A few weeks ago in comments, I was asked if the United States would ever have universal or at least near universal coverage. My response was that we already have it; it is just very unevenly distributed. Massachusetts and Hawaii have 96% to 97% coverage rates at any one time. We have a variety of means and programs and pathways to get to near universal coverage and we have proof of concept in several states. Conversely, Texas has an 18% uninsurance rate.
This is not a problem amenable to modest technocratic tinkering. It is a fundamentally a give a damn problem that once a damn is given, there are numerous technocratic pathways to solving the problem.
This is even more readily apparant in a new paper by Dr. Jamie Daw et al in JAMA Health Forum. They examine the variation in post-partum uninsurance rates for women who gave birth while covered by Medicaid. Medicaid pays for a large plurality of all births in the United States and its coverage rules allow for women with higher incomes than legacy Medicaid. Pregnancy Medicaid goes for sixty days post-birth at which point the woman has to be redetermined into either another category of eligibility for Medicaid or is disenrolled from Medicaid. The American Rescue Plan allows states to file a state plan amendment to extend the sixty days of post-partum eligibility at standard federal cost reimbursement to one year; many states either have or are looking to take up that option.
But there was one line that leaped out at me in this article:
This is fundamentally a give a damn problem.
Barbara
Right. And it always has been. I remember becoming seriously annoyed by a prior post about some of your colleagues whose mission was to prohibit the inclusion of those between ages 21 and 26 from being counted as dependents under their parents’ health plan. Basically, it amounted to technocratic tinkering around the edges, trying to “solve” one problem by exposing yet more people to the risk of uninsurance. Which risk will never go away so long as certain classes of people think that it will only hurt someone else they don’t care about. I get that it’s frustrating not to be able to address that problem through sound policy, but it’s foolish and cruel to act as if that isn’t the main problem.
Matt
@Barbara:
TBH we’d be significantly better off if the people making these policies were simply ignoring the damage, instead of REJOICING in it.
Cutting off postpartum care is entirely on-brand for the “life begins at conception and we DGAF about it after delivery” crowd, who think suffering after childbirth is a Divinely Ordained punishment for fucking (and taking the apple).
Mudbrush
Do all the folks with $3000 deductible ACA plans count as “fully insured?”
VOR
That’s an astonishing difference in coverage.
I always thought universal healthcare in America would come from the Right wing. Corporations would get tired of paying for employee coverage and find a way to push the cost and responsibility off on the government. Instead Corporations just outsource to contractors who are on their own for health insurance or move the jobs overseas.
sab
John Oliver this last week interviewed a bunch of billionaires who thought the average price of a house in NYC outer boroughs was under $100,000. Houses in Akron, Ohio sell for more than that.
So some of these captains of industry aren’t unfeeling monsters. They are just more ignorant than my pet goldfish. So, since they are so ignorant, why do their companies pay them so much?