As Washington DC ponders a new plan for our health care, Americans are likely overwhelmed by the political noise and frustrated by the policy confusion.
Contradictions abound. Under the new health plan being considered in Congress, the Congressional Budget Office says 24 million people will lose coverage while the president promises no one will be left out. The House is moving at breakneck speed while some of their Senate counterparts say “take it slow.” Raucous town halls in their districts have given some politicians pause, while others are simply avoiding confrontations with voters.
Short of clear facts and an easy-to-understand path forward, the American people have only one choice: ask questions. And there are at least six key questions that need to be answered clearly.
Here they are.
1. If I’m happy with my health care coverage, will I be able to keep it?
The proposed plan doesn’t just affect people who currently use the Obamacare exchanges and Medicaid (Medi-Cal in California), but even some people who get their health insurance at work. The bill repeals a part of the existing law that requires most employers to provide insurance to their workers.
And, of course, the Congressional Budget Office says the Congressional plan would lop 14 million people from the health care rolls in just one year, some of whom are currently covered by their employer, not the Obamacare exchanges or Medicaid. Who exactly are these millions of people who will lose their health coverage?
If you have health care now and like it, “will I be able to keep it?” is probably the paramount question you should be asking.
2. Will my premiums or deductibles go up?
The Congressional Budget Office says premiums will go up as much as 15 percent in the first year or two, and then go down later, at least for some. But a lot depends on how old you are. We have to wonder if the Congressional Budget Office is right in concluding that older Americans could pay five times more than younger people.
3. Will my taxes go up or go down?
Supporters of the plan in Congress say if you make more than $200,000 per year, you will see a tax cut and, if you play the stock market, real estate or other investments, you will benefit from cuts to the Capital Gains Tax.
It’s simply not clear what happens to everyone else.
4. Will we do a better job tackling the opioid crisis and other addiction-related problems, or even treating people hit by an epidemic like Zika?
The new plan would eliminate the requirement that states cover addiction treatment under Medicaid. Would states like California and New York manage to keep the addiction coverage on their own? Would states hit hardest by the opioid crisis, particularly in the Southwest, see a spike in overdose-related deaths? How concerned should we be that the plan includes no extra resources for treating people if an epidemic strikes?
5. Will women’s health be protected?
The plan would single out people with Medicaid coverage and blocks them from accessing Planned Parenthood health centers. Where else would these women go for birth control, cancer screenings, and STD testing and treatment?
6. What will be the role be of the HMO and drug company lobbyists who were just appointed to key positions in the U.S. Health and Human Services agency?
Alexandra Campau, a former Washington D.C. lobbyist for Blue Cross and for the German company Fresenius, and Timothy Clark, former lobbyist for the big drug companies, are among the recent new hires. Will these lobbyists turned federal officials be responsible for looking out for the interests of patients?
These are six key questions to ask now and as the health care debate continues. Indeed, the proposed plan is just the first step in what is likely to involve a lot of insider negotiations and compromises. But these are the types of questions that must be asked, no matter how the politics twist or turn.
Most important, if a new plan for our health care ends up getting signed into law in 2017, it is likely to be with us for a very long time. Now is the moment to ask the right questions.
Daniel Zingale is Senior Vice President for Healthy California at The California Endowment
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