Healthcare Crisis in Grays Harbor
By Marianna Hopkins Everson
In recent news reports from the Office of the Insurance Commissioner of Washington State, we have learned that the remaining health insurance providers that cover Grays Harbor are likely to stop providing coverage all together in our community by 2018. According to Commissioner Kreidler this will affect 2,227 people in Grays Harbor.
How does this affect me?
People are covered for their health insurance in a few different ways.
People whose employers do not offer health insurance or are self employed can purchase insurance through the ACA (Obamacare) Exchange: Washington Healthplanfinder https://www.wahealthplanfinder.org. There are 2,227 people who purchase insurance through the health care exchange Grays Harbor. The only option for people who would lose their coverage due to the current changes is the Washington State Health Insurance Pool (www.wship.org); our state's high-risk insurance pool. Created by the state legislature, it originally offered insurance to state residents who were rejected in the individual market due to health issues.
This change will not cancel your policy you if you get health insurance through your employer, but it could affect your premiums and deductibles in the future. Prices rise when insurance companies do not have as many customers.
Medicare: According to cms.gov in April of 2017, 18.889 people were covered by Medicare in Grays Harbor and 870,185 in the State of Washington. This change does not affect medicare.
If you have Medicaid or Children’s Health Insurance Program (CHIP) this change should not affect you, unless your circumstances change to where you are no longer qualified for Medicaid. As of March 2017, Washington has enrolled 1,807,908 individuals in Medicaid and CHIP. 690,332 more people were added as part of the Medicaid expansion due to the Affordable Care Act.
Although this “only” affects 2,227 people, that is 2,227 people too many! One of the greatest things about this community is how we take care of each other. If they come for one of us, they come for all of us!
How did this happen?
According to multiple sources, the government that we elected to represent us in Washington DC is actively working to sabotage the Affordable Care Act (Obamacare), to convince people that the ACA is a failure, and get public and congressional support for the “repeal and replace” agenda. This would leave millions of Americans without health coverage, especially those with “pre-existing conditions.”
New York Magazine:
In early April, Trump sounded the latter note. In an interview with The Wall Street Journal, the president suggested that he would cease paying out cost-sharing reductions — subsidies to insurers that defray the cost of covering low-income Obamacare enrollees — so as to engineer a crisis in the private insurance market, and, thus, generate more support for repealing Barack Obama’s signature law.
The American Health Care Act
Republican elected representatives in Congress have long pushed an agenda to repeal the Affordable Care Act. In fact many of them ran their campaigns promising to repeal Obamacare (ACA). In the seven years the ACA has been the law, they have tried to repeal the law many times. On May 4, 2017, they succeeded in repealing the ACA in the House of Representatives. The bill must now go to the Senate. The Republicans in the Senate are writing their bill behind closed doors with no hearings. This secretive process is not the way American laws are usually passed.
According to the Congressional Budget Office (CBO):
"About one-sixth of the population resides in areas in which the [individual] market would start to become unstable beginning in 2020. That instability would result from market responses to [the approval of state waivers] ... The waivers in those states would have another effect: Community-rated premiums would rise over time, and people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive [individual] health insurance at premiums comparable to those under [Obamacare], if they could purchase it at all ...
"As a result, the [individual] markets in those states would become unstable for people with higher-than-average expected healthcare costs. That instability would cause some people who would have been insured in the [individual] market under current law to be uninsured."
According to http://healthaffairs.org/blog/ :The CBO estimates that the number of people going without insurance would rise by 23 million in 2026 under the AHCA. That is about one million more people remaining enrolled in coverage than under the March version of the legislation. The CBO expects that fewer people would purchase nongroup coverage, but more people would enroll in employer plans, compared with the earlier estimate. Medicaid enrollment is expected to decline by 14 million in 2026, which is largely consistent with past estimates. That reduction is a result of rolling back enhanced federal matching funds for the ACA’s Medicaid expansion and eliminating the tax penalties for going uninsured.
Remember that 690,332 people who gained access to Medicaid through ACA thru the expansion of Medicaid? Those people will lose their coverage if the AHCA is passed. The exchange will never return, and people with pre-existing conditions will not be covered, they will have to resort to the high-risk pool, which is much more expensive that any other insurance, and therefore unattainable for most people.
What can we do about it?
Educate, Advocate, and Activate.
Americans pay, by far, the highest cost for healthcare. A Medicare For All, single payer system would give us the opportunity to negotiate prices for healthcare through the most successful and most approved government system that exists today, Medicare. Lowering the age requirement to birth instead of 65 covers all Americans for the majority of their healthcare. Removing the middleman, insurance companies, allows people to pay for their healthcare, not for the profits of the the health insurance industry. It has been estimated that this would save $400 Billion per year.
Single Payer Health Care has a 60% approval rating across the country. At the Federal Level, in the House of Representatives, HB 676, Expanded and Improved Medicare For All was offered by Representative John Conyers of Michigan. (Introduced 01/24/2017) https://www.congress.gov/bill/115th-congress/house-bill/676/all-info
Expanded & Improved Medicare for All Act
This bill establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.
Only public or nonprofit institutions may participate. Nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities may participate.
Patients may choose from participating physicians and institutions.
Health insurers may not sell health insurance that duplicates the benefits provided under this bill. Insurers may sell benefits that are not medically necessary, such as cosmetic surgery benefits.
The bill sets forth methods to pay institutional providers and health professionals for services. Financial incentives between HMOs and physicians based on utilization are prohibited.
The program is funded: (1) from existing sources of government revenues for health care, (2) by increasing personal income taxes on the top 5% of income earners, (3) by instituting a progressive excise tax on payroll and self-employment income, (4) by instituting a tax on unearned income, and (5) by instituting a tax on stock and bond transactions. Amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the Children's Health Insurance Program (CHIP), are transferred and appropriated to carry out this bill.
The program must give employment transition benefits and first priority in retraining and job placement to individuals whose jobs are eliminated due to reduced clerical and administrative work under this bill.
The Department of Health and Human Services must create a confidential electronic patient record system.
The bill establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability.
The Indian Health Service must be integrated into the program after five years. Congress must evaluate the continued independence of Department of Veterans Affairs health programs.
In California, the 6th largest economy in the WORLD, they have passed a State Senate Bill to provide a single payer system to the residents of their state. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB562
This bill, the Healthy California Act, would create the Healthy California program to provide comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all residents of the state. The bill, among other things, would provide that the program cover a wide range of medical benefits and other services and would incorporate the health care benefits and standards of other existing federal and state provisions, including, but not limited to, the state’s Children’s Health Insurance Program (CHIP), Medi-Cal, ancillary health care or social services covered by regional centers for persons with developmental disabilities, Knox-Keene, and the federal Medicare program. The bill would require the board to seek all necessary waivers, approvals, and agreements to allow various existing federal health care payments to be paid to the Healthy California program, which would then assume responsibility for all benefits and services previously paid for with those funds.
This bill would also provide for the participation of health care providers in the program, require care coordination for members, provide for payment for health care services and care coordination, and specify program standards. The bill would state the intent of the Legislature to enact legislation that would develop a revenue plan, taking into consideration anticipated federal revenue available for the Healthy California program. The bill would create the Healthy California Trust Fund in the State Treasury, as a continuously appropriated fund, consisting of any federal and state moneys received for the purposes of the act. Because the bill would create a continuously appropriated fund, it would make an appropriation.
This bill would create the Healthy California Board to govern the program, made up of 9 members with demonstrated and acknowledged expertise in health care, and appointed as provided. The bill would provide the board with all the powers and duties necessary to establish the Healthy California program, including, but not limited to, determining when individuals may start enrolling into the program, employing necessary staff, and negotiating and entering into any necessary contracts. The bill would also require the Secretary of California Health and Human Services to establish a public advisory committee to advise the board on all matters of policy for the Healthy California program.
This bill would prohibit health care service plans and health insurers from offering health benefits or covering any service for which coverage is offered to individuals under the program, except as provided. The bill would authorize health care providers, as defined, to collectively negotiate rates of payment for health care services, rates of payment for prescription and nonprescription drugs, and payment methodologies using a 3rd-party representative, as provided.
Other states have similar bills and initiatives either pending, in the works, or recently attempted with better-than-expected results. Some of those states are Oregon, Nevada, Vermont and Colorado.
What can I do?
In Washington State we have groups working on the initiative to bring Single Payer Healthcare to a vote.
Democracy Rising is organizing a Community Town Hall Discussion with a panel of experts on Single Payer Healthcare, as well as local clinics, and providers to educate us. Please save the date August 5th on your calendars, more info to come.
We must demand an alternative to kicking people off their insurance and reducing Medicaid funding so that tax breaks can be given to the wealthiest people in the country. Do not be mistaken, the ACA was flawed from the beginning and the AHCA has been foisted upon us so that the people who make the most money and have the most wealth can get tax breaks. That is morally wrong, and the only way it is going to change is if we change. We can no longer afford to sit back and let our elected representatives cater to the monied interests of this country. They are elected to represent all of us, not just lobbyists, Wall Street, and corporate interests. It is time we hold them accountable.
Please save your Senators’ and Congressman's names and numbers in your phones and call them often. Please save your state representatives’ and state senators’ info and call them too. Weekly, daily, whatever time you can spare.
For Grays Harbor County:
D.C. Office: 154 Russell Senate Office Building (20510)
Phone: (202) 224-2621; Fax: (202) 224-0238
Seattle Office: 2988 Jackson Federal Office Bldg., 915 Second Ave. (98174)
Phone: (206) 553-5545; Fax: (206) 553-0891
Web Site: www.murray.senate.gov
D. C. Office: 311 Hart Senate Office Building (20510)
Phone: (202) 224-3441; Fax: (202) 228-0514
Seattle Office: 915 2nd Avenue, Suite 3206 (98174)
Phone: (206) 220-6400; Fax: (206) 220-6404
Web Site: www.cantwell.senate.gov
US House Representative:
D. C. Office: 1520 Longworth House Office Building (20515)
Phone: (202) 225-5916; Fax: (202) 226-1176
Tacoma Office: 950 Pacific Ave., Suite 1230 (98402)
Phone: (253) 272-3515; Fax: (253) 593-6561
Web Site: www.kilmer.house.gov
19th District (Generally South of the Chehalis)
428 John L. O'Brien Building
PO Box 40600
Olympia, WA 98504
(360) 786 - 7806
Olympia Office 437A Legislative Building
PO Box 40600
Olympia, WA 98504
(360) 786 - 7870
24th District (Generally North of the Chehalis)
Olympia Office 132B Legislative Building
PO Box 40600
Olympia, WA 98504
(360) 786 - 7916
Olympia Office 314 John L. O'Brien Building
PO Box 40600
Olympia, WA 98504(360) 786 - 7904
Get involved. Contact us at Democracy Rising.