The federal Affordable Care Act will provide health insurance for tens of millions of Americans who suffer without it. And it provides benefits to those of us who already have health insurance, including elimination of lifetime and annual medical treatment caps, allowing us to keep our kids on our health insurance until age 26, eliminating co-payments for preventive care and certain women?s health care services, reducing prescription drug costs for seniors ? the list goes on and on.
Shared responsibility is a core principle of the act. Originally proposed by the conservative Heritage Foundation, it was first enacted in Massachusetts by then-Gov. Mitt Romney. Conservatives praised this system of ?shared responsibility,? arguing that private insurers, the state and federal governments, employers and individuals should all share responsibility for providing health insurance.
Medicaid, which provides health care for the poorest among us, has always been a responsibility shared by both federal and state governments. In California, the federal government picks up about 50 percent of the cost of Medicaid, or what we call Medi-Cal.
In 2014, the new act expands eligibility for Medicaid to households and individuals with incomes below 133 percent of the federal poverty level ? covering individuals who make less than $15,000 annually. The federal government pays for 100 percent of the expansion for three years, so that 1.95 million more Californians will have health care coverage with no additional cost to California. After 2017 the formula gradually changes so that states pay for 10 percent of expanded coverage after 2020.
After the Supreme Court?s decision, states now have the option to decline the Medicaid expansion without penalty. California should take advantage of the opportunity to cover close to 2 million Californians for three years without a state match.
Even after the first three years, the state will not pay more than 10 percent of the cost of expansion. From 2010-2019, the feds will pay over $37 billion to expand Medi-Cal. In that same period the state?s cost for expansion will be less than 1 percent of its overall expenditures, a very favorably leveraged investment in the health and well-being of Californians.
Californians are already paying for the uninsured, without any help from the feds. Right now every insured Californian is paying about $500, and each family is paying approximately $1,400 per year, in extra health insurance premiums to cover the uninsured. The uninsured get care through our hospital emergency rooms, where it is a lot more expensive to treat them. A substantial portion of those uncompensated costs are shifted by medical providers to health insurers in the form of higher demands for reimbursement for treating insured patients and then passed on by the insurers to those of us with health insurance in the form of higher premium charges ? a hidden tax.
Eliminating this hidden tax on the insured will increase the ability of families, individuals and businesses to spend and invest in other goods and services and stimulate the economy. Eliminating this hidden tax is also simply a matter of fairness.
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