By J. Thomas
November 15 marked the start of the open enrollment period for the nation’s health law which means millions of Americans once again have the opportunity to purchase private health plans on the Affordable Care Act’s (ACA) health insurance marketplaces.
An op-ed in Salon by Public Citizen’s health care advocate, Vijay Das, reveals a glitch in the ACA that adds barriers to coverage for working families. The ACA’s “family glitch” is a drafting error with big effects. As it stands, employers must offer affordable coverage to their employees – but not their employees’ families. So, if an individual plan is “affordable” (i.e., it costs less than 9.5% of what the employee earns), the employee is ineligible for subsidies, even if the cost of family coverage is exorbitant and unaffordable.
Even worse, the ones who are most affected tend to be children from low income households– 460,000 of them, according to the nonpartisan U.S. Government Accountability Office. Meanwhile, parents are faced with a difficult choice – maintain their own too costly family insurance or drop it and enroll their kids in Medicaid or the Children’s Health Insurance Program (CHIP). One more hitch during this post-election “lame-duck” Congress: CHIP expires next October. Nobody knows if Congress will reauthorize it by the end of year, and, if so, at what level the program will be funded.
The family glitch points to a larger problem in American health care. The U.S. stands as the only wealthy nation in the world with uninsured kids and no universal health care. The civil rights movement expanded rights on many fronts: for LGBT individuals, environmental protections and international human rights, to name a few. But when it comes to children’s health, our nation remains far behind the curve. The concept of “American exceptionalism” was meant to symbolize hopes and dreams, not sick kids.
This Labor Day, I’ll be thinking about my family.
My great grandfather, an immigrant from eastern Europe who crossed the Atlantic to work in a western Pennsylvania steel mill, died in that mill in 1929 when a piece of industrial equipment came crashing down on him.
His daughter – my grandmother – was less than a year old.
How many millions of families have suffered similar tragedies? The deadly nature of work in the “Steel Valley” is well documented. Local histories and literary classics such as Blood on the Forge and Out of This Furnace testify to this bloody past.
Clearly, we’ve come a long way since 1929, most significantly with the formation of the Occupational Health and Safety Administration (OSHA) in 1971.
Nevertheless, tragic workplace deaths occur in America almost every day. Scroll through OSHA’s 2014 document recording “FY14 Fatalities and Catastrophes to Date” (PDF), and you’ll begin to get a sense of the lives lost each day that may have been prevented.
As a general rule, cost-benefit analyses are suspect.
Such analyses – which federal agencies perform to weigh the health and safety “benefits” of regulations (benefits like lower infant mortality rates and reliably safe and clean drinking water) against the “cost” of lost profits to Corporate America – result in a distorted model of a regulation’s impact. Invariably, the distortion creates a bias that exaggerates the regulation’s “cost,” largely because cost (measured in dollars and cents) is more easily quantified than benefits.
So one might think it’s a good thing that economists at the FDA have started factoring in pleasure – or, more specifically, its loss – when weighing the costs and benefits of new regulations. And one might think that a regulation that is expected to result in lower infant mortality rates, fewer cancer diagnoses, and longer, healthier lives for the American public to be a winner in terms of “pleasure,” right?
Unfortunately, one would be wrong.
Shockingly, the FDA’s cost-benefit analysis for a new tobacco regulation resulted in the rule’s projected health and safety benefits – fewer instances of heart and lung disease and fewer early deaths – being reduced by 70 percent due to the “loss in pleasure” smokers endure when trying to break their addiction.
As an ex-smoker myself (tobacco-free since 2008), I am well aware that the symptoms of nicotine withdrawal certainly constitute a “loss in pleasure.” But the notion that a smoker’s physical discomfort for a relatively brief period of time somehow trumps by 70 percent the health benefits of quitting (not to mention the increase in one’s disposable income and the gradual restoration of one’s senses of taste and smell) is utterly outrageous.
Yesterday marked the 49th Anniversary of Medicare, our nation’s first national health insurance program. Since its inception, Medicare has extended health coverage to nearly 50 million seniors and people with disabilities.
To celebrate, U.S. Rep. John Conyers (D-Mich.) spoke passionately on the U.S. House floor, commemorating the anniversary of the beloved program and highlighting the benefits of extending Medicare to all Americans.
Rep. Conyers emphasized the huge cost savings (close to $600 billion in 2015) that would be achieved by expanding Medicare and curbing the wasteful spending inherent in the current for-profit, private insurance system used by those not eligible for Medicare or other government-financed programs
In presenting the case for the passage of H.R. 676, Rep. Conyers emphasized that a nationwide single-payer system built off Medicare is the best way to address the core challenges undermining our health care system.