I've been fascinated of late with the conservative activists who have one last-ditch plan to destroy the Affordable Care Act: convince uninsured Americans to stay uninsured on purpose in order to spite President Obama. The hope, of course, is that fewer people will participate, which will cause costs to soar, which will in theory cause the system to become unsustainable.
Struggling families will of course be completely screwed in this scenario, but for the right, that's a small price to pay -- and a sacrifice they're willing to see others make.
And while I've marveled at the almost nauseating moral bankruptcy of those pushing this "Refuse to Enroll" campaign, let's not overlook the intellectual bankruptcy on display. In short, the Republican activists behind this scheme have no idea what they're talking about.
We talked last week, for example, about Twila Brase, president of the Citizens' Council for Health Freedom, who's urging Ohioans who can't afford basic medical care to deliberately avoid health insurance. Christopher Flavelle asked Brase a good question.
I called Brase to ask what she would advise for a 22-year-old who can't afford insurance outside of the exchanges. She started by arguing that getting coverage on the exchanges doesn't guarantee access to care, and so may not be any better than going without insurance.That claim is absurd on its face: Even if you believe that exchange-purchased insurance will offer fewer care options than other types of coverage, some insurance is leagues better than none. Forget about the penalty for not carrying insurance; what if that 22-year-old needs medical care? He can pay his doctors directly, Brase responded, or seek charity care.
Ah, I see. So if you're a 22-year-old who gets into a car accident, or has appendicitis, or perhaps is even diagnosed with leukemia, make sure you have several hundred thousand dollars in your checking account. That, or make sure you and everyone else in your position knows of extremely generous charities that don't mind picking up the tab for six-figure medical bills.
Brase went on to tell Flavelle that there's another option: if you're a 22-year-old who avoided getting coverage, but then has a medical emergency, no problem -- he or she can just sign up for coverage at that point, rather than before.
This, too, is demonstrably wrong.
Sarah Kliff had a good piece on this over the weekend.
The Affordable Care Act has an open enrollment period, which is the time frame when Americans can enroll in health plans on the marketplace. The whole point of this feature is to prevent people from signing up for coverage en route to the hospital.The open enrollment period, for 2014, runs from October 1 until March 31. There are also special enrollment periods to accommodate those who have a major change in life circumstances. If a mother gives birth to a baby, for example, the child can enroll in coverage outside the open enrollment period. If the subscriber has a significant change in income, he or she will also be able to switch to a different (potentially more affordable) health plan.On that list of special exemptions, Adrianna McIntyre comments, "'I accidentally burned my Obamacare draft card' didn't make the cut.'" Come April 1, the health law's marketplaces close until October of the next year. And in 2015, the enrollment period gets shorter, running only from October 7 to December 31.
That "I accidentally burned my Obamacare draft card" references a FreedomWorks p.r. campaign in which the right-wing lobbying group prints up fake "draft cards" and encourages people to light them on fire so as to make sure -- symbolically -- that they have no health care coverage.
Flavelle summarized the problem nicely: "So Brase's advice that people who can't afford insurance outside the exchanges simply go without makes perfect sense -- but only if you're rich, you never get sick, or you only get sick during open enrollment.... This campaign would be amusing, if it didn't stand a significant chance of actually persuading people to sacrifice their own health and finances for somebody else's political cause."
That last point in particular resonates. What we have here is a group of organized Republican activists, who already have health care insurance, preying on struggling families. Hoping to exploit these families' confusion and fear, the activists are pushing a rather disgusting scheme -- they'll go without insurance, not because insurance is bad for them, but because conservatives want to destroy the federal health care system out of partisan spite.
But upon further scrutiny, it appears these far-right activists aren't just offensive on a level of basic humanity, they're also ignorant about the system they're so eager to tear down.
My suggestion to the uninsured would be ignore those who want you to suffer to advance their cause. That said, if you take their advice and find yourself unable to pay your medical bills, consider sending them to FreedomWorks and the Citizens' Council for Health Freedom -- after all, they seem eager to "help" you, right?