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Communities Plagued By Uninsurance Also Suffer From Breakdowns In Trust

By Tara McKay for The Conversation - Dismantling the Affordable Care Act (ACA) without a replacement plan is projected to increase the nation’s uninsured population by 18 million in the first year after repeal and by 32 million in 2026, according to recent estimates by the Congressional Budget Office (CBO). As lawmakers and the American public consider repealing portions of the ACA, it is an important time to reflect on what limiting access to health insurance might mean for Americans and their communities. If a repeal occurs, not only individuals, but also their communities, could be affected. Whether we like it or not, health insurance affects our lives in significant ways.

Sanctuary Cities Are Safe, Thanks to Conservatives

By Noah Feldman for Bloomberg. President-elect Donald Trump says he will make “sanctuary cities” help deport immigrants by taking away their federal funding if they don’t change their policies. The good news is that he and Congress can’t do it -- not without violating the Constitution. Two core rules of federalism preclude Trump’s idea: The federal government can’t coerce states (or cities) into action with a financial “gun to the head,” according to Supreme Court precedent developed by Chief Justice John Roberts in the 2012 Affordable Care Act case. And federal officials can’t “commandeer” state officials to do their work for them under a 1997 decision that involved gun purchases under the Brady Act. Justice Roberts analyzed the ACA Medicaid provisions by saying that, under the spending clause of the Constitution, Congress can’t create a funding condition that is unrelated to the original funding purpose and is so coercive that it amounts to a “gun to the head” of the states. Roberts’s doctrine applies with full force to Trump’s threat to pull cities’ existing funding if they remain sanctuaries by declining to cooperate with federal officials to enforce immigration law.

Many Confused By Tax Filing Requirements Could Lose ACA Tax Credits

By Ricardo Alonso-Zaldivar in PNHP - About 1.8 million households that got financial help for health insurance under President Barack Obama's law now have issues with their tax returns that could jeopardize their subsidies next year. Consumers who got health care tax credits are required to file tax returns that properly account for them, even if they are unaccustomed to filing because their incomes are low. Unless they follow through, "they will not be able to receive tax credits to help lower the cost of their health insurance for 2016," Lodes explained (Lori Lodes, communications director for the Centers for Medicare and Medicaid Services). The 1.8 million households with tax issues represent 40 percent of 4.5 million households that had tax credits provided on their behalf and must account for them. "What the IRS is doing here is sending these people a not-so-gentle reminder that they need to file or they will put their subsidy at risk," said Mark Ciaramitaro, vice president for tax and health care at H&R Block, the tax preparation company. He cautioned that many consumers will find the process cumbersome, so they should waste no time getting started.

Obamacare Enrollees Highly Dissatisfied With Health Coverage

By Kate Randall for WSWS - A new study, however, shows that those enrolled through Obamacare are more dissatisfied with their coverage than any other group of insured Americans. The poll from the Deloitte Center for Health Solutions, research arm of the consulting firm, finds that only 30 percent of people with insurance through the ACA exchanges are satisfied with their plans, mainly due to cost. By contrast, 58 percent of Medicare enrollees are satisfied, while 42 percent of those with insurance through their employer are satisfied. The most affordable plans offered for sale on the ACA exchanges come with deductibles in excess of $5,000 annually and other out-of-pocket costs. Data from the Deloitte poll shows that enrollment in an Obamacare plan is no guarantee that health care coverage will be affordable or accessible. Researchers surveyed 3,887 people who had purchased health insurance on either the state exchanges or the federal web site, HealthCare.gov. The poll found that only 24 percent of ACA enrollees felt they could get affordable care when they needed it, and an abysmal 16 percent felt fully prepared to handle future health care costs.

Obamacare? Wall St. Suddenly Scrambles To Buy Doctors

By Wolf Ritcher in Wolf Street - For PE firms, the fracking boom was nirvana. An eternal-growth industry. A big part of the money they poured into the scrappy oil & gas companies is now going up in smoke. Other industries are mired in a no-growth or shrinking environment. Chaos keeps breaking out in the international markets, most recently over Greece and China. So, healthcare, which accounts for nearly one-fifth of US GDP, “is really the growth opportunity,” Tom Banning, CEO of the Texas Academy of Family Physicians, told The Texas Tribune: “The forces are aligned to force consolidation, and frankly, how those independent doctors are able to compete against well-heeled, deep-pocketed systems or networks is going to be a problem,” Banning said. “

Health Insurance Industry Eats Competition

By Margaret Flowers and Kevin Zeese. Many have argued, though we have not, that the federal health law, the ACA, is a 'step in the right direction' or a 'step towards single payer.' Our analysis is that the ACA is a step in the wrong direction because it further entrenches and empowers the private health insurance industry. Since its passage in 2010, the ACA has led to greater privatization of our public insurances Medicaid and Medicare and greater consolidation of health insurers and health facilities. As you will read in the article below, we are moving in the direction of a single payer health system, but one in which the single payer (or perhaps there will be a few payers) are the private health insurance industry. In this system, the costs of health care will continue to sky rocket and those who cannot afford care will go without it.

The Fight Over Obamacare Was A Giant Political Charade

By Sonali Kolhatkar for Truthdig. The constant attacks on the ACA, including this last attempt, were less ideological than political, and in the end, the Supreme Court ruling was an affirmation of the supremacy of capitalism over human needs. It is true that 6.4 million Americans currently receiving subsidies for insurance would have lost their coverage had the court not voted to preserve the ACA. The vote was 6-3, with conservative Chief Justice John Roberts joining swing voter Anthony Kennedy and the four liberal stalwarts (Sonia Sotomayor, Elena Kagan, Ruth Bader Ginsburg, and Stephen Breyer). The fact that Roberts voted for it, and wrote the majority opinion, speaks volumes about what the ruling really means. According to him, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.” That single sentence clearly lays out the problem with what the right has sardonically named “Obamacare.” In voting to preserve the health care reform law, the court sought to “improve health insurance markets,” not access to health care.

Subsidies Upheld, But Health Needs Still Unmet

By Dr. Robert Zarr for Physicians for a National Health Program. Washington, DC - Today’s decision by the Supreme Court in King v. Burwell to uphold the Affordable Care Act’s premium subsidies in about three dozen states will spare more than 6 million Americans the health and financial harms associated with the sudden loss of health insurance coverage. For that reason alone the decision must be welcomed: Having health insurance is better than not having coverage, as several research studies have shown. That said, the suffering that many Americans are experiencing today under our current health care arrangements is intolerable, with approximately 35 million people remaining uninsured, a comparable number underinsured, and rapidly growing barriers to medical care in the form of rising premiums, copayments, coinsurance and deductibles, and narrowing networks.

Governor Unilaterally Denies ‘Single Payer’ Health Care

Today, Vermont’s governor, after campaigning for single payer for years, announced that he would not work to pass single-payer legislation in Vermont this year. “Single payer” is shorthand for a reform that will replace the present wasteful and chaotic system of private health insurance, Medicare, Medicaid and out-of-pocket cash payments with a single public finance system that will redirect resources in order to guarantee access to all necessary care for everyone, which would include many essentials not covered by any present plan. Governor Peter Shumlin, in his press conference, stated that “now is not the right time” for single payer. I disagree. The time for a single-payer system is now. Our patients in every state urgently need it.

The Struggle For Healthcare Justice

This is the first time I realized I had a real battle on my hands -- not only to fight to save my own life but also the lives of tens of millions of other Americans who are experiencing the same injustice. We have been made to feel so desperate for health care in this country, because of the actions of Big Insurance, or "the Health Insurance Industry," in collusion with the U.S. government. I mean, we have literally had to watch our children die, when methods and doctors were standing by that could have saved their lives, all because an insurance company decided that it did not want to take the financial loss to pay for our health care. Because that is what our health care needs are to Big Insurance -- a loss to their bottom line, to their profits. And Obamacare puts this industry, by law, between us and our doctors.

Continuity of Health Care: Going, Going… Almost Gone!

We have heard the promises as the Affordable Care Act (ACA) was being sold to the public, including -- you can keep your doctor and insurance if you like it. We now know those promises to be mostly false as the ACA enters its fifth year of implementation. Under the guise of "competition" and "efficiency," the ACA has unleashed a new round of disruption throughout the health care system. We are seeing further fragmentation of care, with less continuity of care with patients' physicians. The physician-patient relationship itself is at risk in a "system" increasingly headed for strangers taking care of strangers. More than one-half of U.S. physicians are no longer self-employed and now work for organizations, mostly growing hospital systems but also some insurers that are moving into the delivery side of health care. Two examples illustrate the new landscape: • Several hundred patients at the University of Pittsburgh Medical Center (UPMC) recently received certified letters informing them that they could no longer see their physicians. The reason: their insurance, Community Blue, sold by Highmark, is now both a rival hospital system and an insurer. Patients were cut off from their UPMC physicians even in the middle of cancer therapy. (1)

Saying ‘Hell No’ To Obamacare

Recently, Dr. Margaret Flowers initiated an online petition declaring herself a consciences objector to the Affordable Care Act and asking others to send a message to President Obama that the ACA is a scam. Dr. Margaret Flowers (MFlowers8) is a pediatrician from Baltimore who is an organizer at PopularResistance.org, co-directs ItsOurEconomy.us and co-hosts Clearing the FOG on We Act Radio. She is adviser to the board of Physicians for a National Health Program and is on the steering committee of the Maryland Health Care is a Human Right campaign.

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