Obamacare Bills Reflect A Narrow Agenda

In coming weeks, we can expect the Republican-controlled Congress to push two Obamacare bills that would hike profits for some businesses. What we can’t expect, from either Republicans or Democrats, unfortunately, is any effort to help families, even those with insurance, to stay out of bankruptcy court because of mounting medical bills.

Another inevitable attempt to repeal the whole law won’t go anywhere because there are still enough Democrats in the Senate to block it. But the bills to assist businesses — especially those that make generous campaign contributions — just might reach the President’s desk.

One of those measures would redefine a full-time worker under Obamacare’s employer mandate provision from someone who works 30 hours a week to one who works 40 hours weekly. The other piece of legislation would repeal the 2.3 percent tax on medical devices that helps pay for expanding coverage to the previously uninsured.

Republicans and some Democrats contend that both bills are intended to restore jobs they claim have been lost or will be lost as a result of those Obamacare provisions.

The law currently requires employers with 50 or more workers to provide health insurance to most of their full-time employees. The mandate will go into effect this year for employers with 100 or more workers and next year for employers with 50 or more. It does not apply to small businesses with fewer than 50 employees.

The reason drafters of the reform law set the threshold at 30 hours a week was to bring more people into coverage. Changing it to 40 hours would mean that many folks would likely lose their health insurance.

The tradeoffs are complicated, but ultimately, people needing insurance are a loser. The Congressional Budget Office and the Joint Committee on Taxation estimate that changing the definition to 40 hours a week would reduce the number of people receiving employment-based coverage by about a million. But it would increase the number of people getting coverage through Medicaid or the health insurance exchanges by between 500,000 to 1 million. And about half a million would likely return to being uninsured.

Shifting that many people to the taxpayer-financed Medicaid program or to the exchanges, where most would be eligible for federal subsidies, would increase the budget deficit by nearly $74 billion between now and 2024, both the CBO and JCT say.

Repealing the tax on medical devices would also be a bad deal for just about everybody — except, of course the companies that make the devices. Big companies like Johnson & Johnson and GE would benefit, as would some smaller companies. And now that millions more of us have health insurance because of Obamacare, more of us can now afford the equipment these firms make. They are big Obamacare winners. But the medical device companies want to keep all that new revenue they’re getting.

The industry and its friends in Congress — which even includes liberals like Sen. Al Franken of Minnesota and Elizabeth Warren of Massachusetts (there are a lot of medical device makers in both of their states) — want us to believe that the tax will cost as many as 43,000 jobs.

The Congressional Research Service says that’s bogus, that the tax will result in few if any job losses. But if the tax is repealed, the government will have to find $30 billion somewhere else or scale back coverage, which would put many of us back into the ranks of the uninsured.

I can understand why Republicans want to help those businesses avoid an Obamacare tax. But you’d think that Franken and Warren and their fellow Democrats would consider introducing legislation to help their constituents avoid financial ruin if they get sick.

Obamacare appears to be helping — the Commonwealth Fund reported last week that the number of Americans who went without the care they needed because of cost declined last year for the first time since 2003. But millions of Americans are still struggling to make ends meet because of medical bills.

The Commonwealth Fund also recently reported that the cost of health insurance is still increasing at a faster clip than wages. That means people are still having to devote an increasingly larger share of their paychecks to health insurance, despite Obamacare.

One area that’s taking a hit is savings. Family budgets for most folks are so tight they can’t sock much money away in a savings account. As reported earlier this month, “If someone encounters a significant, unexpected expense outside his or her budget, such as an emergency room visit or a car repair, only 38 percent of respondents say they could cover it with cash they have on hand in a savings account or checking account.”

Older Americans are especially vulnerable.’s survey found that 1 in 5 Americans 50 and older listed medical expenses as their largest expense outside of food and shelter.

The problem is that most of those folks don’t — can’t — contribute much, if anything to political campaigns. Certainly not like Johnson & Johnson and GE. So don’t hold your breath waiting for Congress to do anything to give families some relief when businesses are demanding special consideration.

Former CIGNA executive-turned-whistleblower Wendell Potter is writing about the health care industry and the ongoing battle for health reform for the Center for Public Integrity.

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