Exactly zero of the right wing red-hot-siren warnings about shooting health insurance costs ("rate shock") has panned out, but plenty of rate shock has been received on the other end of the scale - with tons of people shocked to find checks from their insurance companies in their mailboxes, rates reduced for their children with pre-existing conditions, and outrageously inexpensive rates in the state exchanges about to open in less than two weeks.
And here comes another: of the people who are eligible for either Medicaid or premium subsidies under the Affordable Care Act, six out of 10 Americans currently uninsured will be able to get coverage for $100 or less per month.
There are currently 41.3 million eligible uninsured Americans. [i.e. eligible for either expanded Medicare or premium credits under the ACA]. In states that are expanding Medicaid, a total of 23.2 million people, or 56 percent of the 41.3 million eligible uninsured, may qualify for Medicaid, CHIP, or tax credits to purchase coverage for $100 or less per person per month.Sure, these account for cheapest plans participants would be eligible for, but this is terrific news. People who are struggling to pay for health care can finally see some relief. Those who become newly eligible for Medicaid (or SCHIP), under expanded rules extended to people with incomes at or below 133% of the federal poverty level (approx. $15,000 in 2013), will pay no premiums at all. This accounts for 12.4 million Americans. The rest will be able to avail themselves with incredibly inexpensive insurance premiums in the insurance marketplaces, after applying their Obamacare subsidies.
But even though this is terrific news and a testament to everyone who pulled together to pass the Affordable Care Act (especially the President), blind Republican hatred and obstructionism is keeping this news from getting even better: if Republicans in states weren't resisting the Medicaid expansion that is paid for in its entirety by the federal government for the first three years and 90% in perpetuity, nearly 8 in 10 uninsured Americans would be able to obtain coverage for $100 or less. 32.1 million people would be eligible to pay sub-$100 premiums absent the GOP obstructionism.
The problem, of course, is that by blocking the lifeline of Medicaid to those who need help the most, Republican governors and legislatures are blocking health coverage for the poorest in their state. The Affordable Care Act does not provide premium subsidies for those who would otherwise be eligible for Medicaid or SCHIP. Republicans are actively stopping the poorest from being able to see a doctor when they get sick. Talk about a death panel.
Still, the success of the ACA in holding down what people will pay to get insurance is immense, and I have long made the case that eventually, intransigent states will come around to accepting the Medicaid expansion, not because their hearts will ache for the poor but because their own hospital and medical provider industries will beat them to the pulp for making them pick up the tab for uncompensated care. Today's development adds to several other successes the ACA has already experienced, including dramatically lowering the rate of uninsured among young adults and saving billions to people on Medicare. Since the passage of the ACA, the rate of uninsured non-elderly overall has fallen by a full percentage point:
Right wing extremists may be pushing the Republican party in Congress to take the nation into financial abyss if they cannot force a repeal of all of these benefits and a reversal of the trend in lower costs and better care for Americans, but the truth is that this is their endgame. The exchanges are coming. Americans are going to be pleasantly surprised when they see the rates, and especially when they see how little they will pay after applying the subsidies. There is no going back. Obamacare is saving lives, improving health care and arresting cost growth. In a decade's time, even speaking of repealing Obamacare will become synonymous with repealing Medicare.