Health care coverage – still under attack

Photo by 401Kcalculator.org, published under Creative Commons license

Maybe you thought that the defeat of the Republican health care act meant safety for a while? And that we could turn our attention to other battles? Not so fast. The Affordable Care Act — Obamacare — is still under attack, at both the federal and state level.

On April 3, Vice President Mike Pence met with some of the ultra-conservative Republican “Freedom Caucus” to offer them more changes to health care. Specifically, he talked about allowing states to gut the “essential health benefits” now required as part of any insurance policy. This would mean, for example, that an insurance company could refuse to cover pregnancy and delivery. Or cancer. Or mental illness. This change would affect not only the small minority of Americans who buy individual policies but, potentially, everyone with employee coverage, too.

Pence also talked about allowing insurance companies to charge higher premiums to sicker people. That could effectively put any insurance coverage out of reach for someone with, say, heart disease or high blood pressure or diabetes.

Then there’s the state attack. Republicans in the Minnesota legislature have a long wish list of ways to hurt health care coverage, starting with abolishing MNSure, the state insurance marketplace. That would force Minnesotans into the federal marketplace, meaning that if the feds manage to repeal Obamacare, there will be no Minnesota fall-back. They also want to cripple the Departments of Health and Human Services. Session Daily reports:

Human Services Commissioner Emily Piper and Health Commissioner Ed Ehlinger expressed concern over the bill’s lack of an operating adjustment, necessary to continue providing services at their current level.

For DHS, that would mean 300 fewer full-time employees, most of whom work in direct care and treatment. The reductions would also make it difficult or impossible for the department to implement programs and initiatives included in the bill, Piper said.

Other proposed changes would:

• eliminate MNsureand opt into the federal marketplace;
• end more than $40 million in appropriations to MNsure that fund technology platforms shared by DHS and related operating costs and supports;
• repeal the Minnesota Radon Licensing Act, which was passed in 2015 and allows the Health Department to write rules and enforce laws related to the radon industry; and
• increase MinnesotaCare premiums from between $4 and $50, based on income, to between $5 and $85.

Representative Steve Drazkowski introduced a plan to eliminate the “essential health benefits” for Minnesota insurers, which seems to me not to be legal under the Affordable Care Act – so long as it remains the law of the land. Another Republican proposal would repeal guaranteed renewability, letting insurers cut off coverage.

The battle isn’t over yet.