US President Donald Trump, true to his campaign promise, continues to work on damage control for the “Affordable” Care Act (ACA) introduced in 2010 by his predecessor, President Barack Obama.
Without the political support required to simply extinguish this overly complex and punitive piece of healthcare legislation, Trump has focused on amending it to make it more bearable to those of us who simply do not have the money to pay the exorbitant premiums.
The unfortunate truth behind the misleading name of this socialist law is that health insurance today is hideously expensive for everyone who is self-employed. Unless you are very poor or earn just the right amount of money – neither too much nor too little – you won’t qualify for a federal subsidy and face paying the full premium price.
Did anyone ever stop to ask themselves why a national health insurance scheme billed as “affordable” would need subsidies in the first place? Something smelled rotten about the ACA when it was first introduced.
In retrospect, it is clear that Obama lied about the cost/benefit details of this plan from the get-go, in order to shove it down American throats. In Forbes’ coverage of this story, it comes as no surprise that Democratic presidential forerunner Hillary Clinton was completely on board with the Obama plan. Terming it “one of the greatest accomplishments of President Obama, of the Democratic Party, and of our country,” had she been elected President of the United States, illegal immigrants would now be enjoying yet another American freebie.
Instead, as we know, Trump won the 2016 US election and has been busy pulling teeth from the ACA ever since, one by one.
At the top of the list of ACA changes Trump has spearheaded is the matter of federal mandate. “Mandate” means “You must,” and this expression, when associated with the personal matter of selecting a health insurance plan, rankles a lot of freedom-loving Americans. Frankly, a lot of us resent being told what to do, especially by the federal government.
In early January 2018, with the passage of the new US tax bill, not only were income-based tax brackets redefined, but the mandate portion of the ACA was removed. Effective 2019, there will be no more tax penalties applied to filers’ refunds for failing to have health insurance.
During his State of the Union address, President Trump said:
“We eliminated an especially cruel tax that fell mostly on Americans making less than $50,000 a year — forcing them to pay tremendous penalties simply because they could not afford government-ordered health plans.”
In the meantime, IRS Form 8965 titled “Health Coverage Exemptions” can be filed ” if the most inexpensive coverage you can find would cost you more than 8.16% of your 2017 household income,” according to Intuit TurboTax.
Unaffected by the tax bill are the ACA’s individual insurance markets, federal subsidies, and Medicaid expansion in the 33 states that implemented it.
Likewise, Americans lucky enough to have full-time jobs with benefits will continue to enjoy ultra-low-rate group health insurance from their employers. Medicare, Medicaid, and military health plans will carry on, as well, pending future legal changes.
For those who don’t qualify for a health coverage tax exemption, the 2018 tax penalty is $695 per adult or 2.5 percent of household income, whichever is higher. If you don’t have health insurance, don’t qualify for an exemption, and earn $10/hour ($20,000/year), your penalty would be $500. Ouch, baby, ouch.
One problem with sweeping legislation like National Health Insurance is that the laws are written by people who make a lot more money than the “average American” does. It is easy, when you have plenty, to shrug off the problems that scarcity brings. The rose-colored glasses of prosperity cloud the gray reality of American poverty – and near-poverty.
Some analysts are predicting that the consequence of making health insurance a choice, rather than a federal demand, must be higher ACA premiums due to the shrinking pool of healthy insureds who think they don’t need health insurance, or could make do with low-cost catastrophic care. Ironically, ACA is basically high-cost catastrophic care, with its ridiculously high deductibles and out of pocket (OOP) limits.
The reality is that health insurance, like auto insurance, will thrive in a free, capitalistic market. “You get what you pay for,” will be the new slogan for doctor’s offices and hospitals nationwide. Rich folks will go to the Beverly Hills Clinic and poor folks will stand in line at the Walmart (or some similar retailers’) Clinic.
The most recent news about the ACA, under Trump’s directive, just hit the wires. On February 20, 2018, new regulations were proposed to help health insurers provide low-premium, short-term plans that do not include the 10 essential benefits that define ACA plans. Of course, only healthy people would qualify for this type of insurance.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, hit the nail on the head when she told the Huffington Post:
“It’s time to offer more affordable coverage options. It’s about allowing individuals, not the government, to make decisions about what works for them and their families.”
Share if you agree.