Tag: medicaid

Misunderstanding the Affordable Care Act and Understanding Why It Should Be Saved

Obamacare is not failing and has helped millions of people get insurance coverage. All of the plans to repeal and replace it have been huge steps backwards that have been opposed by every major health organization.

If the Affordable Care Act (Obamacare) gets repealed, it likely won’t be because folks understand what it does.

The American Academy of Pediatrics is opposed to plans to repeal the ACA and wants to KeepKidsCovered.
The American Academy of Pediatrics is opposed to plans to repeal the Affordable Care Act and is working hard to #KeepKidsCovered.

It will be because many people don’t realize that they are benefiting from Obamacare or even what it really does.

Obamacare Under Attack

The Affordable Care Act has been under attack almost from the day it was enacted.

Since the original Repealing the Job-Killing Health Care Law Act, and through dozens of others, we have most recently had the:

  • Better Care Reconciliation Act
  • Obamacare Repeal and Reconciliation Act
  • Health Care Freedom Act (“Skinny” repeal)

They all failed.

The latest attempt to repeal Obamacare is the Graham-Cassidy-Heller-Johnson Bill.

Will this bill pass?

As a pediatrician, I am fearful for my patients and the uncertain future they would face under Senators Lindsey Graham (R-S.C.) and Bill Cassidy’s (R-La.) health care proposal, currently set for a vote next week in the U.S. Senate. As president of the American Academy of Pediatrics, I must speak out against this dangerous, ill-conceived policy on behalf of our 66,000 pediatrician, pediatric surgical specialist and pediatric medical subspecialist members, and stop it from advancing…

The American Academy of Pediatrics urges the Senate to oppose the Graham-Cassidy proposal, and instead turn to bipartisan solutions that are crafted in the best interest of children and families, like the Children’s Health Insurance Program and Maternal, Infant and Early Childhood Home Visiting program, which both expire next week. Pediatricians will continue to focus on the children we care for as this process unfolds, and we will not stop speaking up on their behalf until we see legislation that puts them first.

Fernando Stein, MD, FAAP, President, American Academy of Pediatrics on the AAP Statement Opposing Graham-Cassidy Health Care Proposal

Like the other bills, the Graham-Cassidy-Heller-Johnson Bill will fail if any of these organizations that have come out in opposition have anything to say and do about it:

  • American Academy of Pediatrics (AAP)
  • American Medical Association (AMA)
  • American Nurses Association
  • American Congress of Obstetricians and Gynecologists (ACOG)
  • American Academy of Family Physicians (AAFP)
  • American Osteopathic Association (AOA)
  • American Public Health Association
  • National Association of Pediatric Nurse Practitioners
  • First Focus Campaign for Children
  • Children’s Defense Fund
  • Children’s Dental Health Project
  • Family Voices
  • American Psychiatric Association
  • AARP
  • National Council for Behavioral Health
  • American Hospital Association
  • ALS Association
  • American Cancer Society Cancer Action Network
  • American Diabetes Association
  • American Heart Association
  • American Lung Association
  • Arthritis Foundation
  • Cystic Fibrosis Foundation
  • Family Voices
  • JDRF
  • Lutheran Services in America
  • March of Dimes
  • National Health Council
  • National Multiple Sclerosis Society
  • National Organization for Rare Diseases
  • Volunteers of America
  • WomenHeart

How can they pass a health law that every major health organization opposes?

“This bill contains proposals we have seen in previous bills, and we already know they would be bad for people with CF – and some cases, go even further. Graham-Cassidy would allow states to get rid of certain pre-existing condition protections, open the door to annual and lifetime coverage caps and high risk pools, and make massive cuts to Medicaid.”

Cystic Fibosis Foundation

In addition to repealing parts of the Affordable Care Act (ACA), Graham-Cassidy:

  • makes massive cuts to Medicaid
  • turns Medicaid into a block grant and caps its funding
  • ends Medicaid expansion
  • eliminates ACA’s marketplace subsidies

Graham-Cassidy should not be allowed to pass.

Add your voice to the opposition if you agree. Contact your Representative and Senators to let them know that you oppose the Graham-Cassidy ACA repeal bill.

Understanding the ACA

Most people understand that the ACA allowed many uninsured people to finally get insurance. Either with the help of tax credits, simply because the plans were available, or through the expansion of Medicaid, about 20 million have insurance because of the ACA.

What many people don’t realize is that they likely benefited from the ACA, even if they aren’t one of these 20 million people.

Some of the ACA benefits for everyone with any kind of insurance included:

  • no refusal for coverage because you have a pre-existing condition – which could include things like asthma, ADHD, anxiety, and depression or a cancer that is in remission
  • coverage for young adults so they could stay on their parent’s insurance plan until they are 26 years old, even if they are in school, working, or married
  • the elimination of annual and lifetime limits or caps – which some kids with complex health problems could reach in a single year
  • no co-pays for preventative care visits, from well-child visits and vaccines to mammograms and colonoscopies and well adult visits for men and women
  • no co-pays for breastfeeding support, supplies, and counseling
  • coverage for maternity services
  • coverage for mental health and substance abuse services
  • insurance plans can’t drop you if you get sick

Most people like those benefits.

Personally, I no longer see parents who worry about my diagnosing their child with asthma or anxiety because of how it “will look” on their insurance. And we don’t have to worry that a diagnosis of anxiety or depression won’t be covered because they have insurance that doesn’t include mental health benefits.

And, even though the Vaccines for Children program was available, it is nice knowing that insurance covers their vaccines that can protect them from life-threatening vaccine-preventable diseases.

Misunderstanding the ACA

Not realizing all of these benefits is only one way that folks misunderstand the ACA.

Are premiums under Obamacare soaring?

Actually no. Insurance premiums have gone up at slower rates for all of us than they did before Obamacare took effect!

“We have a national law that will continue to work overall, but which has some problem spots. That frames the real choice here. It is not, as Trump, McConnell, and Ryan would cynically lead the American people to believe, between repealing the ACA or coping with impending disaster. Rather, it is between repealing the law and repairing it.”

Scot Lehigh on Hard truths about Obamacare

Do some people have fewer options as some major insurers drop out of the ACA Marketplaces? Sure. But that’s still better than the zero options they likely had before the ACA when they were uninsured.

What about the idea that Obamacare is failing overall? It’s not.

What to Know About Misunderstanding the ACA

Obamacare is not failing and has helped millions of people get insurance coverage. All of the plans to repeal and replace it have been huge steps backwards that have been opposed by every major health organization.

More Information About Misunderstanding the ACA

Tom Price as HHS Secretary – Good for Kids?

Tom Price is not going to support and improve the ACA (Obamacare), strengthen CHIP, or improve access to Medicaid services. He is basically against everything the American Academy of Pediatrics supports.

Many are describing President-elect’s choice of Representative Tom Price as the secretary of health and human services as “scary” and a “radical choice.”

To understand why, you should both understand what he believes and what his job will be.

The HHS Secretary

HHS Secretary Sebelius at a meeting of the Interagency Autism Coordinating Committee.
HHS Secretary Sebelius, NIH Director Dr. Francis Collins, and others, listen to a speech at the a meeting of the Interagency Autism Coordinating Committee, July 10, 2012. (HHS photo by Chris Smith)

Surprisingly, few people probably know the name of the current HHS secretary – Sylvia Mathews Burwell.

She succeeded Kathleen Sebelius, who resigned in 2014, mostly over problems with the healthcare.gov website and roll-out of the Affordable Care Act.

What does the HHS Secretary do?

As head of the United States Department of Health and Human Services, the HHS Secretary is a member of the President’s Cabinet and overseas the:

  • Administration for Children and Families (ACF)
  • Administration for Community Living (ACL)
  • Agency for Healthcare Research and Quality (AHRQ)
  • Agency for Toxic Substances and Disease Registry (ATSDR)
  • Centers for Disease Control and Prevention (CDC)
  • Centers for Medicare & Medicaid Services (CMS)
  • Food and Drug Administration (FDA)
  • Health Resources and Services Administration (HRSA)
  • Indian Health Service (IHS)
  • National Institutes of Health (NIH)
  • Substance Abuse and Mental Health Services Administration (SAMHSA)

As you probably recognize at least a few of those names, like the FDA, CDC, and NIH, you likely know that these agencies “administer a wide variety of health and human services and conduct life-saving research for the nation, protecting and serving all Americans.”

That work can be seen in the current strategic plan of the HHS:

  1. To Strengthen Health Care
  2. To Advance Scientific Knowledge and Innovation
  3. To Advance the Health, Safety, and Well-Being of the American People
  4. To Ensure Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs

And it can be seen in many of the current problems they are tackling, such as combating the opioid epidemic, lead poisoning hazards, the Zika virus, and continuing to get more people insurance coverage, etc.

Problems with Tom Price as HHS Secretary

So what might be the problem with Rep. Tom Price as HHS Secretary, after all, he is a doctor and has been endorsed by the AMA?

“The Association of American Physicians and Surgeons recommends a policy of Non-Participation to all physicians as the only legal, moral, and ethical means of concretely expressing their complete disapproval of the spirit and philosophy behind these amendments.”

THE PRINCIPLES OF MEDICAL ETHICS OF THE ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS

Tom Price is a member of the Association of American Physicians and Surgeons (AAPS), an organization of doctors that was opposed to the establishment of Medicare and Medicaid and which tells its members that it is “legal, moral, and ethical” to not treat patients on Medicare and Medicaid.

The AAPS is also against birth control and pushes a lot of anti-vaccine misinformation that can scare parents away from getting their kids vaccinated and protected against vaccine-preventable diseases!

A Radical Choice

In describing Tom Price as a “radical choice” for HHS Secretary, the New York Times stated that he is “a man intent on systematically weakening, if not demolishing, the nation’s health care safety net.”

In addition to supporting the repeal of Obamacare, Tom Price is a climate change denier, and has been in favor of:

  • block granting Medicaid
  • turning Medicare into a voucher program, which many think is a step towards privatization
  • barring all federal funds for Planned Parenthood, even though the very great majority of their activities have nothing to do with abortion
  • limiting participation in Children’s Health Insurance Program (CHIP) and voting against expanding CHIP several times
  • cutting billions of dollars from the Supplemental Nutrition Assistance Program (SNAP or food stamps) as it was converted to a State Flexibility Fund in the 2015 GOP proposed budget
  • continuing to ban research on gun violence at the CDC as he did not sign a letter with a bipartisan group of 146 other members of Congress, led by Congressman David Price, calling for a lift of the de-facto ban on federal gun violence research

And although his nomination was supported by the AMA, the American Academy of Family Physicians (AAFP), and the Association of American Medical Colleges (AAMC), there are many doctors and medical students who think that “Price’s stances are incompatible with the values of the medical profession and with the stated missions of the above organizations.”

The AAP on the Nomination of Tom Price

What has the American Academy of Pediatrics said about Tom Price’s nomination?

“Above all, HHS should strive to implement an agenda with children at the core and ensure that all children have access to high-quality, affordable health care so they can thrive throughout their lifetimes. All children, regardless of their immigration status, should have affordable health care coverage, insurance with pediatric-appropriate benefits, access to timely and affordable primary and subspecialty pediatric care and mental health services, and receive comprehensive, family-centered care in a medical home.”

AAP’s Blueprint for Children

As is their style, they have not issued a statement, but reviewing the AAP’s Blueprint for Children, it isn’t too hard to figure out what they would say.

Members of the American Academy of Pediatrics routinely volunteer to lobby members of Congress to support pediatric issues, like CHIP re-authorization.
Although they are not always successful, members of the American Academy of Pediatrics routinely volunteer to lobby members of Congress to support pediatric issues, like CHIP re-authorization.

The Blueprint, which “presents specific policy recommendations for the federal government to align its activities to promote healthy children, support secure families, build strong communities, and ensure that the United States is a leading nation for children,” states that they:

  • oppose block grants for Medicaid and other entitlement programs
  • support renewing and strengthening CHIP
  • support maternal and reproductive health programs
  • want to improve access to Medicaid services
  • support protecting and strengthening federal nutrition programs for children and families, including SNAP and WIC
  • support federally funded research to build the evidence base for a public health response to violence, including research on gun violence coordinated by the Centers for Disease Control and Prevention (CDC)
  • want the administration to aggressively addresses climate change
  • support the enactment of comprehensive immigration reform that prioritizes the health, well-being, and safety of children
  • want the administration to address factors that make some children more vulnerable than others, such as race, ethnicity, religion, sexual orientation or gender identity, and disability

And perhaps the thing that is most apparently in conflict with Tom Price’s nomination, the AAP states that they want the HHS secretary and Congress to:

“Support and improve the ACA. The ACA has made important progress for children. Congress should improve upon this progress and enhance pediatric benefits in the marketplaces, allow families that are not eligible for CHIP to purchase CHIP plans in the health insurance marketplaces, improve affordability of plans for families (especially those with children with special health care needs), and strengthen rules to ensure that adequate pediatric networks exist in marketplace plans.”

Tom Price is not going to support and improve the ACA (Obamacare), strengthen CHIP, or improve access to Medicaid services. He is basically against just about everything the American Academy of Pediatrics supports and has been working for.

We don’t need a statement from the AAP to know what that means.

 

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