April 26, 2018
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Affordable Care Act repeal would be a costly mistake

By rufus wanning

Attorney General William Schneider and the governor are making a mistake in seeking to join the lawsuit of state attorneys general against the Affordable Care Act. We stand to lose a lot if that act is repealed or struck down.

I wonder if the two believe the falsehoods told about the law, such as that it will increase the deficit by $550 billion, and that it contains death panels. None of this is true. The nonpartisan Congressional Budget Office announced its most recent estimate on Jan. 6; the legislation would save the Treasury $230 billion over the next decade.

The big political problem with the Affordable Care Act is that it is so big and complicated that hardly anyone knows what’s in it. People fear what they do not understand. But there are a few things that we would lose if the law is repealed.

Starting in 2014, we would lose important subsidies for health insurance for the working poor and not so poor. These subsidies would be available to individuals and families earning up to 400 percent of the federal poverty level, disappearing at $88,200 for a family of four. Thousands of Mainers would gain coverage.

Families would suffer. In Maine, 3,320 young people age 19 to 26 who now receive coverage through their parents’ insurance plans would lose that coverage. Insurance companies would again be allowed to cut off a person’s coverage unexpectedly when she becomes sick. This would leave 69,000 people in Maine at risk of losing their insurance at the moment they need it most.

Seniors would suffer. We Medicare recipients would face a co-pay for preventive services, like an annual checkup visit. Those of us who fall into the “doughnut hole,” a gap in coverage on prescription drug costs, would be especially hurt. The Affordable Care Act would have covered half the doughnut hole expense this year, and shrunk the doughnut hole to nothing in 2020.

We would lose an important guarantee that our health care premiums will work for us. Insurance companies will be required to pay out 80 to 85 percent of premiums for health care, rather than profits or bonuses for executives.

Those with pre-existing conditions would lose a new guarantee that they would be able to get health insurance in spite of those conditions.

It is a fair question, how government can grant all these benefits and still save money. Much of the money will come by squeezing only half the waste, fraud and abuse out of Medicare. A huge amount of unnecessary care is billed to Medicare. There is even some evidence that the less spent, the better.

McAllen, Texas, spends $15,000 per Medicare enrollee, and gets low ratings for health quality, while Rochester, Minn., (dominated by the Mayo Clinic), delivers some of the best care in the country for $6,688 per enrollee.

The other big source of funds is the “mandate.” We cannot guarantee that everyone will be able to buy health insurance, regardless of pre-existing conditions, and not require them to buy health insurance. Otherwise, people could wait until they got sick to buy insurance, like waiting until your house burns down to buy fire insur-ance.

People say that never before has the government required people to buy a product. This is not true, and the precedent goes back to one of our nation’s most important founders. In July 1798, Congress passed, and President John Adams signed into law, an act “For the Relief of Sick and Disabled Seamen.” Ship owners were re-quired to deduct 20 cents per month from each sailor’s pay, and pay it in to the government, which used the money to establish a chain of hospitals in major ports. The plan would have been called “socialistic” today.

What is most striking about the Republican drive to repeal the law is that they propose no alternative. It is a straight repeal, with no way of dealing with the great problems of the American health care system: a steadily increasing number of uninsured Americans, now 50.7 million; skyrocketing costs, while incomes stagnate; mil-lions relying on emergency room medicine; the most technologically advanced system in the world lagging behind most of the developed world in simple measures like vaccination; the 49th highest life expectancy in the world, behind Portugal and Bosnia.

If Gov. Paul LePage and Schneider move ahead with their lawsuit plans, they will be making a costly mistake.

Rufus Wanning is an arborist living in Orland.

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