How Obamacare Ruined Healthcare By Removing Choice For People Without Much Money Left After Expenses
I haven't had enough spare time to dig up what the benefit is -- but there must be one -- behind how Obamacare is written to force people who don't want Medicaid to take it. I'm talking about people who earn money but don't end up with a lot left at the end of the year.
This "take Medicaid or nuthin'" thing is the case here in California where Medicaid is Medi-Cal, and in some other states, too. If you are eligible for Medicaid, you are INeligible for any Obamacare subsidies.
Here's the comment I left on an Avik Roy article about Medicaid at the WSJ:
What few people understand is that Obamacare not only raised the price of previously affordable care but it removes choice from people who don't have much money left after expenses but don't want to go on Medicaid.
To explain: If, after expenses, you have less than the $16,500 floor for Obamacare, you can EITHER go on Medicaid OR you can pay full freight -- like what someone earning $250K a year would pay. You are NOT ELIGIBLE for Obamacare subsidies. Not allowed to take them.
In other words, you are not allowed to choose to pay more -- to take less of a subsidy (like by choosing the plan for people with $16,500K left after expenses). And maybe you never wanted other people to pay for you anyway, but Obamacare ruined your coverage -- to the point where you still have healthcare; you just can't afford to use it.
So...about that biopsy you need to rule out cancer? You tell the doctor you can't afford it. Your healthcare: "I hope I don't have cancer!" Thanks, Mr. Obama! thanks Democrats! --Amy Alkon
And what does Avik Roy say about Medicaid?
First check out the head and subhead:
Medicaid Is Free. So Why Does It Require a Mandate?
The CBO estimates that five million fewer people would sign up without the ObamaCare tax penalty.
An excerpt from the piece:
Medicaid is the largest or second-largest line item in nearly every state budget. But for all practical purposes, the main tool states have to control costs is to pay doctors and hospitals less than private insurers pay for the same care. As a result, fewer doctors accept Medicaid patients, making it very hard for Medicaid enrollees to get access to care when they need it. Poor access, in turn, means that Medicaid enrollees--remarkably--have no better health outcomes than those with no insurance at all.
That brings us back to the AHCA. According to the CBO, able-bodied adults on Medicaid receive about $6,000 a year in government health-insurance benefits. They pay no premiums and minimal copays. You'd think that eligible individuals would need no prodding to sign up for such a benefit.
And yet, according to its analysis of the GOP ObamaCare replacement, the CBO believes that there are five million Americans who wouldn't sign up for Medicaid if it weren't for ObamaCare's individual mandate. You read that right: Five million people need the threat of a $695 fine to sign up for a free program that offers them $6,000 worth of subsidized health insurance. That's more than 1 in 5 of the 24 million people the CBO (dubiously) claims would end up uninsured if the AHCA supplanted ObamaCare.
On its face, there's reason to doubt the CBO's view. The mandate is enforced through the income-tax system, and enforcement of the mandate has been spotty for those in low tax brackets. Many of those eligible for Medicaid don't work or file returns. Under rules established by the Obama administration, those who do can leave the "I have insurance" box blank and face no penalty.
Still, it's remarkable that the CBO believes people need to be fined into signing up for Medicaid. That tells us something about the CBO's assessment of Medicaid's value to those individuals--and it buttresses the GOP's case that Medicaid needs substantial reform.