During Thursday night’s GOP debate, a woman from Florida told the candidates she’d lost her job and with it her health insurance. What would each of the candidates do to get her covered or otherwise provide the health care she needed?
You had to listen carefully, but the effective answer they all gave her was, “this is your problem, not ours.”
Let’s first recall that this woman is not alone. Millions of Americans have lost employer-provided health insurance. That was happening before the recession but has become much worse during the recession. That may be because they lost their jobs and can’t afford COBRA coverage, and the government’s stimulus subsidies for COBRA have expired, or because, even if they still have jobs, their employer stopped providing coverage because of its rising costs. Or they may have lost effective coverage, because even if they have a job, their employer-provided coverage is so weak or so costly with deductibles, exclusions, and co-pays that they’ve effectively lost affordable, meaningful coverage. In the meantime, those on the individual “markets,” which are dominated by highly concentrated oligopolies, are confronted with insurance premiums they simply cannot afford.
As FDL’s Jon Walker has noted, America now has the highest percentage of uninsured in decades, and that’s not going to change unless/until the Affordable Care Act kicks in by subsidizing private insurance and providing millions with access to expanded Medicaid. So unlike many of the debate topics, this woman’s question was extremely relevant to literally tens of millions of Americans.
The answers she/we heard cannot have been reassuring. Mitt Romeny said he’d adopt policies that would lead to her getting a new job. Okay, maybe that happens in a couple years or so, or maybe not. But even when, pre-recession, we had much lower unemployment, we still had tens of millions of people without insurance, and those who thought they had insurance were often ambushed by insurance company rescissions, exclusions, denials and then refusals to re-insure those with pre-existing conditions. Millions of people faced these problem before the ACA and before the recession.
Moreover, if these Republicans were successful in repealing the ACA and block-granting Medicaid, as the GOP-Ryan Plan they all eventually suppported provides, then the woman would not be able to get either subsidized private insurance on a health care exchange or government-provided Medicaid. In Florida in particular, the Governor and state legislature have been particularly vicious in cutting funding for hospitals and providers that treat Medicaid patients, and the GOP-stifled Congress has refused to consider expanded Medicaid beyond the original stimulus, so it would be even less likely this woman could get coverage there.
What’s left? Well, if the woman lived in Massachusetts, she could use RomneyCare’s subsidized private insurance. But Mitt went out of his way, in defending against charges from Rick Santorum, to imply he’d never suggest Florida adopt the same system, let alone mandate it from Washington.
The exchange between Santorum and Romney over RomneyCare vs ObamaCare revealed that Romeny is not willing to explain why the state of Florida should play a role in helping the woman gain affordable insurance where she lives. He didn’t explain why, if you’re relying primarily on private insurance, it made sense for government to subsidize private insurance premiums for those who can’t afford it, and if that’s true, why the same logic doesn’t apply to Florida.
To be sure, Mr. Romney explained the “free rider” issue, which argues that everyone who can afford to do so should either purchase insurance or contribute to the collective costs of providing care to those who aren’t otherwise insured but who must, for legal and moral reasons, be provided care when needed.
Mr. Santorum didn’t seem to grasp this argument, so we can probably conclude that if Mr. Santorum had his way, the woman would likely never get coverage without a job, becoming eligible for Medicaid, or moving to Massachusetts. Similarly, Congressman Paul seems to believe that, gosh, everyone got all the care they needed before we had any of this government Medicare/Medicaid nonsense, so what’s the problem? That’s an interesting argument to make in Florida, but I doubt there’s even the slightest factual basis for it.
Any other solutions? I don’t see one. They all oppose expanding Medicare to younger people, and some would vote for Paul Ryan’s expensive plan to end Medicare as we know it for the next generation. They also opposed expanding Medicaid, and they would vote to reduce it or block grant its funding, which is code for letting governors like Rich Scott cut its funding unless it’s for hospitals owned by the corporation he managed to commit massive fraud. Only Romney supports subsidizing private insurance, but only in Massachusetts, not in Florida. I couldn’t figure out what Gingrich supports today.
So we’re left with hoping that very soon after one of these gentlemen becomes President, 25 million people will find jobs, all with meaningful employer-provided health insurance, and the remaining 25 million uninsured will just have to fend for themselves. Since all of the candidates believe in the kinds of austerity that has worked so well in the UK, leading to record unemployment and a depression that, for the UK, is now worse than the Great Depression of the 1930s, the prospects don’t look good.
The message to this woman is very clear: Lady, you’re on your own.