John, a 60 year old good friend of mine who has a rare form of cancer was recently notified by Medicaid that he no longer qualified for coverage effective 1/1/2014. He is on total disability and has no income other than Social Security. He was told that he had to apply for coverage under Obamacare.
In total frustration and fear, he posted on his Facebook page that he had gotten screwed out of Medicaid by Obamacare. Of course, many of this friends posted comments and condolences and seemed to agree.
It is so discouraging to me the level of misinformation and ignorance around the health care debate in our country. I decided to write to John to give him my thoughts and I share what I wrote here.
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John,
I have been doing a little study and research into what is
happening to Medicaid in NC after the passage of the Affordable Care Act and
your losing your coverage. Also, my son Chris, who is active in the
Social Services field and is a student at North Carolina State, has given me
some interesting insight into the problems facing Medicaid in our State.
He was asked recently to serve on a government committee to suggest
improvements to NC’s Medicaid system. Chris started the Collegiate
Recovery Program at North Carolina State and he was ask by the Governor’s
Office to participate to represent the perspective of those recovering from
Alcohol and Drug abuse. They have met twice so far. By the way, I
am really proud of him for this.
What I didn’t fully realize is the big differences between
Medicare and Medicaid. We all kind of know that Medicare is for people 65
or older and is a “single-payer” system administered and financed totally by
the federal government. Medicare rules and eligibility are the same in
all 50 states. Here is Wikipedia’s words describing Medicaid:
“Medicaid is the largest source of funding for medical and health-related
services for people with low income in the United States. It is a means-tested program that is jointly funded by
the state and federal governments and managed by the states,[1] with each state currently having broad
leeway to determine who is eligible for its implementation of the program.”
The most important difference is that Medicaid is State run
with States footing a good chunk of the bill. States are not even
required to participate in the program, but at present they all do. Yes,
the Feds require some basics but States set the rules. Therefore, there
are major differences from State to State. Texas, for example, has the
largest percentage of uninsured of any state in the nation. As is the
case whenever big money is involved, Medicare rules and eligibility gets very
political. From what I have been reading, in general, Red states have the
most restrictive Medicaid programs vs. Blue states. When budgets get
tight, guess where the politicians look to save money. It is pretty clear
that the changing of the guard in NC has been making things progressively
harder on the poor, minorities, the disadvantaged, and sick.
Chris tells me that the biggest problem that his
constituents complain about are the constantly changing eligibility rules and
what is covered and what is not. It is a constant state of flux with so much
uncertainly. Medicaid was set up to be a temporary solution for the
poor. You know, as soon as the poor finally get off their lazy asses and
get a job, they can get employer provide HC or buy their own insurance like all
upstanding god-fearing citizens do.
Along comes Obama-care which I prefer to call by its proper
name, The Patient Protection and Affordable Care Act (ACA)……less
racist. Obama wanted to pass a single-payer system but had to
settle for what he could get passed……Romney-care, a Republican idea in its
genesis. Wikipedia says,
“The ACA aims to increase the quality and affordability of health insurance, lower the uninsured
rate by expanding public
and private insurance coverage, and reduce the costs
of healthcare for individuals and the government.”
The ACA expands Medicaid eligibility and Federal funding to
up to 133% of the poverty line. Again, quoting from Wikipedia,
“The federal government would pay 100% of the cost of Medicaid eligibility
expansion in 2014, 2015 and 2016; 95% in 2017, 94% in 2018, 93% in 2019, and
90% in 2020 and all subsequent years.”
John, I was a registered Republican all my life, the party
of Lincoln. I am sure ole Abe is rolling over in his grave with what has
happened to the GOP in the past 10 to 15 years. The far right, the Tea
Party, and their ilk steeped in ideology and no-compromise, has driven me out
of the party. I am a proud Independent now. I am socially Liberal
and fiscally Conservative.
My liberal side believes that health care for all is
a basic human right. Of the roughly 38 first world countries, the US is
the only one without universal health care. Sure, many of the health care
systems around first world countries run the gamut in effectiveness but they
cover all. My fiscally conservative side looks at exorbitant cost of our
country’s health care system (we pay something like 60 to 70% more than other
first world countries). We rank about 18th in the world in
outcomes. We also have 50 million uninsured. With the focus access
for all, on preventative care, and on education, the bi-partisan Congressional
Budget office forecasts that health care costs will be driven down under
ACA.
So, my take on your situation is that the target of your
frustration should be on Governor McCrory and the Republican majority in the NC
Legislature. ACA tries to expand coverage for all. The Republicans
seem want just the opposite.
I hope things work out for you with John Schmidt and
BCBS. I am rooting for you.
Your friend, Fred
