by Jim Kasprzyk
- The majority of Americans want medical costs reduced and access to medical care improved.
- As a result of the 2017 tax cuts for the wealthy and corporations, retirement, social welfare and medical programs are targeted for cuts.
Affordable medical care is one of the principal issues of the 2018 election year. It is fiercely argued at every level of government. Polls throughout the U.S. show that the great majority of Americans want medical costs reduced and access to medical care improved. In 2018, for example, the Navigator Research poll found that 78% of respondents believed that health care has become less affordable and that government should do more to fix the problem. Despite this popular tidal wave, the Republican party continues to oppose the Affordable Health Care Act and related social support programs. This disconnect has led even some Republican congressional leaders to express concern that they might not be reelected if health care programs are seriously undermined. Even so, the Republican party platform remains unchanged.
In late 2017 Congress passed an enormous tax cut, primarily benefiting large corporations and wealthy individuals, and locked in that cut for years to come. To pay for this preposterously expensive give-away, the Republicans have targeted retirement, social welfare, and medical programs, “because that’s where the money is,” as Representative Kevin Cramer (R) of North Dakota said. This cold-hearted assessment has led to some brutal attacks on important social programs. For example, in April 2018 the Republicans in the House came close to passing a “balanced budget” Constitutional amendment that would require every Federal budget to be paid from current income. This would have collapsed the Medicare and Social Security funds, which pay benefits from accumulated taxes. It would also have caused great problems for military, Federal Civil Service and other retirement funds. The proposal didn’t pass because a Constitutional Amendment requires two-thirds approval in both houses of Congress, and Democrats opposed it.
Under the cover of “reform” there have been many attempts, some crude and unforgiving, others indirect and subtle, to undermine “Obamacare” or to prove it doesn’t work by restricting its funding, challenging its legal status and impeding its operations. States and health organization have launched numerous court challenges to the Affordable Healthcare Act (ACA), so far without significant success. While some initiatives have failed because of popular outcry, Republicans continue to seek ways to strip mine the American medical benefits system to shore up their budget. There have been assaults on CHIP (the Children’s Health Insurance Program) and on Medicare expansion, as well as bills proposing to allow insurance plans for “catastrophic” medical care only, or permitting individuals to avoid the ACA exchanges. Funds have been cut for programs that help Americans sign up for ACA health care, and other funds have been withheld for risk adjustment payments for insurers.
Attacks from every quarter have tried to limit the health benefits of citizens and move health program funding into the bank accounts of corporations and wealthy individuals. House Majority Leader Paul Ryan (R), with many others in his party, have called for “reform” of Federal health care programs. This sounds harmless enough, but it’s only a ruse. It would take many hundreds of billions of dollars to make up for the estimated 1.5 trillion dollars in deficits left by the tax cuts. How do these attacks on the current health care system affect you? Let’s examine two major programs and their impact on North Carolinians.
Medicare is the mandatory Federal medical insurance program for individuals over the age of 65. Many retired citizens depend on it for their primary health care. Because of North Carolina’s relatively low cost of living, moderate weather, and access to commercial, medical and recreational facilities, our state is a retirement destination. It is estimated that about 25,000 retirees have migrated here in the last few years. Chatham county, with low taxes and nearby recreational areas, has been especially attractive to those over 65, and many retirement communities are located throughout the county. As a result, Chatham residents are far more dependent on Medicare than the average populations of the state and the country. An estimated 17% of the U.S. population is over 65; 17% of North Carolinians are also over 65, but the percentage of Chatham County residents over 65 is almost 24%. Major changes or cuts in Medicare, therefore, will affect Chatham county residents much more severely than elsewhere in the state.
Medicaid is the Federal program that provides healthcare assistance to low-income individuals and families, people with disabilities, and some needy children. It is jointly funded by the state and federal governments – by your taxes – and managed by the state. Close to 2 million North Carolinians are currently covered by Medicaid and the Children’s Health Insurance Program (CHIP). While Chatham county is among the five richest counties in the state and enjoys one of the lowest unemployment rates, it is primarily rural, and income is not distributed evenly. Some 13.6% of Chatham residents live below the poverty level, and thousands more earn so little that they have no practical access to medical care. Access to medical care for low income residents in Chatham county is partly the result of the Republican legislature’s refusal to participate in the Medicaid Expansion program. Gov. Roy Cooper, elected in 2017, began working to expand coverage as one of his first tasks as governor. State lawmakers have so far blocked his efforts. Gov. Cooper’s administration estimates that 624,000 additional North Carolinians would become newly eligible for Medicaid if North Carolina would accept the $40 billion dollars of Federal Medicaid money that the state is leaving on the table over the next 10 years. To quote Governor Cooper (D), “You’re already paying for it” with your taxes.
States have great freedom to operate the Medicaid program and determining eligibility. The Trump administration is considering allowing states to impose work or job training requirements on those who receive Medicaid, although it is unclear if this is another means of restricting the program or just a public relations gimmick to appeal to the Republican base. Many of the potential participants in an expanded Medicaid program clearly could never be required to get jobs: they already have low-paying jobs and are underemployed, are seriously disabled, are children, or are in custodial care. Some states would require individuals to report their job-hunting efforts through the Internet – even if they have no convenient access to computers or smartphones. These new Trump rules are already being challenged in the courts.
The many assaults on affordable health care come from a bankrupt political theory promoted by the increasingly radical conservative wing of the Republican party – both in the Congress and in the North Carolina legislature. You can protect yourself and Chatham county by supporting Democratic candidates this year with your donations and your vote. Oppose the Constitutional Amendments proposed by the NC Republican legislature.
Vote in November!