Health Rising generally stays as far away from politics as possible. While one side of the political realm may at times offer more for chronic fatigue syndrome (ME/CFS), fibromyalgia, and chronic pain patients, the difference is rarely dramatic enough for Health Rising – a largely donor-supported organization – to tread into these rather treacherous waters of supporting one party over the other.
This time I think it’s different. This time the potential exists for major changes to the availability and affordability of health care. So putting aside all other aspects of the Trump administration, and trying to avoid the hyper-partisan environment that prevails today in the U.S., below are some actions to consider when voting in the upcoming election.
The Nov. 6 election will determine which parties control the Senate and the House.
Affordable Care Act
“We’ve mostly obliterated Obamacare” President Trump
Evisceration of the Affordable Care Act (ACA) – Attempts to overturn the ACA began almost immediately after it passed in 2010 but over time a majority of Americans have come to support it. The ACA was never perfect; indeed, it was impossible that such a complex act would not run into problems expected and unexpected over time.
Changes to the Affordable Care Act are reducing access to affordable health care for many.
Rates were clearly much too high for some, but the benefits, particularly for those with two issues rife in the ME/CFS and FM populations – pre-existing conditions and lower incomes – were substantial. Government subsidies and regulations allowed me, for instance, for the first time in years to get excellent health insurance at an affordable price.
The Trump administration has made the evisceration of the ACA a top goal. Recently, President Trump has said he has “mostly obliterated Obamacare”, “essentially gutted” the law and that “Obamacare is finished. It’s dead. It’s gone.” No longer is there talk of repeal and replace – the focus now is simply on getting rid of the law. The Trump administration’s actions have not been wholly negative. At least in one case, a change made appears to have increased access to health insurance in some states.
Despite attempts to weaken the ACA, enrollments have held steady and premiums are down this year – in some states dramatically. Plus health care costs are growing at a lower rate than before the Act was passed and per-person Medicare costs have actually declined. Plus after having problems with insurers dropping out of the market this year, a substantial number of insurers are actually joining the market this year. Problems obviously exist with the marketplace – for some deductibles are sky-high, drug prices can be exorbitant, etc. but the exchanges themselves are thriving.
Strengthening the ACA
Reinsurance Plans Help – The Trump administration has allowed reinsurance plans which allow the states to pay the largest claims with a combination of state and federal funds – an option which some states say has been very helpful – and has led to lower rates.
Hobbling the ACA
Unfortunately, the Administration and its Republican allies have made many changes which are resulting in decreased access to medical care.
Stopped Government Cost-Sharing Subsidy Payments – In October 2017, just as state officials were approving the final rates for 2018, the Trump administration suddenly stopped “cost-sharing” subsidy payments that helped lower co-pays and deductibles for people with modest incomes.
Dropped Core Revenue Source – The penalties for not having health insurance are now gone. There’s no way around the fact that health care is so expensive that the health care of people with illnesses needs to be subsidized. Requiring healthy people to have health insurance was perhaps the easiest (and most controversial) way to do that. it requires that healthy people bear an extra burden now with the knowledge that when they become sick – as they inevitably will – they will be covered. The fact that the healthy people are not now required to have insurance shifts the burden back to those least able to afford it – the chronically ill.
The removal of federal subsidies will primarily affect low income residents.
Attempt to Invalidate Protections for Those With Pre-existing Conditions – The Trump administration joined a court effort to invalidate protections afforded to those with pre-existing conditions. If this effort succeeds, insurance companies will be free, once again, to raise rates for those with pre-existing conditions and/or not provide coverage for them. The Department of Health and Human Services estimated in January 2017 that 133 million Americans have conditions that could lead to their being denied insurance, or being offered insurance rates with exorbitant prices,
Offers “Junk” Insurance Plans – The Trump administration is allowing states to offer cheaper short-term insurance plans that are not required to cover pre-existing conditions or provide essential health benefits like maternity care, prescription drugs, mental health, etc. While these plans – sometimes called “junk” insurance plans – are cheaper, they will likely quickly lead to bankruptcy if any serious illnesses are encountered. Under some of these plans, being pregnant at the time of sign-up constitutes a “pre-existing condition” which is not covered.
Allowed States to Institute Work Provisions for Medicaid – For the first time, the Trump administration is allowing states to institute work requirements for Medicaid recipients, and apply for waivers which reduce the time participants are allowed on Medicaid, allow for drug testing to determine eligibility, etc.
Proposed Allowing Small Businesses to Band Together to Buy Health Insurance – At first blush, allowing small businesses to band together to achieve lower rates is an excellent idea but, because this effort occurs outside the Affordable Care Act, it will likely enroll healthy individuals who would otherwise have participated in the Act, leaving the ACA burdened with more ill people – increasing premiums and further destabilizing the Act. Because small businesses will be able to offer less bountiful plans than the ACA, their employees may also suffer when faced with illness.
Stopped Insurer Reviews – The Trump administration pulled back on reviews to determine whether insurers have enough doctors and hospitals in their networks to provide for their participants.
Cut Back Funding for ACA Promotion and the Time Period for Enrollment – In an effort to undercut the law, the Trump Administration vastly cut back funding for advertising and reduced the time period to enroll in the ACA.
Other Health-Related Changes
It hasn’t happened yet, but the Trump administration is attempting to reduce drug costs.
Reduce Drug Costs – on a brighter note, the Trump administration is attempting to find a way to reduce drug costs. Its latest gambit – to tie Medicare drug prices to those found overseas in developed countries – could help. Plus, the Administration is attempting to reduce drug costs for people on Medicare B – a program which covers a large swath of the population. Give the Trump administration credit here.
An Attempt to Stop Requiring Hospitals to Report Infections – The Trump administration produced a rule to stop federal regulators from reporting on infection rates at hospitals. (In-hospital infections affect about 600,000 people a year.) The administration eventually backtracked on this proposed rule change.
Impede Cannabis Research and Availability – Cannabis presents opportunities to people with chronic pain and sleep problems. Besides symptom relief, several studies suggest medical marijuana results in significant drops in prescription opioid drug use, hospitalizations, and even deaths due to opioid drugs as users switch to the safer drug. Support for medical marijuana and legalization is higher than ever.
Trump’s attorney general, Jeff Sessions, rolled back Obama-era rules which assured states that federal prosecutors were not going to spend time and money going after marijuana users, producers and providers in states that legalized marijuana. Under opposition, the Trump administration rescinded its rollback but is still blocking efforts to increase cannabis research – efforts that could result in more effective pain drugs.
The Trump administration formed a “Marijuana Policy Coordination Committee” which asked federal agencies to provide “data demonstrating the most significant negative trends” about marijuana and the “threats” it poses to the nation.
The Trump administration has also produced new rules to undercut the financial capabilities of cannabis-related businesses. A new rule prohibits banks from using Small Business Administration (SBA) backed loans from financing any business that directly or indirectly interacts with the marijuana industry. Such a rule could apply to a garden supply company which sells potting supplies or fertilizer to a marijuana grower.
The 2017 GOP tax bill did help out corporations and the wealthy but at the cost of a soaring deficit which has prompted calls for cutbacks in health- related programs and the social safety net that chronically ill people may rely on.
Mismanagement of the Veterans Administration – One of the largest governmental organizations, the Veterans Administration employs almost 400,000 people and its budget runs to almost 300 billion a year.
The Trump administration attempted to replace the head of the VA as the VA was in the midst of a mind-bogglingly complex transition – with Ronny Jackson, his White House doctor – a man who had no experience running even mid-level organizations. Despite his lack of experience, Trump called Jackson “highly trained and qualified”. Allegations of misconduct torpedoed Jackson and he is no longer Physician to the President…
NIH Funding Cuts – The Trump administration has three times attempted to drastically cut funding for medical research, twice through budgetary proposals and once through an administrative change. Thankfully, both Republicans and Democrats resisted the cutbacks, but they reflected an administration which places little value on medical research.
2017 GOP Tax Bill – The GOP’s tax bill primarily cut taxes for corporations and the wealthy. While a corporate tax cut was probably in order, the bill raised the federal deficit dramatically – resulting, as opponents suggested it would – in Republican calls to cut Medicare, Medicaid and Social Security – three programs people with low income, the disabled and the elderly depend on.
The massive increases in the deficit resulting from the tax bill will surely put pressure on Congress to reduce spending levels for medical research and health care.
Instead of investing in more equipment or research, or increasing wages, corporations used their tax windfalls mostly to buy back stock options – and reward their investors. Wage growth has been mostly unaffected.
Conclusion
While a few benefits have occurred, for the most part Republican control of the Presidency and both houses of Congress has resulted in reductions in support for the chronically ill. Exploding deficits have already resulted in calls to cut back support for people who are ill and/or have low incomes. Attempts to reduce protections for those with pre-existing illnesses are hard to understand.
More of the same is likely to come, however, if one party continues to control all three branches of government. Joint control of Congress would hopefully force the kind of bipartisanship John McCain asserted in his last days is missing today in the U.S. and is needed to solve the complex health care problems facing the U.S.
Wow. This is worth posting on my Facebook. However before I do I think a little clean up on the editing is required. More notably in the last 3-4 paragraphs.
Thanks for the tip. Underway now.
Go, Cort, go!
I am worn out from all the Trump bashing, and now it comes from you too. This biased article is not why I signed on to receive these emails. The reason the ACA is popular is because most of the plans are subsidized by the government (tax payers). I do not want government health care – the VA is a perfect example of how it will function.
I’m sorry if this feels like piling on. This is such a difficult political climate but for me it’s gotten to the point where it’s time to step into the fray and give the subject a hopefully more or less objective look.
Yes! Health care for the ill is subsidized by the tax payers. That, I’m afraid, is exactly the point.
Consider what happened to someone who came down with ME/CFS or another chronic illness such as a heart attack and cannot work. They employer covered health insurance – if they had it – often carried them for awhile. Then if they had the money they went into Cobra which was extremely expensive but did cover them for a time. Then unless they were able to get disability – an uncertain process which could take years – they were basically on their own. They had a pre-existing condition which insurance plans often did not cover and their insurance rates were higher to boot – while they were unable to work.
Unless that person has help paying for health insurance they’re on their own. It’s a difficult situation. Medical bankruptcy loomed. (I filed for it once. Medical bankruptcy still occurs far too often but rates have fallen dramatically. http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-bankruptcy-20170509-story.html )
The government subsidized health care I receive, by the way, is wonderful. It helps with preventive expensive procedures such as colonoscopy and I can afford to see a good doctor in a good system. He doesn’t know nothing anything about ME/CFS but everything else is covered.
I didn’t get government run health care as in the VA by the way. The health care I get is from a privately run group. The insurance policy which allows me to see the doctor is subsidized by the government but it ends there: the office is privately run.
I do resist the attempt to identify this blog simply as Trump bashing. I understand that it can feel that way in this overheated partisan climate but surely it’s possible to make an objective attempt to analyse this situation. The Trump administration has produced some positives and they are listed. I was quite happy to find them. If you know of more I’m happy to put them on.
Hi Cort, thanks for an objective assessment. I am politically conservative and did not feel there was any “bashing” or partisan approach. ACA did improve things for many and also led to complaints from others including persons I know who are not “conservatives.” I guess I hoped that problems would be fixed by better solutions but this seems to have dropped into low or no priority land. I would suggest that readers, especially those who are politically conservative, send your blog with their comments to their congress people, especially those in midterm election, and request a reply as to what they are willing to support. Sometimes it is mainly a matter of lack of insight. Maybe we need to create a youtube channel or participate in some already out there. There are a number created by young people who have recently become “conservative” due to disaffection with tactics among “progressives” and they still are pushing their more progressive values. They are of all ethnic groups and have millions of viewers. They could be our allies in transforming healthcare no matter who wins midterms. The issues are way bigger than parties and partisan battles. I have been conservative for decades but I would have voted for Bernie. We are looking for good leaders who honestly care about people. And who will listen. Let’s start talking more to them and see who will listen.
As one whose energy level varies greatly, I am never sure what I can commit to, but you have identified an important area and I will see what I can do. And competition often helps get the lead out so not sure what is best way to motivate Congress to remember promise to not just repeal but replace with better. But clear and detailed and relentless messaging with suggestions from constituents couldn’t hurt, as they say. And this shouldn’t stop after the midterm election. A “bipartisan” statement from a chronic illness forum membership addressed to candidates and elected reps from all parties might be a great move and provide a model for other illness groups. If we can as a group show “across the aisle” solidarity for important healthcare requirements, maybe we could help to inspire the same in those who are elected to represent us.
If there are members who would want to join in such an effort, perhaps we should create a new forum for this. Maybe there is already a such a forum. I haven’t looked at the forums for a long time since reading your excellent blogs and the many comments has kept me busy. But your blog has made me think. Whatever the results of the election next week, we need to make a united and continuing push for humane affordable common sense healthcare for all, including conserving the improvements from ACA, as well as fixing gaps and problems and also funding appropriate support for medical research. And the fact that our members are of differing political persuasions should not be a barrier but a potential contributor to the powerful statement we could make and the example we could give.
Hopefully. this is not just my fevered imagination speaking. I am still recovering from a tummy bug. I hope that you and any readers will understand what I was trying to communicate. If not and you let me know, I will try to be clearer. I do think this is something we should consider doing.
I wanted to reply to you, Cort, and Ruth below. Cort, you broke down all the major considerations around where things stand right now in the U.S. with medical care and health insurance. You presented it all succinctly and informatively. I learned some facts I wasn’t aware of. Good, affordable, wide ranging coverage, that is efficient and uncomplicated should be desired by any party or candidate who truly cares about Americans’quality of life and access to health care. Americans pay trillions of tax dollars into the Pentagon, military spending and on weapons systems, yet I rarely hear complaints about such use of taxpayer money. I am glad you finally have some good medical insurance to help meet your needs, Cort. I am 74 and have a Medicare provider insurance that I am so pleased with.
Ruth, you are so articulate! You wrote such a well thought out response. I really liked your suggestions, especially inclusiveness and bipartisan approaches to our elected representatives. The forums may be a way to hash out drafts of letters, or those of us who wish to have input/recommendations can share our email addresses with each other. Hope you see my reply. Cheers! Judith
Hi Ruth,
Thanks for your deep and respectful response. You seem to cross the gap between political parties well by looking at solutions. My sincerest respect.
As a European person, I intended to keep out of this discussion. I still do not chose a position, but I might offer insights from how our good and affordable healthcare system works. It could help you trying and creating a better proposal that both sides can agree on.
Let me start with: good health is priceless. In a free market system the best doctors, hospitals and medical corporations will charge almost that amount. That’s supply and demand and it makes complete coverage near uninsurable.
Price for life threatening curing healthcare will charge close to what enough people can afford. Price for basic healthcare like a local daily practitioner, dentist or basic surgery and medication can be negotiated more.
Not knowing the details of Obama Care I still believe that one of the main complaints is that people must insure themselves and that insurance companies must provide it. That leads to price hikes, people “feeling healthy enough” to not take an insurance being forced to increase expenses a lot and to some companies willfully lowering service in order to reduce costs.
The idea about forced subscription is this: without it mainly the sick and elder will subscribe reducing the money pooled while having increased expenses per subscriber. That model gets very costly for the insured. It seems the Obama model however gets very costly for the younger and healthier.
Part of the cost problem is because the system is new. Many people did not pay any insurance before. Now uninsured people did not support the system in their healthier and younger age. People who are company insured did put some buffer aside but reality with private insurance is that if one gets really longtime sick one often loses its ability to further afford insurance. In reality this allows insurance companies to lower the required buffer. In the free market you pay the correct market price for an insurance with such “incomplete buffer”. This means even insured people haven’t build sufficiently buffers for their full potential future ailments.
Switching from one model to another therefore is going to hike global cost a lot. That is indeed a fair concern of plenty people. Combine it with already very expensive healthcare in the US and that gets troublesome. Maybe the bridge could be divide by going step wise:
* Aiming for at least basic healthcare for all sounds less ideal but easier achievable. Costs per person are far lower. This system again requires forced subscription to work, but at far lower price per person.
* One cannot deny people to keep choosing for their better private insurance. But doing so would leave only the sick and elder to the forced basic healthcare again making it unaffordable. The potential solution here is to split current private insurance into two packages: a smaller basic health care + a bigger premium health care.
* In this model basic health care is forced subscription and pays for a fixed amount for each medical service. Forced subscription is even a bit fair here: many people in the US who can’t/won’t subscribe end up in the much more expensive emergency room who has to take them on. That loads cost, that are ballooned because waiting that long has increased disease severity a lot, onto the hospital and the people who currently have private insurance. So forced subscription for basic healthcare might be no more expensive for the insured people, something that is an important and fair issue for these people and voters.
* People who have full insurance have both basic and premium service. For each request for payback the basic service first pays the predefined amount per service. The rest is payed by the premium service as before. That’s no more then a technical split up done by a performant IT system. When well done it poses few bureaucratic burden. Total price of both packages should be quite close to the previous private price.
* In order to solve the “lack of providers who accept insurance” problem either the insurance companies or the government could organize tenders. These tenders are for a fixed package of services offered by doctors, hospitals and drug companies. All professionals can compete. Important is to include “provide sufficient capacity” in the tender conditions in order to not create long waiting cues.
* It may seem unlikely that practitioners, hospitals and companies would put in a decent offer for such tender. But if I recall correctly it is already how current US private insurance works. And it works in other countries. For example for drugs that are out of patent, competition to be able to supply large amounts of equally quality medicine in very large quantities is attractive.
* If regulation is well thought, for hospitals it may be more attractive to offer a decent priced basic service package then to be loaded with people who can’t afford healthcare and flood the emergency room.
* For practitioners and dentist it may be argued that they will be unwilling to step into the system. There I’d argue that, if one pays for basic service only, one might have to accept that going to a doctor or surgeon with for example 5 years of experience is far better then no service. Of coarse, minimum service levels still need to be contracted. And that going to a further town is better then not to be able to go anywhere at all. I can imagine that having a “fixed stream” of patients with basic care needs is an attractive opportunity for a starting doctor (with ideally options of contracted guidance of a more experienced college).
* In order to not deteriorate premium quality service for the premium members, it is important that they do not have to go with the providers that contracted to this basic service. They can go to any provider they wish and get the same reimbursement as all who are covered by basic insurance plus the nice additional amount from the premium service. In the future they might get even better service as the model allows for younger professionals to gain experience quicker in this model. So when visiting a more experienced doctor in the premium model in the future, he will see a doctor who has gained quicker experience in his younger years.
* When a premium insured person goes to the doctor for a simple ailment such as a common cold he can decide if he goes to his premium doctor paying premium prices and getting the premium reimbursement or going to the cheaper contracted service paying less and getting the basic reimbursement, potentially paying less out of his own pocket. This choice can be made for each individual medical service so that the premium patient always can chose for the best service when needed or reduce cost when any provider will do.
* When designed and run well, the above system may be beneficial in terms of service and money for both previously uninsured people and previously private insured people.
Thank you Cort for posting this “political” blog. It is NOT at all out of bounds. Politics is hugely involved in, and I believe greatly responsible for the horrible state of affairs in our present healthcare system: its exorbitant cost, inaccessibility for many, and over-complexity of its delivery system. Your post is simply accurate and factual. And thank you for all the very hard work you do to make the Health Rising blog possible.
I agree! My feelings exactly. I almost considered unsubscribing to this newsletter after reading this post.
I’m much more concerned about big government hospitals like those in Massachusetts confining an ill person without consent. That poses much more of a threat to us and our children suffering with ME than any imperfect health insurance system. Very disappointed, Cort, despite all the good work you do that you’re not more open-minded toward free-market health insurance solutions and would post such a one-sided commentary at this time.
I’m sorry I’m disappointing so many people! But didn’t we already try the free market solution? The one where insurance companies, trying to protect their bottom line, either wouldn’t insure those with pre-existing illness or did so at rates that sometimes were impossible to afford?
The problem is that medical costs are so expensive now that in a truly free market system the incentive for insurance companies is to cover the healthiest people possible.
Large employers can snuggle people with illnesses into their policies but what if you get so sick that you have to stop working?
You could be in big trouble.
You may not want the subsidy maybe because you can efford the healthcare. Many of us are knocked out of commission and can’t efford or even get one at all without ACA. CFS, along with any spinal problem, is something insurance companies rather stay the hell away from. I myself had to take refuge in Korea for a few years partly because I had both and couldn’t get a coverage at any price.
Anybody is free and welcome to have other, more pressing issues than CFS. But this is a blog for CFS interest group and Cort’s article simply enumerated the implications for CFS patients. If you read that as a Trump bashing, well, please keep your disappointment to yourself.
Sorry for your “being worn out” by all the Trump bashing, but I can not for the life of me see how you consider Cort’s posting as being “Trump bashing”. Each and every point he made is factual, and some actual research on your part- by exposing yourself to credible journalistic sources, would demonstrate the validity of all of his statements. If you indeed suffer from this deplorable disease, then you should know the extreme hardships we patients must endure. Why is there so much disdain in the party you apparently support for helping out those who are truly in need? My spouse & I pay taxes to educate other people’s children, as we have none of our own. I don’t begrudge having to do that. We pay for roads and other infrastructure we will never use. We pay much for the wars which this country so flippantly and much too often wrongly engages in. One last point, as far as the “government run” health care provided by the V.A. my spouse is a veteran and utilizes a VA hospital/healthcare center in our state. The care is excellent, far better than any he has ever received while having private healthcare insurance, which we can no longer afford due to the fact that his employer provides absolutely no healthcare insurance and the disability caused by my ME/CFS has prevented me from being an income earner for most of my adult life.
Grammerly.com
It’s free!
I tried it! I had a technical issue with it unfortunately. I put this blog out before or rather as one of HR’s editors was checking it out.
Thank you Cort for providing a fact based article related to the importance of this election to those of us who’s lives have been upended by ME/CFS and to other patients who have suffered with their own illness. I hope people who see this will forward it to many family, friends, and others who may be enjoying the luxury of good health and help them realize we used to be in their shoes. Illness can take away your health, your job (which is where many get health care coverage), and the means to seek out and utilize the very medical care we now desperately need. Please consider these facts that Cort presented so well and vote accordingly.
Because of Obama, i was unable to afford my Insurance! So many companies dropped out. It is them not the Trump admin. doing this.
Obama, fining people who dont sign up for insurance? Really? These so called affordable care act plans, make u pay back the money they put out for your doctor bills..[read the fine print[ if you make a certain amount more, get an inheritance or win an award from an accident etc.. I know someone who had a better financial year and had to pay back $10,000.00.
Please do your research! I find it sickening that this forum is being used to further political agenda of the owner and telling half truths and lies to ill folk here. I could post more examples of how this is incorrect, but i seriously doubt it will be posted anyway.
Obamacare did have its problems. For you it didn’t work out. For me it has. One of the problems with Obamacare was I noted, was as I noted, that policies too high priced – way too high priced – for some. My sister was one of them. Her policy was unbelievably expensive – changes were clearly needed.
For me, though, the Affordable Care Act provided a huge help. I received excellent health insurance at a very affordable price. The regular double digit increases in health insurance payments I’d experienced prior to that stopped – plus in Nevada I had more health insurance options than I did before. It was basically a total win for me. I understand that it wasn’t for you.
The only way for people with illnesses to be able for afford health care is to get it subsidized and having healthy people do that makes sense to me. Then when those people get ill – as they will – they will get subsidized health care. Think of it as having healthy people taking care of the unhealthy.
I’m afraid I’m lost as to issues with inheritance,winning an award from an accident, etc but if you can substantiate them please post a link.
I reiterate that Obamacare was never perfect – it had problems – of course, it had problems – it was dealing with too complex an issue to not have problems. Anything that can prevent people with chronic illnesses from being penalized for being ill is the way to go in my book. My fear is that the opposite is happening.
So glad I live in Australia where health care is free and we don’t have to fight over this stuff. Multiple governments have lost or come close to losing elections when they tried to tinker with free health care.
Excellent article, you seem to have presented the pros and cons of the last two years with accuracy. Any president that is pro big business will cut programs that help the chronically ill and lower income levels. The current administration seems especially intent on dismantling them all.
So it seems but I don’t know why this is necessarily so. As I noted the Trump administration is attempting to do something no other administration has done – reduce drug costs.
I don’t know how it helps anyone to have a lot of ill people who can’t afford to get good health care. We know that not having health care ultimately increases costs as people get sicker because they can’t afford to get treated.
Productivity declines and costs increase. Families suffer. Bankruptcies go up. People lose their jobs, spend a lot of money on their health – leaving to fewer expenditures for other businesses. Overall it seems like most things get worse.
There has to be a way out of this that both parties can agree on.
“There has to be a way out of this that both parties can agree on.” Yes Cort, one would think so. But even on this forum, many have responded from their partisan affiliation. Conservatives tend to be appalled that you can see anything at all good in ACA and liberals are congratulating you for your endorsement while it appears to me that both parties have put special interests ahead of our interests. How can we expect our leaders to give up some of their knee jerks if we can’t? (We aren’t even well paid for ours like they are.). Could we ourselves model the power of “working across the aisle” for the common good?
Seriously, a blog post is not likely to change how a reader votes. It might motivate them to get out of bed and go vote. But maybe even more effective in bettering healthcare for us all would be for those Health Rising readers with the inclination to participate in a “bipartisan” Health Rising taskforce to work on a common “platform” regarding healthcare, medical research, etc. Unlike the annual efforts like ” on the hill ” that most of us can’t attend anyway, this could be all telecollaboration. After getting it together, we should be relentlessly communicating our message. Weekly if not daily. I have some ideas on this that will not cost anything. But we need to start by developing a coherent bipartisan statement.
So we need to form a bipartisan task group. We could start with your blog and fill in gaps and negotiate how we phrase things. It should be an open process so other health rising readers could comment on progress. So Cort, what do you think? Could we do this? Will how we vote, for parties and candidates who have mostly forgotten not only about us but also about most persons actually fighting chronic illness, likely move the bar on healthcare quality and accessibility as much as working together to create good solutions? That said, everyone who can should vote their persuasion so both sides see our potential power to influence elections and so they may take our statements seriously. A good turnout is a win for us all. And competition may encourage more focused listening. But how about also giving them a clear message from health rising members to listen to? Relentlessly. With a synthesis of the best from both sides. Perhaps we can show them the way. I don’t think it is rocket science. But of course they will have to give up some special interests on each side. Sigh. Maybe we can help create some new and special interests….. The squeaky wheel gets the grease.
The ACA passed by a hair–and during it’s crafting there were a lot of compromises that the Democrats made to help make it palatable the the Republicans. One of those compromises was giving each State the ability to opt out of some of the ACA health exchanges and other requirements. I’m sorry but I cannot be exact in naming them, but the bill passed in a compromised form–which was a contributing factor in the rise in healthcare cost–plus certain States which were unwilling to fully participate.
Many people discussed (often argued) this ad nauseam on the Inspire forum. Unfortunately, in politics it is difficult to please everyone–so this is what we got.
What ever a person’s health care costs–someone has to pay. It is likely that each of us will experience some costly healthcare event at some point in our lives. These are the facts. The ACA seeks to spread the risk and unfortunately because it has been gutted and misapplied, it hasn’t come up to its potential.
I’m sorry to those of you in States who experienced this misapplication of a well meaning policy. To echo Cort’s argument, it’s either the sick pay more so the healthy don’t have to–or we all put money into the pot because our time will eventually come.
Personally, I think if there is good will on all sides, there can be a workable plan for all. Thank you Cort for what I think is a balanced appraisal of this situation.
One would hope that in an issue of this importance to so many Americans that a way can be found to bridge the divide. How nice it would be if this issue forced some bipartisanship.
Thank you for stating so eloquently what seems to me to be necessary: the risk simply has to be spread in some way for those of us who are ill to afford health care. I just don’t see any other way (????)
Nancy and Cort, I agree with you both. Perhaps I should have read through all blog comments before I composd my replies to Cort’s replies to a couple of previous posts. But my fevered brain (I have a tummy bug and my CFS gets worse too so please forgive my rambling) was timing out and I wanted to propose the idea of creating some sort of bipartisan negotiated statement of our understanding of the problems, objectives and potential solutions to present to the outside world using some powerful communications channels which I can describe if there is interest. Please see my replies above and let me know if I am nuts. I value criticism. This idea popped into my head, along with a plan for how such a statement could be widely communicated, while reading this blog and the first few comments. I will save the communication plan for now while we decide if we could create such a statement/platform on healthcare issues. Of course we would want to pull from others’ thoughts on this and try to arrive at a bipartisan consensus. Hopefully we will be offered no incentives by special interests (lol); So, that is why we might succeed.
More voters need a better understanding of the problems, issues, and payback of good solutions, and more politicians need to know that we know. Special interest groups pay lots to influence votes and politicians; people of good will, who care about evidence and truth and fairness, will need to work together to increase clarity in the discussion. We need to try to influence the discussion outside our community among other people of good will who are not afraid of hard truths or the hard work of building bridges and solutions.to hard problems.
I have done advocacy on CFIDS for 30 years. The San Francisco CFIDS Foundation and Hotline was started at about the same time as the CFIDS Asssociation. Mark Iverson and I ran the only two national organizations in the country.
We helped Mark hire the movement’s first advocacy director who we referrred to him. I was on the early Federal Committee and brought Phil Lee to chair it
Over the years we have always been bipartisan and had many Republican friends on the hill.
But the current Congress wants to cut back on Social Security and Medicare because people .,don’t need entitlements..and they are picturing us as welfare recipients.
I can’t live without my SS check and Medicare is the best insurance I have ever had
What ever you believe, see if you can get someome to help you to the pols tomorrow and ask a worker to help you with the ballot..ask to cut Iin if needed. We need y’all out there right now??❤️
A Raise Can Wreak Havoc With Your Health Insurance Subsidy
Obamacare Tax Credits: The Pay Back Requirements For Underestimating Annual Income
For Many Middle-Class Taxpayers On Obamacare, It’s Payback Time
just a couple of article headings, i dont have the energy to try and get the links to work. ..I feel with my limited energy, i cant be wasting time debating this and reading Trump bashing and half truths. I am always appalled that there are so many “lemmings” willing to repost things like this and take them as truth! I will be unsubscribing from this forum, as i will not support the owners political agenda..
Except you’re missing the fact that I actually agreed with your premise that the rates were too high for some – such as my sister who fits your income bracket.
I don’t consider myself a lemming. +I looked up your links to see what I missed and this is what I found.
This link – https://www.npr.org/sections/health-shots/2017/01/10/509012824/a-raise-can-wreak-havoc-with-your-health-insurance-subsidy – goes to a blog which reports that if you don’t report all your income from different sources your subsidy may drop or you may have to repay subsidy payments you received if you didn’t report all your income.
This link =- Obamacare Tax Credits: The Pay Back Requirements For Underestimating Annual Income – https://www.nolo.com/legal-encyclopedia/obamacare-tax-credits-the-pay-back-requirements-for-underestimating-annual-income.html – is the same; it states that if you underestimate your income and get too many subsidies you will have to pay some of them back.
This one – https://www.webmd.com/health-insurance/news/20150226/for-many-middleclass-taxpayers-on-obamacare-its-payback-time#1 – cites a couple who didn’t have any income at the beginning of the year, then got two jobs – neglected to tell the government that they now had income – which the ACA clearly states – and then were upset at having to pay back the subsidies at the end of the year.
I don’t see a problem with any of these. Subsidies are based on your income and if your income rises you’re not eligible for all the subsidies and are obligated to pay them back. What is wrong with that?
Sorry, Emily, there are isolated stories like yours, I’ve read before. I know more who have been greatly benefited from the ACA. My husband and I each have our own an individual health plan because we run a small business with 3 employees. We cannot afford to offer health benefits. Our staff have all acquired health insurance for the first time in their lives thanks to Obamacare/ACA. They are very thankful.
Wow, amazing. What, exactly, passes for “Healthcare” nowadays?
I’m in Massachusetts and despite having Anthem Blue
Cross I can’t find a PCP who accepts insurance. Any insurance!
I’ve been through 5 PCP’s in 5 years through no fault of my own. When they’ve had enough frustration they just disappear.
The good doctors have run for the exits and who can blame them? They’re paper pushing government drones now. Try reading a bit about the administrative burdens and the power and control that has been taken away from physicians under “Obamacare.” Bureaucrats make decisions now, not doctors. I guess by making things “fair,” our overlords meant under the new system, healthcare would suck equally for all of us.
Obama and the Democrats ruined healthcare for everyone in their heavy handed attempt to socialize medicine. There was no need to allow insurance companies all of the seats at the table.
Our system had issues, sure, but they were solve-able. Now comes Single Payer. You won’t like it. And the good docs will opt out. It’s already begun.
I’ll go next to a doctor who I’ll pay out of pocket. Get less, pay more. Pay through the nose, get nothing!
My deductibles, OOP’s, and prescription costs have all gone up each year. My insurance is almost worthless at this point. I’m disabled so I also have Medicare. Guess what, no one takes that either!
TRUMP, MY FANNY!!! So disappointed to see nonsense like this here.
PS You do know that Congress opts out of Obamacare, right?
I’m sorry that your experience of Massachusetts was so bad. My experience with the exact same health insurance was fabulous in Nevada. I had my pick of physicians and was able to go down an extensive list and check out each doctor’s reviews and pick the one I wanted and I settled in with him. I guess different states have different systems. All I can go from is from my limited experience.
I don’t know but I don’t think all the problems are due to Obamacare. I know of a physician in Nevada who switched Healthcare Providers and had a miserable time and eventually opted out of that one.
There’s a lot of negative stuff going on in the modern medical age. Doctor’s are more and more being forced by health providers to see more patients more quickly and overall be more regulated. I don’t think that will change if the Affordable Car Act is totally eviscerated – I think it will probably get worse…
All the players were at the table as the ACA were created – the doctors, insurance companies, hospitals and patient advocates when it was enacted.
Thank you for the good article. I simply like Medicare for all.
Sorry you’re getting some blowback for this informative piece. I found it very helpful. To me, the idea of insurance is to spread risk among a large population. Our existing health insurance system is built largely on employer-provided insurance, which typically spreads the risk evenly among employees regardless of age or health status. Unfortunately, this leaves out all those who don’t have employer-provided insurance, which includes a lot of the sick and disabled. If we don’t want to scrap employer-provided insurance, we have to find a way to provide access to health care for those outside that system, and the ACA was an attempt to design such a system. It was a compromise among many many competing interests and ideologies.
I’m disappointed that so many people just want to throw stones at it or tear it down rather than improve it. Of course our first attempt to provide universal coverage wouldn’t be perfect. What is ever perfect on the first try? But the alternatives are fairly clear. We will have a complex patchwork system like the ACA, or we will move to a single-payer system (with all the rather extreme potential virtues and vices of such systems), or we will be a society that leaves vast swaths of our population without access to adequate healthcare. It’s as simple (and as thorny) as that.
I appreciate all your work on behalf of our patient community.
Thank you, Cort. As always, you did great research. I appreciate this article very much. It appears that improving healthcare was never a goal.
Good article, Cort! Thanks for taking the time as usual to meticulously and objectively
present the facts around the complicated healthcare issue. I am glad you wrote it and also offered the space for people with other information to present their info as well. I don’t know what more you could do.
Ultimately we have to ask ourselves if having more people covered by health insurance is a good thing. Before the ACA, 48.6 per cent of Americans were without health insurance. Last year 29.3 per cent were uninsured. There have been over 200 organizations supportive of the ACA including the AARP, American Geriatrics Assoc., National Council on Aging, The Economist, Easter Seals, Alzheimer’s Foundation, American Academy of Family Physicians, American Academy of Pediatrics, American Assoc. for Cancer Research, American Assoc, for People with Disabilities, American College of Physicians, American Diabetes Assoc., American Heart Assoc., American Medical Assoc., American Nurses Assoc., Arthritis Foundation, Epilepsy Foundation, and National Multiple Sclerosis Society. These groups are hardly radical. They just know that people who have no health care suffer needlessly, discontinue working earlier, and die prematurely. They know that these folks will get their health care in emergency rooms if they don’t have insurance and that the insured will cover their bill. Everyone needs health care at one point or another and until the Republicans come up with a workable solution, which they promised but have not delivered, ACA fills a need. It doesn’t fill all needs, but ask those who are now covered if they want to go back to being uninsured.
Great article Cort! Very informative and nicely balanced—exactly what I expect from the best writer in the ME/Fibro arena.
I am sorry that several of your readers were upset by the article. You’re lucky you didn’t discuss global warming, or decency and honesty in politics, You would’ve been excoriated by the same people.
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Your tireless patient advocacy and fabulous newsletter and website make a huge difference for patients like me. You are a true hero, Cort, and you are appreciated. Thank you very much for all that you do.
I forgot to include global warming. I knew I forgot something!
Thanks Rich and thanks for your support over the years 🙂
Come to Arizona where everyone one was thrown off their insurance after the ACA was enacted and all the insurance companies pulled out of the state except for one company…and no doctor will accept these ACA plans. We now have people who used to have great insurance who can not afford the ACA plans and if they can…no doctor will take it. This mess was created intentionally by the Progressive Left with government control of the healthcare system as the end game…control people’s healthcare and you can control the population…it is another way to pit people against each other…now we have the healthy vs.the sick going at each others throats. This mess was created prior to President Trump taking office.
Arizona in particular has had problems with the ACA and it has often been used as the poster child for ACA’s problems. In 2017 the main insurer posted 51% increases in premiums but in 2018 premium increases were amongst the lowest in the U.S. and most of those on the exchange received subsidies to help them pay the costs.
It’s not true that all insurance companies pulled out of the state, however. At least one was available everywhere in the state and according to this article (https://www.healthinsurance.org/arizona-state-health-insurance-exchange/) two more have joined in 2019. That’s not great and I don’t know why Arizona is so different from Nevada but it is some progress.
Plus from 2013 to 2016 the number of uninsured people in Arizona dropped dramatically and over half a million people were able to get Medicaid because of the law – meaning that many low income people finally had the opportunity to have health insurance.
Overall in the U.S. health care costs have risen at a lower rate than during the Bush administration and a substantial number of new insurers entered the markets this year. – https://www.washingtonpost.com/opinions/the-big-secret-about-the-affordable-care-act-its-working-just-fine/2018/10/31/068da248-dd41-11e8-85df-7a6b4d25cfbb_story.html?utm_term=.77ae9f418e7a This is despite the efforts to kill the ACT. How much better off would we be if attempts had been made to fix it?
Maybe instead of gov’t subsidized flood insurance for the coastal elites, there should be subsidized health insurance for pre-existing conditions. And just because it worked for you, doesn’t mean everybody else has to pay ridiculous rates. I don’t mind a little more, but triple my old rate with a deductible that means it’s nothing more than catastrophic coverage?
I totally agree Lisa. So the question for me becomes how to fix yours and others too high rates while giving protection to those with pre-existing illnesses and those who couldn’t otherwise afford health insurance?
I assert that the easiest way to do that is to fix the Affordable Care Act – not cut it off at its knees – while pushing those with illnesses back into the horrors of the old days when they often couldn’t get coverage.
Dear Cort,
Thank you for taking the risk to publish commentary on these elections and the Affordable Care Act. I really appreciated your analysis.
Best,
Dave
Wow, I could dispute many of the points you made but I don’t have the energy. If you think that steering people toward the radical mess that the Democrat party has become is a good idea, or that ACA is a good thing, you may not be aware of all the issues – like insurance companies that were bailing out or about to bail out because of the cost involved to them, the amount of states with only 1 or 2 insurance companies left, the dramatic increase in premiums and deductibles while receiving fewer benefits, the unfair enforcement of a $2,000 penalty for not joining, the inability to “choose your own doctor” that was promised and other issues that were causing it to implode or Pharma’s stronghold on government. You have one of the best blogs out there and I think this is going to impact your credibility and dampen how many feel about the blog and you.
Thanks for the nice words about the blog. Please note that these political blogs are rare. But back to the issues.
You can say people should have the right to choose whether or not to carry health insurance. I’m sure the same argument was made for mandatory auto insurance. But if you don’t choose to carry health insurance and you get sick society will have to pick up your cost. How fair is that? For that matter how fair is it that people, through no fault of their own, got sick – and prior to the ACA – are faced with not having their health needs covered – or face exorbitant price increases. We have to figure out a way for the chronically ill to get affordable health care.
The ACA has its issues – of course it does – but it is attempting to cover the chronically ill.
I checked out some of the issues you mentioned:
Premiums – According to CMS, of the 39 states on Healthcare.gov, five had double-digit declines, led by Tennessee with a drop of more than 25 percent. Other populous states, including Pennsylvania and New Jersey, had declines exceeding 14 percent. Only three states had double-digit increases, and all the states were small: Hawaii, North Dakota and Delaware. More important, the subsidized premiums across all states rose a mere 2 percent. https://www.washingtonpost.com/opinions/the-big-secret-about-the-affordable-care-act-its-working-just-fine/2018/10/31/068da248-dd41-11e8-85df-7a6b4d25cfbb_story.html?utm_term=.77ae9f418e7a
Generally Affordable Premiums – There are always exceptions – people who for one reason or another face higher than average premiums but in general the premiums seem pretty affordable:
The average premium for a benchmark policy for a 27-year-old is about $405 per month, according to the Department of Health and Human Services. But because of subsidies, the average price a 27-year-old will actually pay is $140 per month. https://www.npr.org/sections/health-shots/2018/10/31/662186774/looking-for-aca-health-insurance-for-2019-heres-what-to-expect
# of Insurers – In 2016 five states had only one ACA insurer available. – https://www.cnsnews.com/news/article/terence-p-jeffrey/single-provider-5-states-will-have-only-1-obamacare-insurance From 2014-2018 a survey of 20 states found that the average number of insurers was five – http://files.kff.org/attachment/Issue-Brief-An-Early-Look-at-2018-Premium-Changes-and-Insurer-Participation-on-ACA-Exchanges
In 2017, though, things deteriorated. Insurers stepped out of rural states in particular. Premiums and deductibles went up for the better off in particular. Instead of over 90% of the population having access to 3 or more carriers only 60% did.
Things are better in 2019 more insurers have joined the market and the number of counties with one insurer has dropped by 25% – but still not as good as they should be.
But the reason for the abrupt drop in insurers in 2017 the study found was not the ACA per se but opposition to it:
Read more about it here – http://www.bu.edu/sph/2018/10/29/opposition-to-aca-may-be-cause-of-decreased-choice-and-competition/
Health Care Cost Increases Less Than Before the ACA – For eight years since the ACA passed, health-care costs have moderated, growing much less than during the George W. Bush administration. Indeed, per-person costs in Medicare and Medicaid have declined, and per-person costs in private insurance have increased on average less than 4 percent annually since 2010. – https://www.washingtonpost.com/opinions/the-big-secret-about-the-affordable-care-act-its-working-just-fine/2018/10/31/068da248-dd41-11e8-85df-7a6b4d25cfbb_story.html?utm_term=.77ae9f418e7a
Most Get Subsidies – Last year, experts said eight of 10 people in the ACA marketplace qualified for subsidies – https://www.news4jax.com/health/stable-premiums-more-options-as-enrollment-for-obamacare-2019-opens
Trump Administration Actions INCREASE Insurance Premiums – By the way a Kaiser Foundation study estimated “that if not for the changes by Trump and Congress, premiums would have been substantially lower next year. Standard “silver” plans will cost about 16 percent more than they would have otherwise – https://thinkprogress.org/study-trumps-actions-are-directly-responsible-for-rising-health-care-premiums-7346811a2003/
You begin your report with a disclaimer of avoiding politics—- and end with a diatribe against our president and the Republican party. You have by this means, discredited your organization’s credibility; my future interest, and any continuing financial support. If you are directly responsible for this irresponsible act of using this forum to generate votes for the Dumb-ocrats, you should render an apology to those in healthcare, CFS victims, and resign!
I’m sorry I lost you Frank! Hopefully time will heal wounds.
I think you have a rather loose definition of diatribe, though! I looked it up. The definition is “a forceful and bitter verbal attack against someone or something.”
I think this as more of a call for bipartisanship. It’s entirely possible that the U.S. works best when the self-sufficiency of the Republicans merges with the desire of Democrats to support their neighbors.
I think its an accurate statement and its a call for bipartisanship.
Cort, I admire your courage to bring up this issue– it would have been so much easier to forgo the effort, knowing that some would likely balk vociferously, without the balance and compassion that you so clearly endeavored to communicate. Indeed, your presentation of the issues was clear, thoughtful and intelligent. Your motivation in writing this post has been backed up over the years by the undeniable care for our community’s wellbeing that you project with each posting that you do. We benefit enormously from the same balance, compassion, clarity and intelligence that goes into every communication you put forth. I also admire the balance and calm with which you respond to others’ ‘diatribes’. Wishing you continued strenth as you articulately advocate for us.
Thanks Jane. I certainly opened up a can of worms! Thankfully HR is 99% politics free and it will soon be back to covering research, treatment and advocacy. I’m rather looking forward to that. 🙂
Frank, you’re the only one I see using insults here. We should be able to disagree with each other without calling each other names.
Cort, I think you’ve struck the right tone. I’m not a partisan but, as someone with fibromyalgia and ME/CFS, the prospect of repealing or damaging the ACA without proposing a replacement frightens me.
To those who don’t want government controlling healthcare, why would you want corporations with an obligation to maximize shareholder profits controlling it? There’s no financial incentive to cover people with expensive, long-term diseases under that model.
Thank you Cort, for another well-researched article with lots of important facts. Everybody needs to be as well-informed as possible in order to cast a good vote, and you have really helped with that.
My entire state has gone to vote-by-mail, which makes it a lot easier for those of us who are stuck at home most of the time. I was doing absentee ballots for years so I didn’t have to go stand in line at the polling station, and now I don’t even need to do that.
Thank you, Cort, for the effort you put in to present the issues in such a well thought-out and researched manner. I don’t understand why anyone has to see your presentation as a partisan attack. You’ve simply laid out information.
Neither political party has addressed the underlying spike in health insurance – the lack of any meaningful check on health care costs. If anyone has any thoughts that the U.S. system operates in a free market environment then next time you get ill, look up the costs for each facility and weigh it against their detailed health outcome quality reports (You won’t obtain this even on a good day). And after several hours of negotiations and if you’re still conscious, choose the best deal. The reality is many won’t have an option beyond the lone consolidated conglomerate that might be available. You will go there, hopefully be treated well and you will be sent a bill that they decide is the proper amount. Period.
So before anyone gets all unnerved over the big bad government getting involved in health care, consider what the current system of maximizing profits above anything else really means for your health and financial solvency.
We can have whole other conversations about what is good government vs. bad government.
As others have mentioned, the A.C.A. was a product of compromise and has flaws that reflect that. It was an honest attempt to help those who most needed it and has succeeded in that regard for many. And I agree that premiums are too high for others. I just ask that people consider the root cause of it. Opposition has tried to dismantle the A.C.A. endlessly without offering any quality solution. As in NONE.
Here is my personal experience with health insurance.
Our premium under the ACA mandated health insurance program for two healthy adults was $1600 per month! This was unsustainable for us! We could not afford dental insurance because of the amount of money we were spending each month on premiums — however, our ACA plan mandated that we have PEDIATRIC dental even though we do not have children. We were paying for dental insurance but couldn’t use it!
After the mandate was lifted, we changed to a non-ACA compliant health insurance plan, which meets our needs. It is only $550 per month. (and it even includes a dental plan we can use)
I feel for you. And everyone else that has to fight to have adequate health care.
My take on it is that we don’t have to reinvent the wheel. Every other advanced country provides health care for it’s citizens. And none of them pay more than 1/2 of what we do for it. It is not an uncommon assumption amongst Americans that we have the best of everything. Statistics in many categories of health outcomes proves this to not be the case. The W.H.O. rates us 37th. Can’t we do better?
Wouldn’t you like to be free of the stress of worrying about having coverage, what all is covered, how to pay for it, what will the next year bring, etc. And the trade-off would be that if any of us has the good fortune of a substantial income in the future, we’d have to pay a higher percentage of taxes to make it work. I for one would love to have enough health back again to be able to earn more income and to contribute more in taxes that are well spent.
I’m glad to hear there was a way out – very glad to hear that and I think your and my story reflects the pluses and minuses of the ACA. $1600 a month is way to much for two people. On the other hand, if you have a low income it can be a life-saver.
My premium at age 59 with a pre-existing case of ME/CFS – is about $440 a month for an excellent, very robust silver plan – the one that’s recommended. With subsidies I pay about $140 a month. That means that your plan cost TWICE mine. Why that would happen I don’t know but it must have to do with how the states ran the ACA.
Should the ACA fail I will likely be back having to pay the full price – something I couldn’t even begin to afford. We’re really at opposite ends of the fence – I found it very affordable and you found the opposite.
There’s got to be a way to provide affordable health care for all.
I don’t know why your plan would require pediatric dental or any dental at all – my plan doesn’t require dental, pediatric or otherwise; it’s an option I can choose or not choose.
I have been a supporter for many, many years. It is the best chronic fatigue, fibro… information I have ever found. That being said, I am unsubscribing as soon as I finish this comment. I am surprised you have the energy to create such a totally misleading, and outright wrong information about Trump. Very well thought out sentences to attribute opinions and actions of others to Trump…
Hi Betsy
If you’ll check I think you’ll find there are links to just about everything on blog; i.e. I didn’t create them and it didn’t take a lot of energy to produce them – I just looked up the Trump administration’s actions on the ACA and other health related issue and I got them from reputable sources. Whether the actions were positive or negative I reported them all.
If you think they are wrong I welcome the opportunity to be proven wrong but that will take your providing the evidence.
For example if you think I made it up that the Trump administration joined a lawsuit to stop requiring insurance companies from covering pre-existing conditions here are three links from three mainstream news organizations – the Economist, NPR and American Legal News stating that fact.
https://www.economist.com/democracy-in-america/2018/06/08/the-trump-administration-joins-a-lawsuit-to-shred-obamacare
https://www.npr.org/2018/06/08/618263772/trump-administration-move-imperils-pre-existing-condition-protections
https://americanlegalnews.com/trump-admin-against-obamacare/
If you think the Trump administration didn’t now cut off subsides to the ACA that were going to help low income people get health insurance – here are three stories on that. All are from middle of road news outlets – NPR, WebMD, Bloomberg News
https://www.npr.org/2017/10/12/540920671/trump-administration-to-end-obamacare-subsidies-for-the-poor
https://www.webmd.com/health-insurance/news/20171013/trump-says-hell-cut-subsidies-for-obamacare
https://www.bloomberg.com/news/articles/2017-10-13/trump-orders-an-end-to-key-obamacare-insurance-subsidies
If you think the Trump administration has not tried to slash the budget for medical research – you’re just wrong. From the Hill, NPR
https://thehill.com/policy/finance/324241-trump-budget-blueprint-cuts-funding-to-nih
https://www.npr.org/sections/health-shots/2017/03/16/520390147/trump-administration-proposes-big-cuts-in-medical-research
https://www.businessinsider.com/trumps-2018-budget-health-2017-5
These aren’t opinions – they’re facts. These are not actions by others either – they’re acts initiated by the Trump administration. They’re not my facts either – they’re facts as reported by mainstream news organizations.
I have quite a different opinion than the author. The federal government has vastly overreached its intended scope, and I’m all for rolling it back wherever we can. It’s not the federal government’s responsibility to provide or pay for anything for which it isn’t explicitly assigned power/jurisdiction in the Constitution, including health care. That power rightly remains with the States and the people. I’m also opposed to the federal government having a Department of Education (to name one example) because authority over education in the USA isn’t granted to by the Constitution.
For me, this is a matter of principle. There’s no doubt that returning to an originalist interpretation of the Constitution would inconvenience many of us in the short term, but by getting bloated federal bureaucracies out of the picture, the free market and State governments would be at liberty to create better solutions over the long run.
Just because something is good doesn’t mean that it should be provided by the government. Government’s rightful duty is to protect the rights of individuals. Anything beyond that is suspect of corruption/power grabbing.
We like to call it leadership…thank you. If the constitution considers women full citizens ..with all the rights…I’m all in
Natural remedies are needed in this condition not toxic useless prescription drugs I have not seen any Doctor & do not plan on it either I am done with their utter b.s.
Well presented info Cort!
The current level of frustration in the above comments makes me realize how unbelievably blessed I am to live in a country with Health Care for all.
I genuinely wish you all a healthy outcome in the coming
weeks/years!
The NIH never really studied diseases that mostly affect women. Look at MS, Lupus, Crohns and there is very slow progress on all chronic diseases. Breast Camcer is now out of the closet, but not auto immune or neuro inflammation
So if you believe women are equal members of society, you know how to vote. And if you want more research money, you know who to vote for.
One thing we have to remember is to be kind. ME doesn’t care who you are, what color, what weath or poverty , what religion, what gender or lifestyle.
And I know one of the major drugs that always help all of us…kindness, love and hope. I want whomever can help me with that. For myself and those I come in contact with. Anger gives me a flare up.
So nicely said Jan. In our very heated political times it’s good to remember to try to be kind and reach over and try to understand what the other person is thinking and saying – not easy an easy thing to do.
The NIH moved slowly on those diseases and now its moving slowly on another kind of mostly woman’s diseases – those that rarely kill, are largely “invisible”, cause enormous amounts of pain and fatigue and effect many women (and men). They include fibromyalgia, ME/CFS, migraine, interstitial cystitis, IBS and others…
They are the most poorly funded disease group at the NIH.
The big picture:
Now some neuro researchers are talking about two kinds of fatigue..the new baby fatigue and the disease fatigue. This makes sense for chronic illness, cancer, all neuro diseases
Cort, as always you have provided an analysis based on well researched facts. Without your site, none of us would have a clue what was happening in research. Thank you so much for all you do for us!
Thanks!
I agree with you Cort. Not political, just the reality. Pre existing condition is what we have.
Cort, thank you for your hard work putting all this information together for our patient community. I was so relieved to see the title of this article, and dove right in, got too sick to read, and after a few days I’m back and DID read it.
Obama Care is a mixed blessing, but I know that in my case, the “psychosomatic” label this illness received years ago played a huge role in my being abandoned by every single person who claimed to love me. The psychosomatic label is still believed to be true by doctors and the general public in spite of overwhelming scientific proof that this is, in fact, a terrible, severely debilitating disease. I am alone due to the misinformation that I am “choosing to lay in this bed” I need to “try harder”, and my former friends and my family say “I hurt too and still push through it”
I have NO ONE. I know I can’t be alone in this.. there have to be other ME/CFS patients that have lost their support system in the same manner.
I receive SSI, who takes 1/2 of my retirement (I had thought my retirement would be my ticket off of medicaid. now it only pays my rent… which after waiting for 8 yrs while being ill, finally has gone down due to getting HUD when the program took applications again . two yrs. later my name came up and I git myself and my child into a hud aporived apartment for 1/3 the rent I’d been paying. Many aids to daily living quit being covered on medicaid because of Obamacare. many programs that helped my autistic child were closed by HHS. We also both lost our doctors.
Still.. at least I have shelter, the lower rent allowed me to get an adjustable bed, allowing me to get jnto a sitting or laying oosition so I’m not trapped in the bedding. I also have Fibromyalgia and that pain added to the ME pain was significantly reduced by this bed, allowing me to lower my pain meds by 50% ON MY OWN. I hate those meds, but my doctor talked me into it after everything else they tried failed from MCS. He said my blood pressure was so high from the pain.. and it did go back down to pre-illness levels when meds helped manage it. Ive gone from a constant level 8 pain to a 4, unless I flare from PEM. Connective tissue injuries, inflammed and the severe edema from normal use of joints are extremely painful.. to the point of sobbing.
If I lost healthcare, there is no way I could afford to buy it, and Cuts in SSI and Medicaid would leave me destitute and homeless. 6 have no doubt, at my degree of Illness severity, that I would die rather quickly if living on the streets.
How many Americans with chronic health issues would be in the same danger if cuts are made or even obliterated.
People, please think. There are people who have literally been put into impossible positions by no fault of their own. We WILL die if our pre existing conditions deny us care. We are not all “lazy druggies” I get drug tested every 3 months via the conditions of the pain contract I signed. My pill counts have been consistently accurate. I also lowered my pain levels as best I could and cut my meds back on my own . To my doctors delight.
I used to work. I was married for 17 yrs and raised 3 responsible young adults before being struck down by mecfs and the subsequent abandoment. And child support is taken by the state to repay my TANF for my child.
So ObamaCare has been a mixed bag, and I had to afjust to it, but at least there is SOMETHING in place that keeps us sheltered and able to receive medical treatment. I literally can’t come up with money to pay for insurance.. and if pre-existing conditions aren’t covered.. it’s a death sentence to many.
I STILL don’t know howvto vote though! ? I think I’m lising my mjnd trying to figure it out!
my state rep is part of the committee that is working to keep pre-existing conditions in place.. but she’s a republican. Obama’s Presidency took so much away from the people with chronic conditions and that included learning challenged children. I am independent.
but as a person with ME/CFS, Both sides are scary.
and I need to get this ballot filled out..
It’s not an easy issue to figure out.
We the People are not sure WHAT is going on!
Keep the politics away from ME advocacy, education and research.