Working Families Need Health Care Too

I've been watching the debate in the Congress over expanding S-CHIP (the State Children's Health Insurance Program) today while waiting for my plane travel to Yearly Kos, and I'm reminded of how dishonest Republicans are on this issue. They created the block grant program to give states the ability to cover children, and now when it's become popular and successful, and state governors want to expand it more, they suddenly want to stop it. And they're using the familiar "this would let illegal immigrants get free health care" canard to try and submarine the bill (incidentally, it doesn't).

It's important to chronicle this, because it's the opening salvo in the battle to change the health care system in this country. In California we're gearing up for health care reform, and today The California Budget Project and the UCLA Center for Health Policy Research released a joint report that ably shows the consequences of maintaining the broken status quo on health care as the Republicans want to do:

...many families spend a substantial amount on health care premiums and out-of-pocket costs, and could face financially devastating medical expenses if they are not adequately protected. The report, “What Does It Take for a Family to Afford to Pay for Health Care?” (available at www.cbp.org and www.healthpolicy.ucla.edu) recommends that health care reform proposals – such as those proposed by the Governor and Democratic legislative leaders – ensure that families can realistically afford premiums and out-of-pocket costs, such as copayments and deductibles.

The report recommends that proposals fully subsidize health care coverage for those who earn up to 200 percent of the poverty line ($41,300 for a family of four) because the cost of housing, food, and other necessities leaves these families with few or no resources to contribute toward health care costs. The report also determines that families need incomes near 300 percent of the poverty line ($61,950 for a family of four) just to afford typical health care costs. Because some families face much higher out-of-pocket health care costs, the report recommends that policymakers consider providing subsidies for families with incomes higher than 300 percent of the poverty line.

This is EXACTLY what the expansion of S-CHIP would do, and yet Roadblock Republicans and the Bush Administration are concerned with defeating it solely on ideological grounds. They don't want America to see a health care system managed in a public way that works. They fear people will see the differences between a system that gives people the choice for affordable care and a private for-profit system that values limiting care above everything, and opt for the former. They don't want government to work, and they will do everything in their power to make it malfunction.

(I do take issue with the idea that "the governor's proposal," which has no cap on affordability or any floor on coverage, would necessarily help needy families.)

Here are some of the key recommendations of the report:

Limiting families’ out-of-pocket costs. Some insured families have very high health costs because they have very high copayments, deductibles, or other out-of-pocket costs. Some of these costs are predictable (for example, if a family member has a chronic illness), but some can be unexpected (for example, as the result of an accident or unexpected illness). Placing limits on out-of-pocket costs is as important as premium subsidies in ensuring affordable health care.

Taking into account expenses families face, such as housing and child care, when determining how much families can afford to pay for health care. Because families face very different costs, such as housing and child care, income alone is an imprecise measure of what families can afford to spend on health care.

An average adult with private health coverage pays almost $800 a year on premiums; a family of four spends $1,800. Poor families cannot cope, and forget about it if they actually want to USE their coverage. We know that almost half of all bankruptcies are due to health care costs.

Californians need to send a strong message to Congress and the President to wholeheartedly support the continuation of S-CHIP. And they need to send the message to our Legislature that we need real health care reform that allows working families to have the peace of mind of medical coverage while also being able to survive financially.