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Are you being Gruberized?

May 8, 2017

If the town hall backlash against their representatives over the AHCA says nothing else, it says that Americans still don’t trust the government. It also points out how well good old-fashioned Cold War era propaganda techniques still work.

Classic propaganda, i.e. delivering  the same message over and over until it is accepted as fact, is delivered  in the form of repetitive sound bites in the media and Twitter accounts. It is the stock-in-trade of AHCA (and Trump) opponents. That’s why you hear every single person repeating the same phrase “Americans will die.”

That it works is crystal clear from the same repetitive signs at the town halls. It’s doubtful that anyone at these gatherings has ever read the bill (use this link to get a PDF of the bill text as passed by the House).

That’s the Jonathan Gruber effect; counting on Americans to be too lazy to get the facts. Democrats used Gruberization to their advantage to pass Obamacare, and they are still using it. (His latest claim is that Obamacare was wonderful and President Trump is making it fail. Really?)

All the people “protesting” seem to be assuming that the Senate will pass HR 1628 without ANY changes.  There are areas that can probably be improved.

For instance the bill says you can’t be “rated” (penalized for a pre-existing condition or not being enrolled) if you are effectively never uninsured (Section D). That’s unrealistic.  The existing 90-day (three month) allowable lapse period should be reinstated if certain narrowly defined conditions apply, because life happens.  People become unemployed or have a temporary lean period where they can’t afford their premiums.  Cut them some slack.

The half truths and outright lies   

Amidst all the hysterical claims of “death by AHCA”, as parroted by Democrats like Nancy Pelosi, Maxine Waters and Chuck Schumer, one fact seems to be missing.

Even under the “wonderful”  ACA, or Obamacare, there were  still approximately 28.5 million nonelderly Americans uninsured as of  2015, according to the Henry J. Kaiser Family Foundation.

Prior to the 2010 passage of the ACA there were an estimated 30 to 50 million people uninsured, depending on the source.

Not counting Medicaid, the ACA has insured some 10 or 12 million of those folks. Even adding  in Medicaid, at best only about half of the pre-ACA uninsured ever got insurance.

There hasn’t been a mass die-off among that uninsured population under Obamacare, so why would passing the AHCA result in that dire outcome? Is there some mortality statistic about Obamacare that Democrats are keeping under their hats?

Apparently unbeknownst to the liberal media, there is a law that mandates that any person can walk or be carried into any emergency room and receive care during emergency situations. The law says that if it is an emergency, all hospitals, public and private, must provide timely care. That is guaranteed under The Emergency Medical and Treatment Labor Act (EMTLA) of 1986.  Privately owned hospitals can refuse routine or nonemergency care.

What is true about both the ACA and the AHCA is that ordinary office visits and follow-up care are less likely to be utilized if the premiums, deductibles and co-pays are so high the patient can’t afford to purchase the insurance in the first place.

Thus, if you are diagnosed with cancer or heart disease, and have no insurance, you may very well die if you can’t come up with the money out of your own pocket to cover the treatments. That was always true, even pre-ACA.

That was the main justification for allowing people to wait until they get sick to get on Obamacare. That turned out to be unworkable financially for insurance companies  and health care providers alike in actual practice.

Data shows that enrollment in government subsidized health insurance or Medicaid does lower the percentage of individual uninsured persons, but may not increase the actual care given or even sought.

Remember, most people are insured under employer plans. Approximately 18% carry individual health plans, including Obamacare.  Even pre-ACA, about 12-15% of the population was completely uninsured. That number has dropped to an average of about 9.5%.  The percentages of uninsured by ethnicity vary widely, with Hispanics (not including illegal immigrants, who are ineligible for subsidized healthcare)  leading the non-white group at 32% of the total uninsured. However, whites still comprise the largest uninsured population, at 45%. (Source:

The largest reason given for choosing to be uninsured is the out-of-pocket cost for services added to the initial premium cost under the ACA, which is why many call it the Unaffordable Care Act.

Another untruth is that people will be kicked off of Medicaid.

The people now on Medicaid are grandfathered into the new AHCA, at least in the iteration passed by the House. What was ended was any further expansion of the Medicaid rolls.  It also attempts to peel off the young, healthy persons who are Medicaid eligible only because the ACA qualifying income limits were raised.  Getting them back into the regular marketplace is projected to help level out the premiums for others.

The current income limit to qualify for maximum subsidies is currently $16,400/yr/single person.

There is no doubt that some facets of the current AHCA, if passed in the same form it left the House,  will have an impact on certain demographics, particularly seniors under age 65. This is the doctrine known as “use more, pay more.” As proposed that would be true only for the first year, but history tells us that such strategies tend to stay in place.

Also unclear is whether the proposed addition to the FIHRP funding pool of $8 billion will be sufficient to cover all those with pre-existing conditions. Part of that question is what exactly will count as a pre-existing condition. The Washington Post just gave the left’s claims that pregnancy, rape or sexual assault are pre-existing conditions under the AHCA a resounding 4 Pinocchios.

In summary

The House version of the AHCA may or may not be a good bill. In fact it’s doubtful that ANY government-run health insurance plan will ever be really good, given that it attempts to do the impossible task of providing perfect, high quality health care to everyone under every scenario.

This isn’t even something that we simply have to hypothesize about, because we have Medicare, Medicaid and the VA health services standing as prime examples of what happens under a fully government run model.

One thing is for sure though…the AHCA isn’t a death sentence for Americans, any more than was the ACA.

Don’t be a Gruberized citizen. Learn enough about the bill to be able to dispute it and make constructive suggestions with knowledge and not emotion. If you have read the bill and don’t understand something in it, ask your representative to clarify the meaning of the language.

Just don’t keep drinking the same old Kool-Aid. You are better than that.

From → op-ed

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