Turning Alternative Facts to Actual Facts

So - let's dig a bit further into the facts of the matter.  The actual facts, not the alternative facts that seem to be the new norm.  And I'll leave it at the top two that talked about the most  Just a reminder - I am not looking for an argument about healthcare for all, the single payer system, insurance companies are the devil, etc - I am reporting the FACTS and laws and how this system works currently.  If you want to change the delivery of the system, you will have the facts to go to your representatives, demand change and go out and vote that change in. 

Before I get started on this.  OBAMACARE IS THE ACA IS PPACA.  Got it?  ObamaCare is a nickname for the ACA.  Watch this link if you don't get this statement.  ObamaCare versus ACA  oh - and yeah, I'll have whatever that last kid is having.  


1. The ACA gets repealed and I lose my insurance because I have a pre-existing condition: Let's speak from the NY State point of view - as you can dig this out for each state on line. NYS has had pre-existing in place for a long time before the ACA came about.  Refer to N.Y. Ins Law 4318 (McKinney 2000) - as long as you have had coverage for the last 12 months without a break in coverage of over 63 days, you cannot be denied services for said condition.  And if you did not have coverage, after that 12 months, you would also be covered.  Yes - I know you are thinking, but why 12 months of coverage?  Looking at this as a risk pool, this law was to protect both the insured and the risk pool in the state.  To put it in different terms - let's say you got in an accident with your car on Monday and then on Thursday you bought a new policy and asked that insurance company to cover the accident on Monday.  What would they say?  They would say no, as they don't want to buy a claim, just like a health insurance company doesn't want to buy a claim.  This is the SAME reason there is a penalty in place under the ACA - we have to have EVERYONE insured in order to cover the most costly diseases and conditions.  Without full participation, you will have a market that people join when they are sick and leave when they are well and that market will collapse.

2. If the ACA is repealed, Medicare, Medicaid and Child Health Insurance Plans will disappear too:  So let's break this down a bit.  Medicare/Medicaid were signed into law by President Lyndon B. Johnson as amendments to the Social Security Act on July 30, 1965.  As a piece of interesting information, President Truman was the first US Citizen enrolled into Medicare as he was the President that started the search for an answer on healthcare for seniors (Medicare).  Now let's clarify what these programs are.  

Medicare: is a Federally Run Program that offers insurance based on paying into a program while you are working.  It is offered to citizens who have worked for at least 30 quarters who turn 65 or to folks who are permanently disabled under Social Security normally for 2 years.  Part A is your hospital coverage and is usually at no cost, if you paid those 30 quarters & Part B, your outpatient coverage, comes with a monthly premium.  Medications are not covered under original medicare, they are covered under the new program Medicare Part D - Prescription Drug Coverage - as part of the Medicare Modernization Act and signed into law by President George W. Bush on December 8, 2003.  

Medicaid: is a State run program that offers insurance to those based primarily on income level.  States are responsible for administering their own Medicaid programs, with the assistance of the federal government funding.  Under the ACA, states were encourged to expand their definition of household income to cover more folks under the Medicaid program as part of ACA reform.  Let's focus back on NY for a moment - this meant that under the ACA, NYS was able to expand the definition of income to 133% of the federal poverty level (FPL) (which is a whole other blog within itself) - but you can find the levels of poverty, as defined by our government here  Federal Poverty Levels

Child Health Insurance Plan: this program was a result of the failed attempt at healthcare reform program under the Clinton Administration.  It was sponsored by Senator Kennedy D-Massachusetts & Senator Hatch R-Utah. It was promoted and supported by Former Secretary of State Hillary Clinton (as First Lady) and was created in 1997.  Each state was given flexibility in its implementation of the program but they had guidelines they had to follow.

So - what does this all mean?  These programs were in place PRIOR to the ACA - the ACA did give states more ability to expand their medicaid programs.  But there were state and federal programs around for seniors, disadvantaged and disabled.  A repeal of the ACA doesn't necessarily mean these program go away.  Yes, we have law makers stating that Medicare should be privatized (in some instances one could argue there is a level of privatization now, if you look at some of the programs that are available through medicare advantage programs.)  And, there are numerous reports that Republican Governors are having meetings with the current administration, their representatives to urge them to be cautious and not repeal the Medicaid expansion.  The following states have adopted the Medicaid Expansion: Alaska; California; Colorado; Connecticut; Delaware; Washington DC; Hawaii; Illinois; Kentucky; Louisiana; Maryland; Massachusetts; Minnesota; Nevada; New Jersey; New Mexico; New York; North Dakota; Ohio; Oregon; Pennsylvania; Rhode Island; Vermont; Washington; West Virginia.  

Arizona/Arkansas/Indiana/Iowa/Michigan/Montana & New Hampshire did not approve the full expansion but did approve Section 1115 Waivers that allow states to test alternative approaches to expansion.  Only 19 states have no expansion or waivers at this time.   

Look at the states that have these programs in place under the ACA and approved them, they are not falling down a party line and this is not a blue red issue.  This is a really purple issue.