Amidst Legislative Chaos, Church Health Stays Strong
Let’s cut right to the chase: what can we make of the chaos in Washington around healthcare?
To be clear, my own personal health insurance has not been affected one bit. That is true for most of my friends and Church Health employees who are enrolled in the health coverage options offered to them here. It is certainly also true for everyone who works for the government.
The only ones impacted are those who can least afford healthcare. And that’s not surprising.
I want to remind you how the Affordable Care Act came into being. It was only because “big pharma” and “big medicine” supported it. And why did they do that? Well, I would like to believe it was because they felt that the poor deserve quality healthcare, but I am afraid it most likely had more to do with the economics of the plan.
We can never forget that 1/6th of the American economy is directly related to healthcare. One third is indirectly connected. Whenever Washington talks about major changes in the funding of healthcare, there are many eyes on the legislation because of the economic impact of any changes. This latest legislative fiasco was no different.
Yes, according to independent observers, 24 million people stood to lose healthcare coverage under the failed alternative to the ACA, but that loss of coverage translates to billions of dollars – dollars the poor would otherwise not have for their care. It was a sad day when healthcare for the poor became tied to the ability for the poor to pay to be cared for. That day began in 1968 with the advent of Medicare and Medicaid. And sadly, the sun has not yet set on the monetization of healthcare for the poor.
The good news for the work we do at Church Health is that last week’s legislative nightmare had little impact on our patients. That is because the Affordable Care Act (Obamacare) has had little impact on our patients.
This surprises many when I say it. It is because there is no such thing as Obamacare. It’s simply shorthand for the Affordable Care Act, which makes it possible for the poor to acquire health insurance in one of two ways. Either through a state’s expansion of Medicaid or through purchasing insurance through the Exchange known as Healthcare.gov.
In Tennessee and every state in the south except Arkansas, our state government chose not to expand Medicaid. Therefore, those who have been added to the roles of Medicaid in other states, ie. the working poor, remain ineligible in Tennessee.
As for purchasing health insurance off the Exchange, there is a major roadblock that most people do not understand. If your income is below 138% of the poverty level – which for a family of four is roughly $24,000 – you cannot receive a subsidy to buy health insurance. In the creation of the Exchange, it was assumed that every state would expand Medicaid, and that has not happened. If someone who might benefit from expanded Medicaid attempts to buy insurance off of the Exchange, they are told to apply for Medicaid in their state. It is a vicious catch 22, since that is not an option. You might think I am making a cruel joke, but I am not when I say that the poorest people get nothing. This is true of 90% of the patients who come to Church Health.
When I first began Church Health, it never dawned on me that the work we do would almost every day bump into the matters of government funding for healthcare for the poor. These days, I am keenly aware of the problem.
I am praying daily that the politicians in Washington will come to their senses and realize that it is real people’s lives that are at stake in the decisions they make. In the meantime, we will keep doing what we have been doing for 30 years. We will provide the same quality of care you would want your mother to receive through the goodness of volunteers, donors and those who work alongside us caring for the people whose lives have worth and dignity.