File this in the "another reason why single-payer health care" is the only real answer to our health care crisis file.
Under the Affordable Care Act, individuals will be eligible for Medicaid if they make up to 133 percent of the federal poverty line. Between 133 percent and 400 percent of the federal poverty line, they'll be eligible to join the government -- through tax credits -- in lining the pockets of big-profit insurance through the purchase of a high-deductible junk policy. Unfortunately, this "uniquely American" health care non-system will mean that within a year 28 million people are expected to "churn in and out of Medicaid," according to a new report from Dr. Benjamin Sommers at the Harvard University School of Public Health.
The authors of a new study appearing in the February issue of Health Affairs estimated that as many as 28 million U.S. adults might "churn" in and out of health insurance programs during the course of a year, sometimes losing coverage more than once.
"It's a critical issue," said Cathy Schoen, senior vice president of The Commonwealth Fund, who was not involved with the study. "You could get a raise or lose a week of work or gain a week, and move in and out of coverage."
What this problem means for many Americans -- particularly young adults just starting out who are already among the most uninsured in America -- is that the health insurance nightmare created by our big-profit friends at Aetna and CIGNA is far from over.
Transitioning from Medicaid to a big-profit plan, or from a big-profit plan to Medicaid, will still mean months without coverage -- and the risk of serious financial harm, bankruptcy or interruption of critical care that comes with such a system. (Don't you think for a second that the profit-obsessed retroactive rescission/denial wizards at Aetna and CIGNA aren't already planning for how they will deny coverage to cancer patients who really should have been on Medicaid when they were receiving a big-profits subsidized plan instead.)
"The [insurance exchanges] and Medicaid worlds don't exactly align so there may be one-to-two month gaps without coverage," added study co-author Dr. Benjamin D. Sommers, an assistant professor of health policy and economics at the Harvard School of Public Health in Boston. "The administrative costs are also huge. And even if there aren't gaps in coverage, Medicaid and the exchange plans could be very different in terms of networks. One month you're seeing a particular doctor, and the next month that person's not in your network."
By taking a look at U.S. Census data from the last five years, Sommers and a colleague estimated that in the first six months, 35 percent of families with incomes below 200 percent of the poverty level ($20,760) will change eligibility while half (28 million) would have crossed the threshold at least once during the first year.
An estimated one-quarter of beneficiaries will likely have their coverage disrupted by crossing the income dividing line at least twice in one year, and 39 percent will over the span of two years, the authors added.
Talk about a cluster fuck! And this is reform?! Medical bankruptcies will not end in this country when millions of people are without coverage for months at a time due to this convoluted system. Raising pennies for care will still be a "uniquely American" occurrence as individuals with serious diseases -- or the misfortune to incur serious accidents -- find themselves needing care as they wait for the big-profit bureaucrats to mail out an insurance card after leaving Medicaid eligibility.
Of course, all the pain won't be felt by patients. Even big-profit insurance company profits could take a hit as a result of this mess.
Within four years, up to 38 percent will have their coverage disrupted four times or more, they predicted.
And the authors expressed the concern that some people will just get sick of the aggravation and paperwork, and opt to live without health insurance.
Because income changes are more common among younger, better educated adults, the insurance pool could be deprived of the healthy members it needs to stay financially solid.
Of course, I haven't even begun to talk about the enormous disincentive this "non-system" creates for individuals to earn enough income to move off Medicaid. Medicaid, while it can sometimes be tough to find a doctor, typically provides vastly more comprehensive services than for-profit insurance at zero cost to the patient. Not to mention the dental, orthodontic and long-term care benefits that are often part of Medicaid in more generous states, like Connecticut. Start making 134 percent or more of poverty, though, and you're instantly stuck in a plan with massive cost-sharing through a huge deductible, co-pays and co-insurance.
Of course, the author of this plan has an idea.
"It would be easier to fine-tune if it was a continuous program," Schoen said, and it would reduce costs.
Sounds like someone is talking about Medicare for all.
It is disgusting how much pain and suffering our politicians are still willing to force us to incur in order to save the big-profits insurance industry from having a diminished role in American health care. You know those insurance company bureaucrats will do whatever they can to leave people out in the cold -- still -- by gaming the new system to drop expensive patients who they contend should actually be in Medicaid at a given point. Again, what a freaking mess! And, of course, all this "musical chairs" nonsense will cost the government an enormous amount administratively -- think the big-profits insurance company CEOs whose monster salaries that the Affordable Care Act subsidizes will step up to the plate to pay those costs? Nahhh...
What a mess -- and nobody is talking about this.