publicidad
Vijay Das
Opinión

Vijay Das is a Washington-based writer and advocate. He’s written extensively on drug pricing, health care access and economic justice issues.

Here are two ways Republicans interested in governing can help working Americans access better health insurance

Here are two ways Republicans interested in governing can help working Americans access better health insurance

In states like Florida and Texas, over a million Latinos alone can't get good healthcare today. With Trumpcare crashing, it's time Republicans address Obamacare's coverage gaps by expanding Medicaid and fixing a drafting error that punishes low-income Latino families.

salud obamacare

The American Health Care Act’s demise is a car-wreck for House Speaker Paul Ryan and President Trump. President Trump promised to deliver a health care plan that expanded coverage to everybody. Instead, the Republican plan ripped it away from 24 million people.

Republicans are correct to say health insurance is still out of reach despite the passage of Obamacare. But they, and only they, can fix its glaring coverage gaps.

Millions of Americans cannot afford health insurance because Republicans have not cooperated with Democrats to fully implement and fix the law. Obamacare expanded Medicaid, a half century old means-tested public insurance program, to many more people. Republicans should pressure every governor to expand Medicaid eligibility. Furthermore, congressional Republicans should support legislation to close the ‘family glitch’, a coverage gap that makes private health insurance unaffordable for low-income families.

The Affordable Care Act expanded Medicaid eligibility to low-income adults earning less than 138 percent of the federal poverty line. In 2012 the U.S. Supreme Court ruled this provision as optional for states to comply. In 2020, states will have to kick in 10 percent of the costs to expand Medicaid. Until then, the federal government picks up the entire tab.

Nineteen states currently opt not to expand Medicaid eligibility. Too many of America’s home health aides, line cooks, waiters, and sales clerks are stuck in a rut. Because of partisan politics and anti-Obama sentiment, 2.6 million adults in predominately Republican-led states can’t afford health care because they earn too much to qualify for traditional Medicaid but not enough to obtain income-based tax subsidies Obamacare provides for individuals to buy a health plan off Obamacare’s state-run marketplace. These patients don’t get coverage through work.

publicidad

Governors are playing politics with the working poor's health. Worse, they are denying health benefits to millions of Medicaid eligible African American and Latino families living in the Deep South. Patients of color reel from poor health outcomes like higher rates of heart disease and infant mortality because of meager health insurance access.

Families currently in this Medicaid coverage gap cannot afford private coverage. It’s too burdensome. The Kaiser Family Foundation found that in 2016 the national average unsubsidized premium for a 40-year-old non-smoking individual buying coverage through the Obamacare Marketplace was between $250-$300 monthly for a basic health plan. That’s more than half of income for those at the lower income range of people in this gap and about a quarter of income for those at the higher income range of people in the gap. If poor people have to decide between insurance and goods like shelter, they understandably choose shelter and food. Uninsurance persists.

Republicans, a party that claims to celebrate economic growth, would be smart to expand Medicaid because of its economic benefits. The Robert Wood Johnson Foundation surveyed 11 states like California, Michigan and Kentucky and found that expansion resulted in less state spending for uninsured populations, more job growth, and reduced hospital uncompensated care costs for uninsured patients. Expanding Medicaid gives more workers access to comprehensive health insurance, a better chance to stay healthy and be productive.

publicidad

Congressional Republicans can immediately close another coverage gap, ‘the family glitch’ affecting 2.3 million low-income families. Under Obamacare if one family member has job-based insurance that’s deemed affordable by the government - costing less than 9.56 percent of the family’s income - then every member of that family is not eligible to qualify for government subsidies to help pay for insurance off Obamacare marketplace. The Internal Revenue Service’s (IRS) interpretation of an insurance subsidy eligibility can ignore the cost of insuring an entire family, which is much more expensive than individual-only coverage.

More than six million people are ineligible for subsidies because of the family glitch. Such families can face health plan premiums 1 6 percent of household income, 12 percent after factoring in tax advantages of obtaining health coverage on the job.

Republicans can re-introduce and support the Family Coverage Act, introduced by Sen. Al Franken (D-MN), to ensure all families have access to affordable coverage. The bill would amend the Internal Revenue Code to determine Obamacare subsidy eligibility based on the cost of family coverage and not of a worker in that family.

To be sure, there’s more to be done to address working families’ health care woes. The Affordable Care Act’s implementation is riddled with problems related to underinsurance. People are facing unaffordable monthly premiums, deductibles, copays, and provider out-of-network out-of-pocket costs. The Obamacare marketplaces are working well in many parts of the country yet not in others. Patients still can’t buy quality health insurance at a reasonable monthly price.

publicidad

Obamacare’s problems are complex, requiring cooperation from both parties in Washington to offer solutions. Indeed, with the collapse of the American Health Care Act, America can scrap its multi-payer inefficient health system and join the rest of the industrialized world to fully embrace universal health care, a single-payer Medicare-for-All system that shrinks the size of for-profit health insurance and guarantees health care a right for all.

Despite President Trump’s recent revelations of American health care being complicated, it's not difficult for Republicans to figure out what to do now that their health agenda failed. Republicans should lick their wounds and help the people that sent them to office get better health coverage. The Republican plan didn’t do that. With new approaches to America-first leadership, Republicans can make sure Obamacare’s unaffordability and coverage gaps close for good.

publicidad
Contenidos Relacionados
07 nov, 2017 | 01:10 PM
Puerto Rico Rises Up
publicidad
Latino millennials account for almost half the 27.3 million eligible Latino voters in this election. But Latino turn out is traditionally far lower than black and Anglo voters. J.P. Dominguez asks “when are we going to wake up?”
A study by the Institute on Taxation and Economic policy found that undocumented immigrants pay $11.64 billion a year in state and local taxes. The undocumented pay on average 8% of their income on taxes while the wealthiest 1% pay only 5.4%. J.P Dominguez says that's "trumped up."
During the first presidential debate, the candidates took a chance to bring up each others past mistakes to affect their performance.
After the "Taco trucks on every corner" comment from the co-founder of Latinos for Trump, part of his immigration past emerged. This is JP Domínguez's take on the issue.
Donald Trump's wife and aspiring First Lady is an immigrant who says she always "went by the law" - but her story is a little 'SUS'.
Tips para celebrar Thanksgiving sin subir de peso
Para que disfrutes sin culpa de los platillos de Thanksgiving, incorpora estos hábitos saludables y prepárate para cuando llegue la hora del festín.
Soluciones prácticas para organizar la alacena
Aquí te decimos cómo hacer de tu alacena o despensa un espacio práctico y eficiente. Pon manos a la obra y dile adiós al desastre.
¿En Canadá están recibiendo solicitudes de asilo de quienes van a perder el TPS?
Crecen los rumores en torno a que el país norteamericano amparará a las personas que pierdan el Estatus de Protección Temporal (TPS), cuya última extensión para Nicaragua se cumple el 5 de enero del 2019.
publicidad
Hombre murió intentando detener un robo de auto en Coral Gables
Según versiones preliminares, un chófer del hotel Marriott fue arrollado mortalmente cuando intentó interponerse en el camino de un sujeto que acababa de hurtar el vehículo con el que trabajaba la víctima.
Supremacistas blancos atacan en ciudades santuario alardeando su simpatía con Trump
Un reporte oficial que estos grupos están vinculados a un incremento en los crímenes de odio en Los Ángeles. Los mexicanos conforman el cuarto grupo que reportó más ataques de este tipo.
Conoce a Doug Jones, el olvidado rival de Roy Moore en un choque entre la vieja y la nueva Alabama
El contraste en la elección especial para el Senado de EEUU el 12 de diciembre no podía ser mayor. Mientras que Moore es acusado de abusar de adolescentes, Jones hizo justicia al procesar a los supremacistas blancos que mataron a cuatro niñas negras en los '60. Si este gana le daría a los demócratas su primera victoria en un cuarto de siglo en una campaña al Senado por Alabama.
Llevan 20 años condenados por asesinato y violación, ahora ordenan su libertad y un nuevo juicio
Exámenes de ADN apuntan a que Nevest Coleman y Darryl Fulton no son culpables de la muerte violenta de Antwinica Bridgeman, ocurrida en 1994. “Estamos emocionados porque estará en su hogar para Thanksgiving", aseguró la abogada de Fulton.
Tiro de esquina para Querétaro
Tiro de esquina para Querétaro on November 18, 2017
Diabólica goleada del Ajax envía mensaje para el PSV del 'Chucky' Lozano
El equipo de Ámsterdam vapuleó 8-0 a NAC Breda y no se aleja de los primeros puestos en la Eredivisie.
Tiro desviado de Edgar Benítez
Tiro desviado de Edgar Benítez on November 18, 2017
Tiro desviado de Brian Figueroa
Tiro desviado de Brian Figueroa on November 18, 2017