Health Care 'Access' is Not the Same as 'Coverage'
There's that word "access" again. By now, I suppose, we should know from experience that only the president's most recent version of the truth should be believed, if that.
What gives? Is promising "access" a nice-sounding squishy doublespeak way to say, "We're not giving you any more money to help you buy insurance?"
That's the biggest reason why the CBO and other analysts expect to see millions lose coverage under the Republican plan. Yet Speaker Ryan and other GOP leaders are more excited by the $337 billion that the CBO says the federal government will save over the next decade by shifting most of the ACA's health care burden back to the states and to individuals.
The Republican plan would remove mandates that require everyone to buy insurance, which enables the ACA to bar insurance companies from denying coverage because of preexisting conditions. It would replace subsidies with tax credits to help low-income people buy insurance and expand health savings accounts so more people could save more of their own money to pay for their own health care.
But market-driven incentives work best for people who can afford them. I like HSAs, for example, but households that are living paycheck-to-paycheck often find they simply can't afford to salt away much savings. One health crisis can eat up your health savings overnight. And there goes your "access."
All of which makes it all the more poignant -- or sad, as President Trump might tweet -- that the biggest losers in what's being called "Trumpcare" probably would be the core supporters of President Trump's election campaign.
The same lower-income, older voters who voted for him in rural red-state America stand to lose more in federal insurance subsidies than any other demographic, according to an analysis of country voting and tax credit data by Noam Levey of the Los Angeles Times.
That's the political base that Trump in his inaugural address lauded as the forgotten men and women to whom he had given a political voice. Now the burden is on Trump to show whether "access" to health insurance is as good as the real thing.
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(E-mail Clarence Page at cpage@chicagotribune.com.)
(c) 2017 CLARENCE PAGE DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.
