Since Senator Ted Cruz from the state of Texas has been the champion for defunding Obamacare, I have a couple of questions for him and some of his friends that would be helpful to us all. Let me start with an overarching comment. In the recent Commonwealth Fund study on how well insured Americans are measured over the 2010-11 timeframe, it is noted that of Texans (age 19 – 64) whose income is less than 2 x the federal poverty limit, 55% of them do not have healthcare insurance. The same study notes that 31% of all Texans do not have healthcare insurance ranking the state of Texas as dead last out of the 50 states and our territory, Puerto Rico. My question is what do you propose to do about them if Obamacare is defunded?
My follow-up questions are if Texas is dead last, why are you not supporting Obamacare which is largely a Republican idea which will offer access to care with subsidized premiums in insurance exchanges? Also, why have you not done more to expand Medicaid to help those citizens who make less than 133% of the federal poverty level? The expansion of Medicaid has been portrayed by the Rand Corporation as a win-win for the state’s economy and those people in need of healthcare.
The Commonwealth Fund is a private foundation whose mission is “working toward a high performance health system.” Their website has interesting state rankings and data regarding how states are doing to deliver healthcare to Americans. The country map can be accessed by clicking on the attached link: http://datacenter.commonwealthfund.org. Overall, it is noted between 2010 and 2012, 55 million Americans age 19 – 64 either continuously or periodically spent time without healthcare insurance. We should not lose sight of the key mission of Obamacare which is to give access to affordable healthcare to more people through employer plans, insurance exchanges and expanded Medicaid. And with our poverty problem in America, it is essential to get more people access to healthcare. 62% of personal bankruptcies in the US are due to no or poor healthcare insurance.
The exchanges are actually an idea Republicans have supported and should support as they introduce more competition in each state. The various Blue Cross Blue Shields have been offering their own exchanges for some time and they work reasonably well. The competition will only help in making the market in each state more competitive. The feature of Obamacare that gets left off is the premiums will be subsidized based on your income relative to the poverty level eventually phasing out at incomes of 4 x the poverty limit.
Yet, one key part of Obamacare that has still not been picked up by 25 states is the expansion of Medicaid for those making up to 133% of the poverty limit. It is not ironic that the states who have elected not to do this rank very low on the Commonwealth Fund statistics for health quality and were highlighted in an earlier post I wrote called “Why are the states with the worst healthcare not expanding Medicaid” at https://musingsofanoldfart.wordpress.com/2013/06/18/why-are-the-states-with-the-worst-healthcare-not-expanding-medicaid/.
But, let’s give Senator Cruz a break and ask some of his colleagues the same questions. Senator Marco Rubio, the state of Florida has 48% of its people (age 19 – 64) making less than 2 x the poverty limit without healthcare insurance. With 28% of overall Floridians in the age group without healthcare insurance, Florida ranks 49th out of the 51 states and Puerto Rico. Congressman Paul Broun, since you are medical doctor, you may not appreciate the state of Georgia has 45% of its people in this age group making less than 2 x the poverty limit who are without healthcare insurance. With 26% of overall Georgians in this age group without healthcare insurance, it ranks 46th out of 51 states and Puerto Rico.
I have said it countless times – Obamacare is not perfect and is complex. Yet, with the exchanges which should work well once the kinks are worked out and the expansion of Medicaid in the states who elect to do so, it will move the ball forward and get access to coverage to millions more people. And, in so doing will help them, help the hospitals and providers in the state by reducing the unpaid care costs and help the economies of the states. Let’s give it chance to work and improve it where we can.