Health care has moved to the top of people’s concerns this election year even as the “good” news keeps coming. The question is, how much more good news can people stand?
First there was the renegotiated North American Free Trade Agreement, or NAFTA Lite, which the president bragged was going to punish Canada and Mexico for abusing the prescription-drug market. It punishes them by giving the giant U.S. pharmaceutical companies a monopoly on many new drugs for 10 years, banning competition from lower-priced generic alternatives, which often came from Canada and Mexico. It will drive up drug costs in Canada and Mexico and, over time, in the United States by protecting monopolies and blocking lower-cost and life-saving medical options.
Trump was being criticized because the administration and Congress plundered the Affordable Care Act last year to end health insurance for many people and drive up the premiums for others in Obamacare’s insurance exchanges. But now, despite those efforts, the premiums in the exchanges are about to go down slightly this winter while premiums and deductibles for nearly everyone else — people in employment plans outside the Affordable Care Act — are rising sharply.
But the president promised that he was going to go after Big Pharma and make them lower their drug prices. Big Pharma naturally was cheering after the NAFTA deal, but last week the administration revealed its strategy. It is going to adopt rules requiring pharmaceutical companies to mention prices somewhere in all their medicine commercials. Man, that will show them. Hold your breath until drug prices fall.
The investiture of Brett Kavanaugh on the U.S. Supreme Court this month was treated as great news in some quarters because it seemed to ensure that fresh challenges to the Affordable Care Act will succeed in the federal courts now that an anti-Democratic majority on the Supreme Court will be reviewing the law in the next two years. Arkansas’s attorney general filed an intervention with other Republican states urging the courts to repeal the law. That would end all protections for people with pre-existing conditions, end medical coverage for some 300,000 Arkansans and reduce Medicare benefits for tens of thousands of Arkansans. For many, particularly a Republican contingent in the Arkansas legislature, that will be a stellar triumph.
It also will put many community hospitals in jeopardy. Because the state took advantage of the expanded Medicaid coverage in the Affordable Care Act, not a single Arkansas hospital has folded since the law was passed. Texas and other Southern states that rejected the coverage for poor people have not been so lucky. Ten have closed in Texas, unable any longer to bear the costs of uncompensated care. Uncompensated costs are inching up in Arkansas, including the state medical center, as the state has been lopping off tens of thousands from subsidized coverage under the Affordable Care Act exchange.
That brings us to the latest “good” news. The state Department of Human Services boasted Monday that it had been able to cancel Medicaid coverage for another 4,100 poor Arkansans, bringing to 8,500 the number who have lost coverage this fall. Another 30,000 or so will be uninsured by spring after the state applies its “work requirement” to younger indigents.
This is all good news, Governor Hutchinson explained, because it means all these people have left the state, gotten a job and maybe acquired insurance, or else they just don’t want insurance enough to go out and get one of the regular jobs that are just waiting for them. Besides that, not having to subsidize their medical care and drugs will save the state some money, $7 next year for every $93 that the federal treasury spends in the state on their treatment and medicine.
A fairer explanation is that thousands of people couldn’t navigate the wall of paperwork and computer methodology that the state bureaucracy has erected for them to continue to get medical care. Many don’t know they’ve lost coverage. They’ll find out when they try to pick up their prescriptions or go to the emergency room.
Hutchinson said no tears should be wasted on the people who have lost coverage. They wanted it that way. He said many have been getting jobs as a result of the state’s adopting the “work requirement” for keeping coverage early this year and others will land jobs as soon they find they’ve lost coverage.
If that were the case, we should be seeing a sizable increase in the state’s labor force, the number of Arkansans working or seeking work. But the Arkansas labor force, according to Donald Trump’s Department of Labor, has been declining steadily for the past year. Nearly every month, fewer Arkansans are working or seeking work. Go figure.
It could be just an overabundance of good news.