By Peter White
NASHVILLE, TN — A handful of ministers and two political candidates went to Senator Lamar Alexander’s office on West End Ave. He wasn’t there and they weren’t allowed into the building.
Representatives of the Southern Christian Coalition (SCC) wanted to talk to Alexander about people with pre-existing health conditions needing affordable healthcare. They worry too many people can’t get the care they need at a price they can afford.
The Department of Justice (DOJ) announced in June that it would no longer defend the Affordable Care Act (ACA) against legal challenges. The Republicans have tried and failed more than 60 times to repeal the ACA. U.S. Attorney General Jeff Sessions wants to ignore a law his party doesn’t like but hasn’t gotten rid of yet.
Alexander was in Knoxville June 22 with Labor Secretary Alexander Acosta and Tennessee’s Insurance Commissioner Julie McPeak to pitch a new Trump Administration initiative. The U.S. Department of Labor announced a new rule last week to allow Association Health Plans (AHPs).
It’s the latest Republican attempt to fix Obamacare, or if you believe the ministers, it’s an end run around the ACA’s requirements to include pre-existing medical conditions in healthcare plans. Under the ACA companies cannot reject people who have a chronic illness.
Alexander said the new plans will help self-employed people and employees of small businesses get the same health coverage that employees of large companies have.
Joseph Sheeran attends the Vanderbilt Divinity School and is a member of the SCC.
“It’s a move that effectively signals this administration’s intent to repeal this vital legislation thru a back door. At the same time our legislators are rolling out yet another repeal bill in their unceasing efforts to undo protection that millions of Americans are counting on,” Sheeran said.
“Nearly 180 million Americans get their insurance on the job, and generally they are happy with it because premiums are several thousands of dollars lower a year, and their policies include patient protections such as coverage of pre-existing conditions,” Alexander said. He claims AHPs will offer the same benefits as the ACA but at a lower cost.
They might but AHPs will be created under a new Labor Department rule, not an executive order, and will not require Congressional action. That means Congress is unlikely to make AHPs conform to the benefits required under the ACA.
“Buyer beware,” says Dr. Carol Paris, President of Physicians for a National Health Program.
Paris cited the Farm Bureau as an example of an AHP in Tennessee that was grandfathered in after the ACA passed in 2010. She said the Bureau’s health insurance undermined the health exchanges established by Obamacare.
“Healthy young people bought insurance from the Farm Bureau and it left older sicker people in the ACA plans,” Paris said. She said that led Tennessee into having the highest state premiums and several insurance companies deciding not to write policies in Tennessee at all. She predicts AHPs will destroy Obamacare without actually repealing it.
“If you stay young and health you think it’s a good deal because you’re not spending as much for health insurance but if you actually get sick or get hit by a truck and don’t die, you may find out very quickly what the limitations of the coverage is in those plans. That’s how they can have such affordable premiums because they actually cover diddly-squat,” Paris said.
In a statement Alexander said businesses can form AHPs on the basis of geography or industry. Self-employed people could join or form their own AHP. The new plans could roll out by September 2018. Alexander is Chairman of the Senate Health Committee. He is holding hearings in Washington on how to reduce health care costs.
Both Sides Quote Numbers
The Congressional Budget Office (CBO) predicts 4 million people will join AHPs by 2023 and projects premiums will be $1,900 to $4,100 lower than the current yearly premiums in the small group market. The CBO says yearly premiums in the individual market will be $10,800 lower by 2022.
Alexander said Americans stuck in the Affordable Care Act exchanges have seen their premiums go up by more than 105% since the exchanges opened. He noted 15 million working Americans and their families do not have health coverage and 9 million Americans buy coverage in the individual markets without a subsidy.
Premiums have doubled under Obamacare but the ACA requires companies to cover ten basic health benefits in their plans. They are outpatient care, prescription drugs, emergency care, mental health services, hospitalization, rehabilitative service, preventive and wellness services, lab services, infant care, and maternity and newborn care.
“You have to read the fine print, “ Paris said. Her daughter bought a plan that she thought covered labor and delivery. It turned out it only covered complications in labor and delivery. Her daughter had a normal birth and it cost a small fortune.
“Another thing they will do is say ‘you got a bump taken off your head by a dermatologist last year, so we’ll cover you but we’re not covering anything involving your skin for one year. Then if you have another skin problem we’ll cover it.”
“That’s because they don’t want to get stuck with someone who might have melanoma,” Paris added “This is what they did before 2009. This was the kind of shenanigans that people dealt with all the time before the ACA,” she added.
In 2015, Tennessee’s Republican-controlled legislature refused to accept Medicaid expansion that would have put $22.5 billion into the pot to subsidize health services for 250,000 Tennesseans over the next decade. Companies like BlueCross BlueShield looked at the numbers and looked what the ACA would require them to provide and, excepting Knoxville, they left the state.
According to the Chattanooga Times Free Press, most of Tennessee now has just one insurer under Obamacare. BlueCross Blue Shield restored individual coverage in Knoxville only because there was no other company willing to offer it.
But a new health insurance company has entered the Nashville market. Joshua Kushner, the brother of Jared Kushner, President Trump’s son-in-law, founded Oscar Health Insurance last year. It is a subsidiary of New York-based Mulberry Health, Inc.
“Just here in Tennessee over 2.7 million Tennesseans live with a pre-existing condition. That’s just over half of all Tennesseans. Over 355,000 are children many are seniors and 630,000 are adults between 55 and 64 who are approaching Medicare eligibility,” Sheeran said.
“If the ACA and its vital protections are repealed all of these Tennessean could be denied life-saving medical care. And this would all be legal,” Sheeran said.
Both Alexander and Senator Bob Corker have their Nashville offices in a private building with tight security. Taxpayers pay the rent on those offices but the door is locked. You have to have a card key or be invited to enter.
“We ask our elected officials to join us in loving our neighbors as Christ commands us to and end this attack on the most vulnerable among us,” he said.