Real Fix of ACA Would Be Medicare For All, Say RNs

National Nurses United today condemned the narrow vote by House Republicans as a form of “cruel and unusual punishment” that could deprive tens of millions of Americans of health coverage and threaten millions more with bankruptcy for being sick.

“The celebration by Republican leaders and the White House on the passage of this draconian and mean spirited, punitive legislation is an appalling spectacle that symbolizes a new nadir in American politics,” said NNU Executive Director RoseAnn DeMoro.

“What should have been clear, from months of protests, to those who have added their name to the dishonor roll today, is they will pay a price from the constituents they have harmed today,” DeMoro added.

Voters will also be reminded, said DeMoro, that the legislators benefited from the hundreds of billions in tax cuts shoehorned into the bill. Of the $275 billion in new tax cuts in the bill, 80 percent go to those with incomes over $1 million a year, which includes a large chunk of those who voted for it.

“Nothing could be more immoral than handing out huge tax cuts for the wealthiest Americans while slashing our health care safety net,” DeMoro said.

The tax cuts contrast with cutting some $880 billion from Medicaid, affecting the most low income Americans and driving up the cost of insurance premiums, according to projections, by $142,000 for 40-year olds with metastatic cancer, $18,720 for congestive heart failure, $17,320 for pregnancy, $8,490 for certain mental health conditions, $5,600 for diabetes, and $4.340 for asthma.

In a letter to House members April 27, NNU Co-Presidents Deborah Burger, RN, and Jean Ross, RN, called the bill even worse than the original bill defeated in March.

Burger and Ross cited “abhorrent proposals” they noted that would:

• Eliminate the Prevention and Public Health Fund, which will worsen the health of our communities, spread infectious disease, and increase health system costs;
• Phase out coverage for Medicaid expansion in Medicaid expansion states beginning in 2020, while preventing new states from receiving enhanced Federal Medical Assistance Percentage in order to expand Medicaid;
• Institute a per capita cap for Medicaid, along with the option for states to use a block grant instead. Both options will reduce coverage for the most vulnerable, shift care from clinics to emergency rooms, increase system costs for the chronically ill as they defer treatments because of cost, and unfairly shift the burden of costs to the states;
• Empower individual states to determine eligibility, scope and benefits for Medicaid as per their own discretion, but there will be no increase in federal monies to cover expanded eligibility;
• Eliminate funding to Planned Parenthood which will worsen women’s health, and create burdens for women, families and society from unsafe pregnancies and other health conditions no longer treated;
• Eliminate the definition of “essential benefits” – a move that makes all patients vulnerable to the distortions and marketing games of  insurance companies;
• Repeal the cost-sharing subsidies of the ACA, and destroy the ability of 80% of people currently buying insurance on the Exchanges to maintain coverage;
• Open the door for junk insurance.  The bill includes a penalty for lack of continuous coverage, creating a big incentive for patients to buy low-cost, no-coverage plans;
• Fail to encourage low-cost coverage, because the legislation shifts thousands of dollars in spending from insurance company spending to the individual’s out of pocket costs;
• Reproduce the failed “high – risk pools” of the 1990’s and 2000’s, through the “Patient and Stability Fund”.  It is inevitable that the number of eligible patients will overwhelm the resources of these high risk pools;
• Repeal the Medicare Hospital Insurance Tax, which will reduce funding and destabilize for the Medicare program that our nation’s seniors rely on;
• Allow insurers to charge seniors five times the amount of a younger person. This revision will prove to be deadly for our nation’s seniors, and it reveals the extent to which this reform will benefit the profit margins of insurance companies, at the expense of patients’ lives.

While it is true that the Affordable Care Act had significant weaknesses, that included leaving 28 million uninsured, and failing to control ever increasing out of pocket costs, “severely eroding the improvements in the ACA, and imposing far worse conditions is a disgrace,” said DeMoro. “There is only one way to fix healthcare – to improve Medicare, one of the signature reforms in U.S. history, and expand it to cover all Americans.”