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Health Care Saves Lives Contention

COVID-19 is resulting in a loss of health insurance and curtailed health insurance

Blumenthal, July 22, 2020 David Blumenthal, M.D., M.P.P., Elizabeth J. Fowler, Ph.D., J.D., Melinda Abrams, M.S., and Sara R. Collins, Ph.D., July 22, 2020, New England Journal of Medicine, Covid-19 — Implications for the Health Care System, https://www.nejm.org/doi/full/10.1056/nejmsb2021088

The pandemic has significantly undermined health insurance coverage in the United States. A sudden surge in unemployment — exceeding 20 million workers1 — has caused many Americans to lose employer-sponsored insurance. A recent Commonwealth Fund survey showed that 40% of respondents or their spouse or partner who lost a job or were furloughed had insurance through the job that was lost.2 Although many will continue to get employer coverage or become eligible for Medicaid or marketplace plans, a substantial number will probably become uninsured.3,4 Even workers who keep their jobs may find their coverage dropped or curtailed as financially strained employers cut costs. These developments will add to the 31 million persons who were uninsured and the more than 40 million estimated to be underinsured before the pandemic struck.5,6

Implementation limits have reduced the ACA’s effectiveness

Blumenthal, July 22, 2020 David Blumenthal, M.D., M.P.P., Elizabeth J. Fowler, Ph.D., J.D., Melinda Abrams, M.S., and Sara R. Collins, Ph.D., July 22, 2020, New England Journal of Medicine, Covid-19 — Implications for the Health Care System, https://www.nejm.org/doi/full/10.1056/nejmsb2021088

This new crisis of coverage has at least two causes. The first is our continued reliance on employer-sponsored insurance to cover approximately half of Americans against the cost of illness. The second is failure to vigorously implement current law. By design, the Affordable Care Act (ACA) helps persons who lose employer-sponsored insurance by making subsidies available for the purchase of individual insurance in the ACA marketplaces, by expanding Medicaid eligibility, and by requiring that private insurance cover preexisting conditions and a basic package of benefits. However, although states with their own marketplaces have alerted the recently unemployed to their potential eligibility for subsidized plans,7 the federal government has not engaged in a parallel effort. It has neither educated the newly unemployed about their immediate eligibility outside of open enrollment periods for subsidized insurance in the federally run ACA marketplaces nor opened special enrollment periods for those wishing to enroll even if they did not previously have coverage. Furthermore, 14 states have chosen not to expand Medicaid.

Trump’s health care reform is not effective

Abagail Weinberg, August 8, 2020,  Mother Jones, Trump Says He’s Improving Health Care. It Couldn’t Be Further From the Truth, https://www.motherjones.com/politics/2020/08/trump-says-hes-improving-health-care-it-couldnt-be-further-from-the-truth/

But Trump’s health care record paints a different picture. While expanded telehealth services could be a boon for people covered by Medicare and Medicaid, Trump has attempted to cap the federal government’s Medicaid spending by instituting “block grant” waivers that allow states to cut back on care. And Trump’s telehealth services do nothing to aid the roughly 4.7 million Americans who lack insurance because their states have not expanded Medicaid. His executive orders for curbing drug prices turn out to be more PR than policy, offering minimal relief for a minority of Americans if and when they’re eventually implemented, NPR reports. The measures are also unlikely to reduce prescription drug prices by 50 percent, as Trump has repeatedly claimed. The order allowing the importation of lower-cost drugs from other countries, for example, could take months to implement; another designed to lower Medicare patients’ premiums requires that neither federal spending, premiums, or patient’s out-of-pocket costs increase, meaning that the order will likely never go into effect. Trump has also repeatedly and falsely claimed that he protects people with preexisting conditions. Meanwhile, he has tirelessly attempted to undermine Obamacare regulations that do just that.  One thing is true: Trump helped eliminate the individual mandate—paving the way for a lawsuit that could jeopardize the entirety of the Affordable Care Act and leave the 23 million Americans currently covered by Obamacare uninsured. The Trump administration has supported Texas v. United States, the lawsuit brought by Republican attorneys general that argues that the loss of the individual mandate invalidates the entirety of the Affordable Care Act. The Supreme Court will likely hear oral arguments on the case in the fall. Trump has failed to release the alleged Obamacare replacement plan he has repeatedly promised. Meanwhile, nearly 28 million non-elderly Americans were uninsured before the pandemic, and the United States remains dependent on an employment-based health care system that strips people of their coverage during an economic downturn caused by a global pandemic. A study by the nonpartisan Families USA estimates that 5.4 million people lost their employer-based coverage along with their jobs; when the Kaiser Family Foundation took into account the family members of the uninsured, the number who lost coverage jumped to 27 million.

Millions of Americans will lose health care due to the economic crisis

National Center for Coverage Innovation @ Families USA, July 31 31, 2020, https://familiesusa.org/wp-content/uploads/2020/08/COV-184_Job-Loss-Report_07-31-20-1.pdf, Without Federal Support for Health Insurance, Many More Jobs Will Be Lost

Major health insurance losses are under way, resulting from the COVID-19 economic collapse. This report finds that, even if economic conditions remain no worse than those in May, health insurance losses will trigger enormous revenue reductions for hospitals, doctors’ offices, and other health care providers that end 1.5 million to 2.5 million jobs. If American employment falls significantly below May levels, as many as 4.7 million could lose their jobs in health care and related industries. Reduced revenue for health care providers has already taken a terrible economic toll. It caused 29% of the second quarter’s record-setting GDP drop, significantly more than any other industry’s contribution to economic decline. More than a million health care workers lost their jobs, more than any other private industrial sectoroutside the restaurant business. To prevent further revenue losses that eliminate millions more jobs and obstruct economic recovery, Congress must protect and restore American health insurance as part of COVID-19 emergency legislation.

Even after the ACA, 30 million Americans don’t have health care

Danielle Parnass and Adam Schank, July 29, 2020, Washington Post, What Made U.S. Health Care So Vulnerable to Covid-19: QuickTake, https://www.washingtonpost.com/business/what-made-us-health-care-so-vulnerable-to-covid-19-quicktake/2020/07/29/2443ba3a-d159-11ea-826b-cc394d824e35_story.html

Government involvement in health care goes against the libertarian streak that distinguishes the U.S. from, say, the U.K. and Canada, whose state-funded health systems guaranteeing care for all are derided by some Americans as “socialized medicine.” Only about 36% of Americans, mainly the elderly and poor, receive health-care coverage through the government, via the Medicare and Medicaid programs. More than half of Americans have health insurance as a benefit through work (and can lose coverage if laid off). The 2010 Affordable Care Act, more commonly called Obamacare, has helped about 20 million Americans get health coverage by expanding access to Medicaid and subsidizing purchases of individual plans. Still, as of 2018, about 9% of the population, or 28.3 million people, had no health insurance.

5 million have lost health insurance

BRC News, July 30, 2020, https://www.bcrnews.com/2020/07/30/health-care-coverage-is-now-more-important-than-ever/a9651ld/, Health care coverage is now more important than ever

Protecting and improving upon the Affordable Care Act is absolutely essential, now more than ever. Our current leaders have consistently tried to do away with medical coverage provided by the Affordable Care Act and exclude those with pre-existing conditions from receiving necessary coverage. The Trump Administration filed another lawsuit in its continued efforts to dismantle the Affordable Care Act, even as over 5.4 million Americans have lost their health care coverage since March. The current administration has shown that they have no alternative plan to provide health care coverage should they be successful in abolishing the Affordable Care Act.

Millions losing health insurance, Trump trying to strip more

Hebah Kassem, MPH, is the organizing associate at the Progressive Caucus Action Fund where she leads the organization’s advocacy efforts on Medicare for All. She is a long-time organizer and advocate for communities of color to achieve racial and health equity, July 27, 2020, We Should Be Fighting For Healthcare For Everyone, Not Taking It Away, https://www.commondreams.org/views/2020/07/27/we-should-be-fighting-healthcare-everyone-not-taking-it-away

A deadly virus has infected millions of people worldwide. Our President refuses to acknowledge this and refuses to take aggressive action to control the situation. Millions of people lack adequate healthcare coverage and can’t afford a trip to the doctor. Hospital systems are overwhelmed with patients and essential workers are risking their lives and their families across the country, without access to proper PPE or hazard pay. Instead of protecting us, the Trump Administration is trying to strip health coverage from millions of its citizen. It sounds like a dystopian movie plot, but this is our reality. In the midst of a pandemic and some federal and state officials are trying to slash healthcare coverage exactly when it is most needed. Despite Trump’s false statement that the virus just “…snuck up on us,” epidemiologists warned of the coming disaster months ago. As other countries are on their way to containing the virus and carefully reopening their economies, the U.S. hit another record day of coronavirus cases. Despite Trump’s claim that we would run 5 million tests a day in late April, we’re still only testing about 500,000 people a day. Because of the administration’s failure to implement basic public health tools and its lies about the pandemic, we are falling further and further behind other countries in testing, tracing, and ensuring that all our people have the healthcare and financial safety net needed to weather the storm. The pandemic is exposing the true cost of our for-profit healthcare system. As COVID-19 disproportionately impacts communities of color, overwhelms our hospital systems, and shuts down businesses leading to an all time high unemployment rate, one thing remains clear: our ramshackle healthcare system is failing in the face of the pandemic. At the start of this pandemic, 87 million people were already uninsured or underinsured. That number has continued to grow as 5.4 million people and their families have lost their employer-sponsored insurance amid the crisis, which is more than in any other single year. Additionally, immigrants were excluded from coronavirus relief enacted into law thus far and nearly 202,500 DACA recipients and approximately 131,000 TPS holders serve on the frontline of this crisis and lack access to healthcare.    To make matters worse, Republicans from 20 states and the Trump administration are challenging the Affordable Care Act (ACA) in court and working to strip health insurance from millions of people, during a pandemic. President Trump asked the Supreme Court to strike down the entire ACA since “the individual mandate penalty has been set to $0.” The Supreme Court already dealt a serious blow to the ACA’s protections this term by ruling that allows employers to refuse to include contraceptives in their health plans. We should be working to ensure healthcare coverage for everyone, not taking away people’s health insurance or access to basic health care like contraceptives. Instead of trying to dismantle health care protections during a pandemic, Congressional Democrats are fighting to strengthen the ACA through H.R. 1425, the Patient Protection and Affordable Care Enhancement Act, which passed in the House on June 29, 2020 with some key additional positive amendments. This legislation would significantly increase the ACA’s affordability subsidies, negotiate for lower prescription drug prices, expand coverage, and strengthen protections for people with pre-existing conditions. It’s a step in the right direction, but we must go further. Congressional Progressive Caucus co-chairs Reps. Pramila Jayapal and Mark Pocan and other progressive champions successfully added positive provisions from Reps. Jayapal and Haaland’s Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act that would expand access to healthcare for DACA recipients. DACA recipients, especially the 27,000 DACA healthcare workers, often struggle to obtain healthcare coverage and have been excluded from other relief packages. Although the Supreme Court overturned Trump’s termination of DACA, hundreds of thousands of Dreamers still face a number of challenges including accessing healthcare. The HEAL Act is crucial and would provide immigrants with some of the relief and protections they deserve, including removing the restrictive 5-year waiting period to enroll in health coverage. In June, Democrats in the House passed the Heroes Act, a $3 trillion dollar relief package that will provide people with continued unemployment benefits, direct cash assistance, housing protections, relief for immigrants, voting rights, and more. Instead of taking up the Heroes Act or the HEAL Act, the Republican-led Senate is pushing for more corporate bailouts, resisting continuing expanded unemployment insurance, and trying to give corporations immunity from lawsuits if they recklessly endanger their workers and customers. The pandemic is exposing the true cost of our for-profit healthcare system. As a nation, we will only be healthy if everyone has access to healthcare. The only comprehensive solution is Medicare for All. People of color are dying at disproportionate rates due to COVID-19 and although the virus does not discriminate, our healthcare system does. Dreamers and immigrants are left behind, people are unable to afford testing and treatment, and the pandemic is only getting worse. With the expiration of expanded unemployment insurance, millions facing evictions as layoffs continue, and cases, hospitalizations, and deaths surging nationwide, we need to do more, not less. Congress must take immediate action to help those in need during this crisis, and then we must build a system that could have prevented many of the issues we face today. That means fighting to achieve Medicare for All.

espite high spending and specializations, US life expectancy low relative to its peers

Danielle Parnass and Adam Schank, July 29, 2020, Washington Post, What Made U.S. Health Care So Vulnerable to Covid-19: QuickTake, https://www.washingtonpost.com/business/what-made-us-health-care-so-vulnerable-to-covid-19-quicktake/2020/07/29/2443ba3a-d159-11ea-826b-cc394d824e35_story.html

The system encourages more expensive, specialized treatment over primary care. This does make the U.S. a leader in many aspects of medicine. It’s long been at the forefront of research and has lower death rates for breast cancer, heart attacks and strokes. Patients face shorter wait times to see specialists and can have access to state-of-the-art procedures. U.S. doctors earn roughly twice as much as those in other wealthy countries. At the same time, the U.S. has some of the worst health outcomes, including the lowest life expectancy among its peers and the highest rate of “avoidable deaths” — those that could have been prevented with effective care.

Immediate health insurance needed by those with chronic conditions

National Center for Coverage Innovation @ Families USA, January 31, 2020, https://familiesusa.org/wp-content/uploads/2020/08/COV-184_Job-Loss-Report_07-31-20-1.pdf, Without Federal Support for Health Insurance, Many More Jobs Will Be Lost

Health problems unrelated to COVID-19 have grown in prevalence and severity. Comprehensive health insurance is essential for people with diabetes, high blood pressure, cancer, and other chronic illnesses to obtain prompt care that can prevent permanent damage to their health or even save their lives.

Without health insurance people cannot meet basic needs

National Center for Coverage Innovation @ Families USA, January 31, 2020, https://familiesusa.org/wp-content/uploads/2020/08/COV-184_Job-Loss-Report_07-31-20-1.pdf, Without Federal Support for Health Insurance, Many More Jobs Will Be Lost

Nearly half of the country has lost employment income. Tens of millions of families now report an inability to buy necessary food and serious concerns about making rent or mortgage payments. Without health insurance, significant medical bills will further burden these families. Many may have to choose between obtaining essential health care and meeting other basic needs.

5.4 million are employed in health care

National Center for Coverage Innovation @ Families USA, July 31 31, 2020, https://familiesusa.org/wp-content/uploads/2020/08/COV-184_Job-Loss-Report_07-31-20-1.pdf, Without Federal Support for Health Insurance, Many More Jobs Will Be Lost

Hospitals, clinics, doctors, and other health care providers now employ one in seven U.S workers. A large decline in insurance coverage, which would cut revenue to the health care industry, could thus have significant economic consequences. The resulting staff layoffs at health care providers would trigger job loss in other industries as well, exacerbating the current downturn and undermining recovery.

39-1 million health care workers have lost their jobs in the pandemic

National Center for Coverage Innovation @ Families USA, July 31 31, 2020, https://familiesusa.org/wp-content/uploads/2020/08/COV-184_Job-Loss-Report_07-31-20-1.pdf, Without Federal Support for Health Insurance, Many More Jobs Will Be Lost

Diminished revenue for health care providers has already taken a serious economic toll. According to data from the U.S. Bureau of Economic Analysis, the health care industry’s revenue losses accounted for 29% of the second quarter’s record-breaking drop in gross domestic product, contributing more than any other industry to our country’s economic decline. More than 1 million workers lost health care jobs during the pandemic’s first few months, a number exceeded only by unemployment in the restaurant industry. Health insurance critical to stop disease transmission, federal action is needed Comprehensive health insurance provides families with access to essential health care, preventing illness, stopping disease transmission, and savings lives, with both COVID-19 and other health conditions. Such insurance also makes an important economic contribution by providing revenue that keeps the lights on at hospitals and other health care providers. To avoid a new round of job losses that deepens the COVID-19 downturn and slows economic recovery, federal action that maintains comprehensive health

Even after the ACA, 30 million Americans don’t have health care

Danielle Parnass and Adam Schank, July 29, 2020, Washington Post, What Made U.S. Health Care So Vulnerable to Covid-19: QuickTake, https://www.washingtonpost.com/business/what-made-us-health-care-so-vulnerable-to-covid-19-quicktake/2020/07/29/2443ba3a-d159-11ea-826b-cc394d824e35_story.html

Government involvement in health care goes against the libertarian streak that distinguishes the U.S. from, say, the U.K. and Canada, whose state-funded health systems guaranteeing care for all are derided by some Americans as “socialized medicine.” Only about 36% of Americans, mainly the elderly and poor, receive health-care coverage through the government, via the Medicare and Medicaid programs. More than half of Americans have health insurance as a benefit through work (and can lose coverage if laid off). The 2010 Affordable Care Act, more commonly called Obamacare, has helped about 20 million Americans get health coverage by expanding access to Medicaid and subsidizing purchases of individual plans. Still, as of 2018, about 9% of the population, or 28.3 million people, had no health insurance.

Millions uninsured and facing health issues

Darrouzet, 7-7, 20, Michael Darrouzet is the CEO of the Texas Medical Association. Jennifer Hanscom is the executive director and CEO of the Washington State Medical Association. Philip Schuh is the executive vice president and CFO of the Medical Society of the State of New York. All are board members of The Physicians Foundation, STAT News, Health care reform: The ‘new normal’ needs to go beyond clinical care,

https://www.statnews.com/2020/07/07/new-normal-health-care-go-beyond-clinical-care/

And that was before Covid-19. How does our notion of “risk” change when more than 36 million Americans have filed for unemployment benefits in the past three months and nearly one-quarter of U.S. households are reporting that “the food we bought just didn’t last, and we didn’t have money to get more”? Millions of patients will show up in clinics exhibiting the physical toll of skipping meals to feed their children. They will have made impossible tradeoffs between refilling their heart medicine or buying food. They will carry the stress of spending weeks trying — and failing — to find a job as bills pile up and they fear losing their homes as the rent or mortgage goes unpaid and eviction bans get lifted.