We may have wanted the puree of a single payer system or a strong public option, but we will probably end up with the potpourri of policy ingredients in the House or Senate bills. People who would be better off under the bill are pressing for it. Our legislators, even progressives, are cramming it down our throats. No one in the elite, political class is willing to listen, but what exactly will happen to the masses of people who will genuinely not be able to afford the premiums? What will be done about people diligently paying the premiums, but then unable to pay the copayments and deductibles. Our legislators and President seem unwiling to grasp the fact that these bills improve the situation for people who earn more than $60,000, but in the range of $15,000 - $40,000 people may still not have access to health care.
Last week Paul Krugman posted a premium and subsidy calculator on his website. I posted it here and it is at
healthreform.kff.org/subsidycalculator.aspx.
I ran this program and posted the results here for the $35,000 income level, which is 323% of the poverty level, single & ages 24-64. The result is a mandated premium payment of $280 to $310 per month for those ages 54-64 who do not have a cheaper payment under an employer plan. The problem is that given rent, taxes (self employment tax for many), student loan payments, utilities, food, etc., the premiums will be unaffordable and the deductibles and copayments will be additionally unaffordable. There are vast variations in rent, utilities and car expenses in different parts of the country, but many people in their fifties will be hit hard by this.
I have been calling the offices of Congressmen and Senators on this issue and there isn't very much listening. I was given deliberate misinformation by the office of one member of the progressive caucus, who said a person in that income range would be eligible for expanded Medicaid. I pointed out that the income for expanded Medicaid was $14,400 and that the poverty level for a single person is $10,835. Am I wrong? Can someone show me where a single person at the $35,000 income level can get Medicaid? On the West Coast, Rep. Woolsey has an "Are you insured" poll, followed by an add for the bill, stating that subsidies are available. Nowhere did her ad state that the subsidies are, in fact, inadequate.
We have to face reality that after this bill passes there will be a class of people in the $14,401 - $40,000 income level who will not be able to afford the premiums. And the $13,000 in premiums for a family of 4 on $55,000 will also be a struggle.
I haven't heard anyone say what premiums will be charged if a person becomes unemployed? Will they have to sell their car and all their possessions and go on Medicaid? COBRA is not affordable on unemployment.
Yes, I am willing to listen to those who plead that their situation will be much better under this bill than under no bill. But what will be done about the fact that there will be masses of people who will be mandated to pay premiums when they simply do not have the money? Are we going to let such people be subjected to interminable collections and fines on top of bills they can't pay in the first place? This is the problem with policy by percentages. The percentage thrown under the bus are real people and this will be a real problem.