The U.S. Senate is reportedly considering a healthcare bill, although few will admit to seeing it or knowing its contents. Rumors indicate it will not, as hoped, be a “kinder, gentler” version of the House bill. There’s been a great deal of criticism of the direct effects of the House bill including, but not limited to, tens of millions without insurance, astronomical cost increases for seniors and those with pre-existing conditions, inability to get coverage for preexisting conditions, watered-down coverage (with many standard situations not covered) and loss of support for those in nursing homes. However, I’ve heard little regarding the effects on those not included above.

Please note the following is not deeply researched, but largely the product of my own logical process and as such could be far from accurate. I’d love feedback from those more deeply-informed than I.

Let’s imagine an employed head of family with a spouse and two children. Insurance for this family is provided by his/her employer and deducted from his/her paycheck. In fact, both spouses enjoy this benefit, so if one loses his/her job, there’s a back-up plan. This happy family is probably laboring under the illusion that they have nothing to fear. I believe this is far from the truth!

The disappearance of billions of dollars from medical payments will impact clinics and hospitals. Personnel will be laid off and programs will be cut. Wait-time for all services will be longer and some “frills” will disappear. If you need a class on dealing with your child’s juvenile diabetes, for instance, it may no longer be offered as often or not at all. If it takes you a month to get an appointment with your doctor now, that wait may double. If you child falls off the playground equipment and breaks an arm, the emergency room visit may stretch to eight hours as opposed to four.

 

Ted Chan, founder of Care Dash, an online site for feedback on doctors, (yeah, I did some research!) was quoted in Becker’s Hospital Review on March 9, 2017, as saying: 

“Repealing the Affordable Care Act (ACA) without clear guidelines for replacing coverage will drive up costs across the board for patients, employers, and hospitals. Without requiring all to be insured, hospitals will be the insurers of last resort and will absorb the costs of uninsured patients seeking care. One recent study found that half of hospital bills go unpaid and that will only likely increase without an individual mandate….

When hospital bills go unpaid, taxpayers and local governments are often forced to pick up the tab. The question is not whether healthcare coverage should be paid for, it’s who pays.”

 

If you live in a rural area, the impact may be even greater, as rural medical services are economically tenuous. With fewer patients to serve and more low-income individuals, tight budgets are a constant. Under the ACA, there were supposed to be provisions to help rural medical programs, but many of these provisions were revised or never implemented.

Our happy fictional family may find their medical costs increase despite their insured status. When a family isn’t insured, that doesn’t mean they don’t get sick! They do, however, wait longer to seek treatment, present as sicker when they do go to the doctor, and their treatment is therefore more expensive. Since the bill is less likely to be paid, the hospital must recoup as much as possible in the form of increased costs for those WITH insurance. When insurance companies pay more, they’re going to raise the cost of their policies. Our fictional family will pay in increased insurance costs.

People who don’t have insurance are more costly employees. Since they can’t afford preventive care, they’re more likely to be sicker and miss additional time at work. (I’d prefer they NOT work, since someone coughing over my fast-food order is not something I relish!) I suspect this was one original motivation for employer-sponsored healthcare coverage.

Therefore, Fictional Family will be affected directly by the proposed healthcare bill. The medical services they need may well become harder to access, their health insurance costs increase, and their communities become a less pleasant and welcoming place to live.

PERHAPS WE SHOULD BE SHARING THIS MESSAGE FOR THOSE WHO MISTAKENLY ASSUME THEY’LL NOT BE AFFECTED BY THIS [“REPEAL AND REPLACE”] LEGISLATION.


Deborah G. Hankins is a retired “worker” who lives with her husband Milt and their little chihuahua Jose in Ashland, Kentucky. She is a leader in the local “Indivisible” group and is seriously concerned about our future under the present administration.