Jimmy Kimmel is Right and Seriously Wrong
When Jimmy Kimmel objected to Graham-Cassidy he was right and very wrong. His first big mistake was that he ignores the vast difference in the quality of insurance individuals obtain and instead talked about those who would 'lose' coverage as if their coverage and his were the same.
Naturally, like everything else in our country, this is not true. The quality of your medical care is strictly dependent on what you can pay. No, if heaven forbid someone else's child faced what Kimmel's did, today that child likely would not get the same care as Kimmel's child.
Kimmel is right to object to the Republican plan because it continues and worsens the deception of Obamacare that falsely gave hope to Americans. Yes, emergency medical care is covered by plans under Obamacare, with the only balance billing portion of the law that requires all ERs in the US to accept your ER coverage. But, once stabilized Obamacare also allows you to be shipped off to a hospital that accepts your insurance.
This means that all the hospitals that rejected Obamacare plans, or your plan, only provide services to stabilize, not complete treatment. Many Americans already know or should know that the best hospitals do not accept their health insurance, therefore, unlike Kimmel, their children would not receive the care that Kimmel's child did.
Then there's the out of pocket deductible. For cheaper health insurance, people opted for higher deductible plans or the HSA style plan, which both Democrats and Republicans and Insurance companies push because it reduces their administrative work (you submit medical expense receipts and can use your money to pay for services) and then it includes health insurance policies that like others include copayments, coinsurance and non-covered items. I'm willing to bet that Kimmel doesn't have one of these plans that in the face of medical needs results in the pernicious challenge of underinsurance, where people who have and pay for health insurance still find themselves unable to afford care.
Kimmel also wasn't clear on whether his plan would be available if as provided in Obamacare, a Cadillac tax (supposed to become effective in 2018) actually kicked in without yet another arbitrary delay by Obamacare administrators in order to avoid the objections of the rich, the ones likeliest to have those Cadillac plans. Therefore, perhaps, if this medical challenge had occurred with Obamacare having either been implemented as described or past the current 2018 date, Kimmel would not have waxed so sentimentally grateful for his health insurance plan.
I agree with Kimmel that simply handing out money to the states is a bad plan, for several reasons, the first of which is that the healthcare crisis resulting from the health insurance crisis showed a level of incompetence, unwillingness and perhaps even crookedness in state insurance departments that did have authority to manage the insurance companies doing business in their states and failed, and failed, and failed.
Simply returning that authority to these failures of state insurance departments is absurd but Kimmel fails to notice that Obamacare has shown that our federal government is a similar failure in administering health insurance.
The federal government has proven itself at least equally incompetent, unwilling and perhaps even crooked under Obamacare's shift to federal management. The federal government's oversight of everything they were supposed to oversee under Obamacare can only also be called a failure.
The fraud of wrongful payments by the federal government under Obamacare was publicized by no other than the Obama government when for two years in a row it publicized that false applications for Obamacare were approved to the tune of 11 out of 12 applications. Overpayments were rampant, with the federal government "forgiving" those overpayments instead of collecting them. The new costs in government infrastructure, salaries and benefits paid were incalculable as again, the Obamacare government informed they would not count these monies but instead would focus only on health insurance only costs. (Following In Obama's Footsteps on Health Insurance Could Cost Trump Moderate Republican Support, 6/21/2017). These are just a few and omit the enormous amount of unrestrained authority given to government, like the IRS expanding the meaning of state established exchanges in King v. Burwell to pay more, the delay of dates for provisions of the law to take effect, the requirements of the law to prevent fraud in payments, to name another few.
Kimmel was also correct when it comes to lifetime caps and pre-existing conditions, addressing the deal Obama made with insurers in accordance with the deal the insurance lobby offered Obama, "We'll cover those with pre-existing conditions IF you REQUIRE people to purchase our product," (AHIP, 2008). This is the individual mandate. The Republican plan includes this same requirement to purchase the health insurance product but calls it continuous coverage, which requires us to buy the product or be penalized in following years for not having it, just like Obamacare which charged a tax penalty if we didn't buy, except Republican punishment payments would be charged by insurers themselves.
Again, however, Kimmel ignores the fact, not the guess, the fact that COST of the health insurance product remains a challenge for the middle class and has risen steadily in the face of Obamacare, in the double digits for many of us.
Especially, with the expiration in the law of Obamacare of government payouts to insurance companies, Obama knew this was coming when from the beginning the CBO said of reinsurance, "Reinsurance payments that the government makes to insurance plans whose enrollees incur particularly high costs for medical care will be phased out over the next two years, placing upward pressure on exchange premiums…" (CBO, Pub. 49973, page 22).
In the few years of Obamacare, we've seen these results as the people opted into the cheapest and most basic plans, that there is no single risk pool for those deluded enough to not have noticed that from the start Obamacare shifted the risk pool allowing surcharges to be charged based on age and whether a person uses tobacco--no single risk pool. Further, this strategy also failed as the cost of insurance prompted individuals to choose Bronze level plans under Obamacare, or flocked to temporary health insurance plans, or simply stopped paying their share of premiums, as evidenced by the millions of lapsed plans that change the claimed enrollment numbers into actual enrollments of millions less each year.
In other words, the Republican plan LIKE Obamacare, leaves those of us who cannot afford Kimmel coverage in physical and financial jeopardy in the event of illness.
Kimmel sounds as if he's advocating for a health care RIGHT, which we have never had and still don't have. Obamacare provides no RIGHT to health care. The Republican plan creates no right to health care.
What Obamacare did prove is that even taking steps to expand the opportunities for health insurance by expanding Medicaid or by creating entitlement payments to middle class people whose income falls within a certain range, that we STILL left tens of millions of Americans, often the poorest Americans without expanded access to health insurance and in a diabolical tradeoff actually made health insurance less attainable for some working Americans and instituted a set of minimum standards that policies provide INSTEAD OF meaningful coverage in the event of medical need as evidenced by increased deductible, copayments, coinsurance fees charged if you need medical services that our system is not working for most Americans.
Naturally, like everything else in our country, this is not true. The quality of your medical care is strictly dependent on what you can pay. No, if heaven forbid someone else's child faced what Kimmel's did, today that child likely would not get the same care as Kimmel's child.
Kimmel is right to object to the Republican plan because it continues and worsens the deception of Obamacare that falsely gave hope to Americans. Yes, emergency medical care is covered by plans under Obamacare, with the only balance billing portion of the law that requires all ERs in the US to accept your ER coverage. But, once stabilized Obamacare also allows you to be shipped off to a hospital that accepts your insurance.
This means that all the hospitals that rejected Obamacare plans, or your plan, only provide services to stabilize, not complete treatment. Many Americans already know or should know that the best hospitals do not accept their health insurance, therefore, unlike Kimmel, their children would not receive the care that Kimmel's child did.
Then there's the out of pocket deductible. For cheaper health insurance, people opted for higher deductible plans or the HSA style plan, which both Democrats and Republicans and Insurance companies push because it reduces their administrative work (you submit medical expense receipts and can use your money to pay for services) and then it includes health insurance policies that like others include copayments, coinsurance and non-covered items. I'm willing to bet that Kimmel doesn't have one of these plans that in the face of medical needs results in the pernicious challenge of underinsurance, where people who have and pay for health insurance still find themselves unable to afford care.
Kimmel also wasn't clear on whether his plan would be available if as provided in Obamacare, a Cadillac tax (supposed to become effective in 2018) actually kicked in without yet another arbitrary delay by Obamacare administrators in order to avoid the objections of the rich, the ones likeliest to have those Cadillac plans. Therefore, perhaps, if this medical challenge had occurred with Obamacare having either been implemented as described or past the current 2018 date, Kimmel would not have waxed so sentimentally grateful for his health insurance plan.
I agree with Kimmel that simply handing out money to the states is a bad plan, for several reasons, the first of which is that the healthcare crisis resulting from the health insurance crisis showed a level of incompetence, unwillingness and perhaps even crookedness in state insurance departments that did have authority to manage the insurance companies doing business in their states and failed, and failed, and failed.
Simply returning that authority to these failures of state insurance departments is absurd but Kimmel fails to notice that Obamacare has shown that our federal government is a similar failure in administering health insurance.
The federal government has proven itself at least equally incompetent, unwilling and perhaps even crooked under Obamacare's shift to federal management. The federal government's oversight of everything they were supposed to oversee under Obamacare can only also be called a failure.
The fraud of wrongful payments by the federal government under Obamacare was publicized by no other than the Obama government when for two years in a row it publicized that false applications for Obamacare were approved to the tune of 11 out of 12 applications. Overpayments were rampant, with the federal government "forgiving" those overpayments instead of collecting them. The new costs in government infrastructure, salaries and benefits paid were incalculable as again, the Obamacare government informed they would not count these monies but instead would focus only on health insurance only costs. (Following In Obama's Footsteps on Health Insurance Could Cost Trump Moderate Republican Support, 6/21/2017). These are just a few and omit the enormous amount of unrestrained authority given to government, like the IRS expanding the meaning of state established exchanges in King v. Burwell to pay more, the delay of dates for provisions of the law to take effect, the requirements of the law to prevent fraud in payments, to name another few.
Kimmel was also correct when it comes to lifetime caps and pre-existing conditions, addressing the deal Obama made with insurers in accordance with the deal the insurance lobby offered Obama, "We'll cover those with pre-existing conditions IF you REQUIRE people to purchase our product," (AHIP, 2008). This is the individual mandate. The Republican plan includes this same requirement to purchase the health insurance product but calls it continuous coverage, which requires us to buy the product or be penalized in following years for not having it, just like Obamacare which charged a tax penalty if we didn't buy, except Republican punishment payments would be charged by insurers themselves.
Again, however, Kimmel ignores the fact, not the guess, the fact that COST of the health insurance product remains a challenge for the middle class and has risen steadily in the face of Obamacare, in the double digits for many of us.
Especially, with the expiration in the law of Obamacare of government payouts to insurance companies, Obama knew this was coming when from the beginning the CBO said of reinsurance, "Reinsurance payments that the government makes to insurance plans whose enrollees incur particularly high costs for medical care will be phased out over the next two years, placing upward pressure on exchange premiums…" (CBO, Pub. 49973, page 22).
In the few years of Obamacare, we've seen these results as the people opted into the cheapest and most basic plans, that there is no single risk pool for those deluded enough to not have noticed that from the start Obamacare shifted the risk pool allowing surcharges to be charged based on age and whether a person uses tobacco--no single risk pool. Further, this strategy also failed as the cost of insurance prompted individuals to choose Bronze level plans under Obamacare, or flocked to temporary health insurance plans, or simply stopped paying their share of premiums, as evidenced by the millions of lapsed plans that change the claimed enrollment numbers into actual enrollments of millions less each year.
In other words, the Republican plan LIKE Obamacare, leaves those of us who cannot afford Kimmel coverage in physical and financial jeopardy in the event of illness.
Kimmel sounds as if he's advocating for a health care RIGHT, which we have never had and still don't have. Obamacare provides no RIGHT to health care. The Republican plan creates no right to health care.
What Obamacare did prove is that even taking steps to expand the opportunities for health insurance by expanding Medicaid or by creating entitlement payments to middle class people whose income falls within a certain range, that we STILL left tens of millions of Americans, often the poorest Americans without expanded access to health insurance and in a diabolical tradeoff actually made health insurance less attainable for some working Americans and instituted a set of minimum standards that policies provide INSTEAD OF meaningful coverage in the event of medical need as evidenced by increased deductible, copayments, coinsurance fees charged if you need medical services that our system is not working for most Americans.
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