So what is next?
What should one do in the next sixty five days or so?
There are three immediate health care things that I can think of that will be relevant to do soon.
First, if you are eligible for an ACA plan or Medicaid today, sign up now. We know from 2017 that the first executive order signed was to substantially reduce outreach and availability of ACA plans. We know that this led to a substantial (25-30%) decrease in average applications submitted per county immediately after the inauguration of Trump than before during the Obama administration. We can anticipate a substantial increase in administrative burden to prove “deservingness” and eligibility on January 21st. So if you are eligible, sign up NOW. Get the contract signed and initiated for January 1 coverage.
Second, if you are at all thinking about reproductive health care for you, your partner(s) or other people in your life, get what you can get done now. If you want an IUD or other LARC, go get it. If you think that Plan B is part of your package of reproductive autonomy, go order a few extra packages as it is shelf stable for most of a Trump term. We know that there are large natalist factions in the GOP and the plain logic of Dobbs indicates that Griswold is not safe.
Third, if you have medications or other medical consumable goods that have substantial foreign components in them, see if you can stockpile or extend your script to a longer prescription in December. If we are to see 20-30-40-50-100% tariffs the entire supply chain is going to be an omni-shambles. Extending a 30 day scrip to 90 days might let you skip the initial ombi-shambling implementation and give you until March until you need to figure out what to do next.
I’m thinking about a lot more things, especially on the home health workforce angle, but these are three concrete steps to do NOW.
Nukular Biskits
David, if you haven’t already, strongly suggest you post each of these suggestions on social media.
v/r
David Anderson
Just put it up on Bluesky — I am in the process of nuking my Twitter presence once I get my data downloaded.
Rose Judson
Thanks for this, David – sharing it with the family back home.
randy khan
A friend of mine who works in foreign trade has suggested that Trump is going to face enormous pressure from traditional Republican interests (notably agriculture) not to impose the tariffs. But I am skeptical that he will pay any attention. And this same friend says he basically has the discretion to do it on his own, so there are no guardrails to prevent it.
sab
David,
Thanks for the practical, doable advice on such short notice.
Rileys Enabler
Good morning, and thanks for your work on this. Question: my 24 year old step daughter and 20 year old son are on my (corp) insurance. Do you think they will try to nullify the “keep kids on until 26”?
David Anderson
@Rileys Enabler: That would require legislation
That is not a January 21st problem.
Ned F
In about 45 minutes I will finally get a visit from the weatherization people to have insulation installed throughout my home. I applied to Delaware assistance back in April as soon as I finished my taxes for the income requirements. The program is financed by the Inflation Reduction Act, actually a climate program, which I am sure the incoming fools will eliminate so they can provide taxbreaks to their rich donors.
The program offers federal help to pay for heating and cooling uprades, insulation, heat pumps and solar. I qualify for all free as I’m in that income group, not totally poor, but low to moderate. Obviously, I am really pissed that this program will surely end before I and others can finish what swe worked hard to get.
JMG
Question: How is it possible to determine if prescription drugs have a significant foreign component? I have no idea what’s inside my blood pressure meds except generally how they work. If the answer is something simple like google it I apologize in advance.
gene108
@JMG:
Check with your pharmacy where they source their generics from. Is it made in the U.S. or a foreign country?
Depending on how common the drug is the pharmacy should be able to change suppliers, if tariffs are an issue.
@JMG:
What terrifies me about Republican economic thinking is a lot of them are opposed to energy efficient appliances, energy saving upgrades to a home like you are doing, and want consumers to stick the out dated technology.
The end result is going to be other countries will be ahead of where the U.S. is in consumer goods manufacturing and when it becomes crystal clear to enough people the U.S. isn’t close to being #1, Republicans are going to look for people people to blame because they can never admit a mistake.
No Nym
David, how do you see Medicare and Medicaid funding being affected by Trump Unleashed?
Sister Machine Gun of Quiet Harmony
A common flaw in intelligent, educated people (like myself) is arrogance. It is arrogant to be definite about knowing the future. We don’t ultimately know all of what he’s going to do, we just know most of what he says he’d do is really bad. We also know he has a lifetime of abusing power and being corrupt. Trump will likely do some of what he promised and loudly claim (despite abundant evidence) he never promised the rest as he has in the past. He feeds off the adoration of others and if his proposals are unpopular enough that his fans start booing, it is likely he will reverse course as he has in the past. He will then will probably loudly blame his failed efforts on others as he has in the past. He has no core values. Most of what he promises and says are lies. It is arrogant to assume he will fail and people will realize we were right all along. Let that go. We can’t just sit back and wait for the people to FO. They may never understand it was Trump that caused their misery. We have to be clear eyed. We have to be ready for anything. We have to protect ourselves, protect each other, and figure out how to change our warped culture into one that rewards kindness and expertise instead of spite and ignorance.
Ohio Mom
We were really looking forward to that $2,000 cap on drug purchases for people on Medicare. And idea David how that might shake out?
We had vague plans to replace the washer and dryer. Well, we know they have to be replaced, we were putting off thinking about the sequence of basement renovations. But with the threat of tariffs, time to get started comparison shopping.
I think about all the people like us, fast-tracking purchases because we are worried about price hikes, whether through inflation or tariffs or some combination of, and of course, December’s holiday shopping.
There’s going to be lots of money churning theough the economy until January. Ha, the numbers might start looking bad right away for Trump.
Nelle
@Ohio Mom: We came to the same conclusion about replacing aging appliances.
We’re still thinking about how much money to move to our bank in New Zealand. If our son decides to go back (he has permanent residency,), then we’ll return.
Ramalama
I have an American friend who lives in Mexico but has been generally a pilgrim of the world. Works sometimes in the US before heading down south. Last year he was in India for a month or two (it’s cheap to be there!) when his boyfriend learned he needed cancer meds, costing something obviously insane. I don’t recall if it’s $40,000 or $400,000. Anyway, my friend got the script from the boyfriend who is in Mexico, and scored the meds for something like $900. Travelled back first to the US and then to Mexico with the meds. I think by flying in. I don’t think he had any problems with customs/meds. He is not rich, looks scruffy because he’s super poor but is a white American.
He’s going back again to India for another year’s reup (costing more this year at $4000 but still cheaper)…and I wonder if doing something this would be a good idea for people and expensive meds with the Republicans coming in? I hear of medical tourism, but my friend is the only one I know who has done this.
Any thoughts about this? I kind of want to reach out to my friend and see if he would be willing to do the same for other people (people we know personally), and he gets a couple hundred dollars for doing it, supplementing his meager earnings, while also helping people out.
Eunicecycle
@Ohio Mom: which he will of course blame on Biden!
beckya57
David, thanks for the practical advice.
Chris Johnson
@Ohio Mom: One thing about appliances? The right wingers are always screaming in terror about robbers and gangs and monsters invading their homes and stealing their shit etc etc etc.
As the actions they’ve put into play, harm people increasingly hard, there’s likely to be things like that happening to people. I know some of my work is towards being able to replace my prized musical instruments with virtual, downloadable ones so if I’m harmed in that way I’m not rendered helpless, can still create.
But nobody breaks your window and runs off with your FRIDGE. I burned a bunch of cash on a heat pump water heater, replacing an old dying one with a new one at least three times the value. Nobody is stealing THAT. I’m getting my house painted at last. Maybe that will attract burglars thinking I didn’t just blow my life savings on it. If so they may steal guitars but they ain’t stealing the paint.
Anyone in a house situation has things they can do that are proof against bad times because they’re infrastructure. I’m going to have a lot of solid infrastructure, and hope that the fun stuff I also have doesn’t get taken from me.
And of course the stuff I can give, that can’t get taken at all, and nobody can stop me. I had a down coat and comforter that I replaced because I decided I was a bit allergic (and the woman I was dating, was). So they were in my basement in plastic bags. This next Sunday they’re going to my 12-step meeting, ‘cos there’s a kid who’s struggling and he was already hating the cold and I can literally give him warmth (assuming the other guys don’t simply rip him off, but I’ll have tried).
Working water heaters, clothes washers, are immune to currency crashes. If you can power ’em, there’s the value right there. I like that :)
(the heat pump water heater also saves on bills, which could become a big deal in some circumstances)
Ohio Mom
@Chris Johnson: Your comment reminds me of a family story. My uncle owned a small furniture store in Queens, NYC. Mostly he sold mattresses.
One day (my memory is this was sometime in the late 70’s-early 80’s), two fellows came in with guns to rob him. Much to their dismay, they soon figured out that mattresses are not a cash-and-carry business.
My uncle had around $20 in his wallet, that’s all they got, plus his old calculator which couldn’t have been worth anything. He was tied up and later discovered by his friend, the shopkeeper next door who owned a Mailboxes Etc. franchise.
When my uncle got to the police station, they were all ready to file a report until they heard only $20 were involved. Wasn’t enough money to make a strong enough case, they bide him adieu.
Growing up in NYC gave me a broad perspective on life.
KatKapCC
Regarding Plan B: Note that it is less effective for people at a heavier weight. I’ve seen 155 and 170 as the data points, but also a BMI above 30, which seems like the more accurate measurement, since 155 is going to be very different on a person who is 5’0″ and a person who is 5’7″.
Kayla Rudbek
I’m on a medication that’s either from Germany or the UK depending on what supplier Caremark CVS goes with. Fortunately my doctor writes the subscription for 90 days and I can miss up to a week without running into medical issues. And I should buy some Plan B while it’s still available.
WV Blondie
David, you’ve been immensely helpful in the past, and I’m in a dilemma. My spousal unit and I moved to a different state in July. He’s got ongoing health issues, so we went through all the hassles of changing his insurance coverage outside the open enrollment period; we didn’t want to take a chance on his health taking a turn, and we wanted a local PCP to handle his numerous prescriptions. I, OTOH, enjoy (for now) much better health; for instance, I take one blood pressure med and a statin, but that’s it.
My biggest issue about changing plans is the physician network – I don’t have a doctor here yet, but I’ve encountered problems elsewhere in years past where the physicians “in-network” aren’t taking new patients. How can I learn more about the networks so I can make a more informed decision? So far I don’t need specialists (my current, soon-to-be-former, PCP was great about keeping track of mammograms, GYN exams, etc., to make sure I scheduled them).
Mark von Wisco
As a survivor of thyroid cancer, my daily dose of levothyroxine is an absolute necessity. I’m also on losartin for hypertension (thanks Dad!). The manufacturer of my levothyroxine has plants in both the US and India. The manufacturer of the losartin is in India.
Your thoughts? @David Anderson
Fake Irishman
@Ohio Mom:
you can also get a tax credit for energy efficient appliances under the IRA
sab
@sab: Checking on it, apparently everything I am taking is manufactured either in China or India, or both.