Texan Mosaic

by STACY JOHNSON//Editorial Assistant

The Patient Protection and Affordable Care Act is a law contentious enough to cease the operation of the United States government, as we saw in 2013.

Was this an overreaction by headstrong partisan leaders, or an attempt to save the people of our country from an ineffective policy that amounts to little more than extortion by government and leaders of industry?

I believe that basic medical care is a necessity for the success of both individuals and society as a whole.  In a country as prosperous as the United States, it is something that every citizen deserves equal access to, regardless of income level.  This is why I am in favor of repealing the Affordable Care Act (aka “Obamacare”) and replacing it with a system that actually serves to achieve that goal.

Most of us recognize “Obamacare” as a government program intended to provide health insurance to people who would otherwise be financially unable to see a doctor.  Those who qualify for a subsidy can receive health insurance at a discounted rate.  Eligible Americans pay a portion of their monthly premium, and the U.S. government picks up the tab for the remainder.  The mandate incentivizes participation by requiring uninsured individuals to pay a penalty on their federal income taxes.

While the program has successfully decreased the number of uninsured Americans, health insurance does not equal health care—it’s an important distinction to make.  Indigent and self-pay discount programs offered by counties and health care providers most often require patients to be uninsured in order to participate.  The impossibly high deductibles levied by the low-cost bronze plans give the poorest of Americans a choice between becoming insured and losing access to these programs, then going without health care when they are unable to meet their deductible, or remaining uninsured and paying an increasingly hefty fee to the government come tax time.

Speaking of the poorest Americans, in order to be eligible for the subsidy, a person must make more than 100 percent of the federal poverty level, regardless of whether he or she is employed.  That’s right—you can be too poor to receive low-income assistance, even if you’re working.  People living below the poverty level receive no assistance, not in spite of their financial situation, but because of it.  Aren’t these the very people the health care law was intended to benefit the most?

Medicaid is there for those who earn too little to qualify for a subsidy, but Texas—the country’s second most populous state—is one of 19 states that chose not to expand their Medicaid programs, a provision that was made completely optional under the health care law.  Texas, in particular, has some of the most stringent eligibility requirements in the country.

In order to qualify for Medicaid in Texas, one must not only demonstrate financial need, but must also be pregnant, or be older than 65, have at least one dependent child, or be either disabled or have a household member who is disabled.  The “Medicaid coverage gap,” as it is commonly known, is a real problem for underemployed and unemployed Texans.

Is all health insurance created equally?  Those who can afford to spring for a silver plan with a more reasonable deductible face other issues.  While it’s typical for insurers to negotiate what they pay out to medical providers, plans offered through the subsidized health insurance exchange reimburse significantly less than what a full-price insurance plan would.  As a result, many providers are refusing to accept the subsidized plans entirely.  This limits patient options, overburdens participating medical professionals, and increases wait times to ludicrous and sometimes dangerous levels.  Emergency rooms serve to merely stabilize patients with life-threatening conditions and refer them to the appropriate provider or specialist.

Government-mandated health insurance unnecessarily inflates the cost of medical care for everyone, skirting the natural effects of the free market.  I feel that we can reign in inflated health care costs and provide timely medical attention to those in need by repealing the Affordable Care Act and replacing it with a free market system.

Truly affordable and readily available health care is social progress.  But before we can make progress, we need to be willing to admit that our current solution is a part of the problem.