The case for single payer – Medicare for All
By Jeoffry B. Gordon, M.D., M.P.H.
December 3, 2014
The Patient Protection and Affordable Care Act (ACA) has as its main and overriding purpose the expansion and subsidization of health insurance coverage for many (usually poor and uninsured) Americans who were previously unable to reliably access medical services. Under its auspices, the federal law has provided for health insurance enrollment for 1 million to 3 million additional 19- to 26-year-olds; 6 million new, expanded Medicaid enrollees; and 7.2 million commercial Qualified Health Plan enrollees. Of the latter, about 80 percent qualify for financial subsidy. Taking into account additional factors, e.g. the fact that some of the new enrollees were previously insured, there has been a net gain of about 10 million people who have coverage. Yet even at full expansion, it is estimated that the ACA will not insure another 30 million U.S. residents.
In the 2014 midterm elections, opposition to the Affordable Care Act — i.e., Obamacare — was a clear political winner. That’s obvious from the election results themselves but also from polling that consistently finds that far more of the electorate disapproves of the law than approves of it.
“The holiday shopping season kicks off tomorrow with Black Friday, the annual mad-dash for good deals and early-morning sales. This year, shoppers in a few states will see something new this year at shopping malls–and its not exactly a hot new store. It’s…Obamacare.
In an effort to boost floundering enrollment numbers, the Department of Health and Human Services has taken to partnering with retail stores, pharmacies and websites to promote the open enrollment period, which lasts until Feb. 15. Enrollment workers will be present on Black Friday, Small Business Saturday, and Cyber Monday to tell shoppers about how to sign up for a plan on the exchange.”
“Illegal immigrants protected from deportation under President Obama’s executive action will be eligible for Medicare and other benefits once they enter the federal system.
The sweeping White House announcement last week means that up to 5 million people will be considered lawfully present in the United States despite having entered the country illegally.
This status makes them eligible for programs such as Medicare and Social Security if they work and submit payroll taxes that flow to those programs. This fact was noted Tuesday in a report by The Washington Post.”
“As employers try to minimize expenses under the health law, the Obama administration has warned them against paying high-cost workers to leave the company medical plan and buy coverage elsewhere.
Such a move would unlawfully discriminate against employees based on their health status, three federal agencies said in a bulletin issued this month.”
“Just days before the health law’s marketplaces reopened, nearly a quarter of uninsured said they expect to remain without coverage because they did not think it would be affordable, according to a poll released Friday.
That was by far the most common reason given by people who expect to stay uninsured next year, according to the latest tracking poll by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) Forty-one percent of individuals without health insurance said they expected they would remain uninsured, while about half said they plan to get coverage in the coming months.”
“Self-avowed liberal law professor Jonathan Turley is representing the House GOP in its lawsuit against President Barack Obama’s implementation of Obamacare and at least one House Democrat wants him punished for it
Turley, a George Washington University law professor, is also a frequent media commentator on political issues. Despite describing himself as a political liberal, he’s long been harshly critical of Obama’s use of executive power and said he’d jumped at the chance to represent the House GOP in the lawsuit against unilateral changes to the Affordable Care Act in its implementation.”
“The implementation of the Affordable Care Act seems like an unending nightmare. Desperate for some good news, the White House is justly relieved and celebrating the fact that the government website is not plagued with last year’s disasters.
But other big challenges loom, including the administration of the law’s hideously complex insurance subsidy system, as well as coverage and cost problems.”
“Former Health and Human Services secretary Kathleen Sebelius, who infamously presided over HealthCare.gov’s flop, swore Monday that her administration was “forthright with the American public” about Obamacare.
“We were very forthright with the American public — I think members of Congress who wrote this legislation were very forthright,” Sebelius said on CNN’s “New Day.” “It was both about — having affordable coverage was certainly a piece of it, but also people getting coverage they didn’t have.””
“The latest Kaiser Health Tracking Poll finds that just prior to the Affordable Care Act (ACA) open enrollment beginning this past Saturday, the uninsured remained largely unaware of its start, although about half of the uninsured expect to get health insurance in the next few months and seven in ten say that health insurance is something they need. Opinion on the law remains similar to past months – 46 percent say they have an unfavorable view of the law and 37 percent say they have a favorable view. Americans are divided as to what Congress should do next on the law – 29 percent say they support repealing the law entirely, 17 percent say they support scaling back what the law does, 20 percent support moving ahead with the law as is, and 22 percent feel that the law should be expanded. But like opinion on the law overall, partisans fall on opposite ends of the spectrum. The public has no expectation that debate on the ACA will die down soon; a finding that Democrats and Republicans agree on. Most say that now that the midterm elections are over the amount of partisan debate will increase or stay about the same. Finally, on the heels of the midterm elections, few voters (9 percent) named health care as one of the two most important factors in their vote, ranking 5th behind partisan control of Congress (27 percent), a candidate’s platform (18 percent), the economy and jobs (17 percent), dissatisfaction with government (16 percent) and similar to a candidate’s personal characteristics (9 percent).”