, of course, you lose your job. Personally, I am disgusted at the idea that people are not able to get basic health care because they can’t afford to.
Ronzoni Rigatoni
Now I’m “undefined?” Well, shit!
Marcellus Shale, Public Dick
the only silver lining, or the hope that a vote can swing in favor of keeping ACA,if you’re cynical, is that romney is in deeper shit, and the republicans are in deeper shit, policy wise if they have health care reform suddenly thrown in to the mix for november.
i know horse racing isn’t living, but its something.
the republicans at least agree that something needs done, and have also argued themselves via ryancare vouchers into a huge abyss.
fwiw. and i know it doesn’t keep food on the table, or take care of anyone in the interim, while we start over, but it is something.
who knows, maybe a strong executive mandate for a robust public option can rise out of the ash heap. maybe this is the coattail issue that makes that possible.
lol
My gut says it’s upheld 6-3.
Scalia’s book smells a bit like someone who made an argument that no one other than Alito and Thomas listened to and is now trying to get out ahead of the decision to say “LISTEN TO MEEEE!”
lol
@Marcellus Shale, Public Dick:
Don’t kid yourself, we’ve already seen the Republican health care plan – it’s do nothing. That’s what they did during the Bush administration, why would you ever think they’ll address the problem in any meaningful way now?
Brian
We pay their salaries… shouldn’t we have to opt in to paying for their healthcare now? They are obviously political.
ericblair
@lol:
This is my guess as well, for what it’s worth. If Scalia was on the winning side, he’d wait until after the decision to release his book, so he could bask in the glory and feed the smiling crowds his pearls of wisdom.
Thanks to gooper neo-Leninism, every fucking thing is political now. I don’t know how we get out of this.
loretta
We could reiterate what a poor job the Obama administration did to sell the bill to the general public, or how dismal the job the Democratic congress did to promote the benefits to its constiuents, but as a professional with a dog in this fight, allow me to remind people of what is already in effect – especially the AARP bunch:
1. 50% of the cost of Rx are currently subsidized when a senior in Medicare Part D falls into the coverage gap (donut hole). Prior to 2010, a senior had to spend $4,000.00 out of pocket in order to recieve catastrophic coverage. Now, they spend half that. There are at least 5 million (over 10%) of Medicare beneficiaries that are helped by this new law.
2. All preventive care is no charge to Medicare beneficiaries – mammograms, colonoscopies, bone density screening, cancer screening, etc. About 25 services are now offered at no co-pay to seniors. That has saved them millions.
3. Currently, states are offering a high risk insurance pool for the under 65 group and it has been in effect for a year. This is a plan administered by a private company but offered through the state, taking almost everyone who was uninsured or had a pre-existing condition.
4. Medicaid progams stood to gain funds, thus all the private companies that stood to gain from the increase in Medicaid beneficiaries are hoping the ACA does not get overturned. Once the ACA went into effect, the insurance companies created a way to make money on it, and they are ready to roll.
I think the ACA will be upheld because the insurance companies actually want it more than they want to overturn it.
WereBear
Now is the perfect thread to urge everyone to get a hold of:
How We Do Harm: A Doctor Breaks Ranks About Being Sick in America
It’s by Dr. Otis Brawley, the chief medical and scientific officer of The American Cancer Society, and a practicing oncologist.
He tells one story about a woman who showed up with terminal breast cancer… and she was employed, with insurance.
BUT, her giant employer had a policy for employees at her level; any sick time had to be taken in day-long increments. With cancer treatments, she would have used up all that sick time, lost her job, and lost her ability to keep treating her illness, and her ability to feed her kids. Ten years ago, when she felt the lump, they were all small and vulnerable; now, the youngest is going to be graduation from high school. She literally made the choice to die to keep her kids fed and a roof over their head.
From a fiscal standpoint, it’s like this: they could have spent thirty grand to cure her several years ago. Now, they are spending three hundred thousand dollars to let her die.
From a humanitarian standpoint, it’s like this: this is so mind-bogglingly awful, and it’s been going on for so long. And yet, everyone who struggles with this somehow thinks two utterly wrong things, which is that it is only their problem, and that nothing can be done about it.
READ this book; I think it has vital information for anyone. You will never look at cancer treatment the same way again.
Punchy
@lol: Yes, but after the string of rulings this week, The 5 seem just going for broke, balls-out to gut everything progressive. Im expecting doom.
Craig
@NotMax: Thank you, NotMax. It’s fun to beat up on legislators, but we should remember that they are public sector employees. They don’t get anything “for free,” any more than you do when you go to work. You may think any particular Senator is the greatest assclown in human history, but the fact remains that he or she was hired by the public to do a job. Senators get a paycheck and insurance from their employer, the American people. They also get a desk and a telephone. WHY DO SENATORS GET FREE OFFICES AND PHONES WHEN YOU AND I DON’T? Because being a citizen of a republic and being an employee of the government are two separate things.
Legislators have used their powers unfairly from time to time to give themselves perks and exemptions that don’t apply to anyone else. This isn’t one of those cases. They have pretty much the same insurance options as your local National Park ranger or food safety inspector.
beltane
@ericblair: Neo-Leninism is right. These people owe their sole loyalty and allegiance to the Republican Party and not to the United States of America, which is the mere canvas upon which the goals of the Party are to be painted. When you hear teabaggers snarl about people who are not “Real Americans” all they are really saying is “Not a member of the Glorious Republican Revolution”.
Andrew Sullivan referred to the wrong group of Americans in his little 5th column screed it would seem. We do have a dangerous anti-American element in this country but it exists on the Right, not the Left.
beltane
@WereBear: But you know there are millions of “nice” people, with well-kept lawns, pretty children, and a perfect record of church attendance who will say it’s this woman’s fault for not being in the ranks of management where she could use her sick leave as she saw fit.
The reason we have a rotten health care system in this country is that we as a country mostly subscribe to a truly rotten, vicious, and ultimately self-destructive set of values.
Keith
@ericblair: I think both of you are WAY too optimistic. If it feels like it will fall, it is going to fall. 4-5.
ET
Sadly there are a lot of people that are going to get hit and only then will people pay attention to what good was being done. If this law is struck down I can’t wait for all the stories to start hitting the papers/news outlets.
Americans only seem to learn after the fact. A large part of the argument has been theoretical up to this point and many Americans who have been or could be helped by the law have been convinced Obamacare is the WORST THING THAT HAS EVER HAPPENED TO THE UNITED STATES OF AMERICA AND IT IS GOING TO BE THE DEATH KNELL FOR AMERICA. Until they feel the negative consequences they won’t believe what anyone else says to the contrary.
Maude
@Keith:
You could read entrails and see what they tell you about the upcoming decision.
chopper
@dp:
and changing the size and shape of the strike zone whenever they feel like it. roberts forgot to mention that bit in his confirmation testimony? well, shit.
Scott S.
@Punchy: That’s what I’m thinking, too. They’re hopped up on Jolt Cola and Pixy Stix, and they’re gonna see if they can blow everything up as fast as they can.
I’m irritated that the media is so in-the-tank/apathetic that they won’t even comment on how radical the court really is…
WereBear
This is like our “official stance,” I agree. It can take a lot to make the sheep look up.
But I think we have reached that point now; the only reason it has gone on for so long is the corporate grip on what news reaches whose ears. There are literally so many sad stories like that woman I described that it is no longer news.
As humans, we don’t know what we’ve got ’til it’s gone. But President Obama gave so many people something that now, IF it goes away; it will get noticed.
The Republicans are digging their graves. It’s just going so damn slowly.
Punchy
@Scott S.: Well, that would be disrespectful. Cant criticize the Gods In Robes! Theyre judges, so beyond reproach, or so Im about to be told Monday by every RW radio fuck.
Interrobang
@WereBear: That’s horrible, and I say that as the adult daughter of someone who found a lump in her breast, ignored it for far too long because she didn’t want to find out that it was cancer, then got the lucky break that it hadn’t metastasised all over the place. My mom did chemo first (to shrink the tumour), mastectomy, and then radiation, which she finished on Tuesday. She was diagnosed in October.
Since I live in Soviet Canuckistan, the total cost of the treatment was the sum of the hospital’s exorbitant parking for outpatient stuff, plus the lost income my mom didn’t make from her usual seasonal job as a tax preparer. Fortunately, my dad is retired from a well-paying union job and has a pretty good pension. Note also, for those of you who’ve heard the line about Canadians waiting forever for healthcare, the time from diagnosis to completion of treatment was eight months. Consider too that they have to wait a month between chemo and surgery.
I get desperately angry about the US healthcare system killing, sickening, and maiming my friends (present company included for rhetorical purposes at least), because you could have it so much better…
sparky
@loretta:
I think the ACA will be upheld because the insurance companies actually want it more than they want to overturn it.
Omnes Omnibus
@sparky: Sometimes corporate and public interests are aligned. Each gets something different out of it, but, yeah, I think the ACA was designed to buy off the ins. companies to some extent.
Judas Escargot, Acerbic Prophet of the Mighty Potato God
@loretta:
Here in Massachusetts, the insurers have already announced that they’re not planning on changing anything currently in effect (such as the under-26 rule) even if the ACA is overturned in full.
Granted, this is MA and Romneycare won’t be affected (though I expect a host of nuisance lawsuits by the local cranks to start upon ACA overturn… thank you, Scalia)… but even in other states simple bureaucratic inertia will limit just how quickly they can adapt to the outcome.
loretta
@Judas Escargot, Acerbic Prophet of the Mighty Potato God:
United Health Care (one of the biggest providers in the country) also announced to its brokers via email that they would continue to create products and support the current ACA provisions even if it is overturned.
Actually, of all the big providers (Aetna, WellPoint [anthem], UHC, Humana), UHC has been the most amenable to the provisions from early on. Anthem/WellPoint fought like hell to keep the bill from passing and is still upset. WellPoint and Aetna flat out quit selling childrens’ individual policies when they were forced to take anyone. That was a PR mistake! They eventually caved, but would be happy to get out of it.
However, all the Medicare Advantage providers and PDP providers (all the above, plus a zillion others) want the ACA to be upheld.