The PPACA and the Uninsured, Sanders, and HRC

I have been listening to the Sanders healthcare Uninsured narrative and his own Undetailed healthcare plan. To me, much of this sounds like Republicans tossing around the usual nonsense about the PPACA. It would be better if Sanders just said we can do better than the PPACA and here is how we can get there (and then explain it). There is something to remember though and pre-PPACA involving the last all out effort to install healthcare in 1992 as led by HRC. It failed because Congress did not lead it and nothing else “major” has been brought to the table by Republicans except a lot of excuses. The Democrats do not escape critiquing either as they have been equally negligent in producing something, anything of plan to get people healthcare. The prelude to the passage of the PPACA was the Senator from Aetna, Joe Liberman, holding the PPACA captive until some fast maneuvering by Reid and Pelosi. Now Sanders may believe he can command a better healthcare plan into being; but, I doubt it will happen until people begin to demand it and change Congress. Not enough of people are doing so today.

“‘You’ve got to take out the Medicare buy-in,‘ Mr. Lieberman said. ‘You’ve got to forget about the public option. You probably have to take out the Class Act (Long Term Care), which was a whole new entitlement program that will, in future years, put us further into deficit.’”

A Blue Dog Senator, Ben Nelson wanted to know the impact of the Medicare buy-in. “I am concerned that it’s the forerunner of single payer, the ultimate single-payer plan, maybe even more directly than the public option.”

What happened then and why we have ended up with the PPACA in its present format was an agreement made by Congress Person Nancy Pelosi and Senator Harry Reid. With the winning of the Massachusetts Senate race by Scott Brown, the dynamics had changed once again in January of 2010.

The Christmas Eve passage of the PPACA bill by the Senate was on the table to be tweaked considerably to get what they wanted to pass into law with the 60-vote majority with Paul Kirk (replaced Edward Kennedy) and later with the election of Martha Coakley. The election of Republican Scott Brown as the new Senator from Massachusetts, stopped any thought of tweaking the Senate bill by the House especially with the conversations going on between Senators Lieberman and Nelson. Instead, Congress Person Nancy Pelosi and Senator Reed decided to take up the already passed bill from the Senate on the Floor of the House. It passed and the PPACA as we know it has been brought up some sixty-something times after the House Republicans passed it 219-212.

Since its passage, there has been a dispute over how many people are actually covered by the PPACA and why those who are not, are not. There have been mega-fabricated-stories on why it has failed people and there has been reasons or facts about why the PPACA does not cover people. Charles Gaba at ACASignups has tracked the signups to the PPACA since it was passed into law in 2010. He has one of the more accurate measurements of signups, why people lose coverage, and why they are not covered detailed on his site.

2016_total_coverage_pie_chart

If you click on the Pice Chart, you will get a readable version of this pie chart. If you doubt its accuracy, Larry Levitt of Kaiser Family Foundation had this to say to Charles Gaba:

“Obviously some of the estimates are approximations, but I do not see any glaring problems. — Larry Levitt (@larry_levitt) March 29, 2016

Let’s get into this a bit and what I want to look into are the “Uninsured.”

• Adults Medicaid Eligible: 5.0 million; And not covered due to the state not expanding Medicaid
• Children Medicaid/CHIP Eligible: 3.0 million And not covered due to the state not expanding Medicaid
• Medicaid Gap: 2.8 million; States not implementing the Medicaid Expansion have penalized citizens from Medicaid (except as already
established under state law) and from the PPACA Market Exchange.
• Undocumented Immigrants: 4.7 million; Federal Law says no coverage available.
• Eligible for Subsidized Exchange policies: 6.5 million; And chose not to sign up.
• Ineligible for Subsidized Exchange policies: 7.0 million; And have the chance for ESI policies or has an income above the 400%.

Except for the 4.7 million undocumented immigrants, all people have a chance to have healthcare insurance of some type unless their state governments disenfranchise them. Now is this going to change with the election of a new president? Probably not until gerrymandering goes away and Congress changes which will not happen under HRC or Sanders. Stomp your foot all you want to, it will remain the same until people wise – up and figure out the Republicans and the big-money people are not on their side. Our biggest issue right now is to get a Justice on SCOTUS who will favor the people and not moneyed or religious interests like the Koch Brothers and Hobby Lobby. To bow out of an election if HRC wins or Sanders wins is self-defeating and not a good choice.

The links are there if you wish to read Kaiser or Charles Gaba. This is briefly what both had to say on the topic of the insured and uninsured. The election comments are my own and I hope you think carefully about the 2016 election.

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