ACA Open Enrollment

It’s that time of year again when people without employer provided health insurance can sign up for a plan on marketplace provided under the Affordable Care Act, also known as Obamacare. Open enrollment started November 1 and runs until December 15. Donald Trump with help from congressional Republicans has made it harder for people to sign up by reducing the open enrollment period and cutting funding for promotion and assistance it’s still possible to find help if you need it.

Healthcare.gov has links to local assistance providers as well as renewing or updating your existing plan. While Trump has been messing with the financing he managed in some ways to accidentally lower the premium in some cases. In Guadalupe County a 40 year-old making $20,000 a year can get a Gold level insurance plan for just $32 a month or a Bronze plan for $0. If that 40 year-old earns $35,000 a Gold plan will cost them $223 a month or $105 a month for a Bronze plan. Gold level plans have lower deductibles than bronze or silver plans.

Previously I’ve spoken to folks who help people sign up for Obamacare plans and they told me that while some folks don’t qualify for the subsidies that get the premiums so low they also find people who qualify for Medicaid or their children qualify for CHIP and don’t know it so they help them sign up for that. If you know someone without health insurance now is the perfect time to help them contact Seguin Community Health Center at 1104 Jefferson Street, Seguin, phone number (830) 379 – 9797 for assistance in applying.

There are roughly 5 million Texans without health insurance or nearly 18% of the state population. Texas has both more people uninsured as well as a higher percentage of uninsured of any state in the country. Approximately 1.25 million Texas children under 18 are among those uninsured.

A study done by the Texas Alliance for Health Care., shows the lack of health insurance would cause hardships for hospitals, physicians, and ordinary Texans.

Among the study’s findings: In 2016, the cost of lower lifetime earnings and worse health for uninsured Texans was $57 billion. Barring any change in policy, that cost will rise to $178.5 billion by 2040. The $3.5 billion price tag for hospitals and physicians who provide unsubsidized and uncompensated care in 2016 will rise to $12.4 billion by 2040 without a change in policy. The value of lost earnings and poor health due to lack of health insurance in Texas is estimated to be $178.5 billion in 2040 (or $74 billion in 2016 dollars).

Speaking of uncompensated care, Texas is seeing a rash of closures of rural county hospitals primarily due to funding shortfalls caused by the state failing to accept Medicaid expansion. You can thank, our state representative John Kuempel and Governor Greg Abbott for that.

All the Democratic candidates for president are talking about how they plan to fix this nation’s health insurance mess. Bernie Sanders and Elizabeth Warren offer sweeping plans that would take Medicaid and CHIP out of the hands of the state and make sure every American has health insurance. Consider that when listening to all the candidates as you decide who to support in the March primary.

Published in the Seguin Gazette - November 13, 2019

Kuempel's Smoke and Mirrors

Once again our state representative, John Kuempel, has mailed one of his puff pieces to residents in Guadalupe and Wilson counties. As usual he touts purported accomplishments which are often as not failures.

His missive spends half a page on state funding for public education and without background it sounds pretty good until you realize that the state still hasn’t restored all the funding it took away in 2011. Instead of fully restoring funding our legislature with Kuempel’s vote in favor chose to forcibly reduce property tax rates school districts around the state had used to make up for the state cuts. So he’s cheering about a solution to a problem he helped cause in the first place. In the SCUC ISD where I live my property taxes will go down a whopping $12 a month. That’s not enough to buy a half tank of gas and I’m not going to notice it in my monthly budget. Had our district been allowed to keep some or all of those funds we wouldn’t have to again request a waiver on the maximum number of students per teacher in K-3 classes. K-3 is the age where children learn the most quickly and need to most attention and our district like many others still can’t cover the cost to properly educate them.

It isn’t just that Kuempel and his Republican cronies haven’t fully restored funding of public education they also restricted how the additional funding they did provide can be spent. It never ceases to amaze me that the politicians who talk the most about local control and not forcing one size fits all solutions on the public are the very ones most likely to do the exact opposite. I think we’d all have been better served if the state had left the choice to maintain or reduce property taxes up to the various districts.

Kuempel goes on to tout what he calls increased transparency in property taxes but in reality it’s just a requirement to hold elections to increase property tax rates. If he really believed in transparency he’d work for passage of legislation that requires purchase price of every transfer or real property to be reported to the local appraisal district. Right now wealthy folks who purchase multi-million dollar homes often use the option to not report so that the home can’t be properly appraised and therefore save thousands and tens of thousands on their taxes all while you and I pay the full share. Our former Republican state senator, Jeff Wentworth, tried for a decade to pass such a bill. If Kuempel is going to talk about transparency he should have the integrity to stop protecting the rich folks behind the curtain.

Another area where Kuempel obfuscates is his claim the legislature provided funding to cover shortfalls in Medicaid and state hospitals. Had he and his Republican colleagues voted to accept Medicaid expansion as offered under the Affordable Care Act the federal government would have provided an additional $100 million to Texas every year. That funding would have assured that many if not all of the rural hospitals that have closed and will close of the next few years were funded without costing Texas taxpayers a dime.

The general theme here is that Kuempel is taking credit for half measures designed to smooth over problems he and his fellow Republicans created in the first place. This time next year we may have a chance to replace him. I hope voters will see through the fog of Republican claims and elect someone who believes in solutions not bandaids.

Published in the Seguin Gazette - October 11, 2019

Guadalupe Rallies to Defend the ACA/Medicaid/Medicare

Last Saturday more than 80 area residents rallied at the Guadalupe Regional Medical Center on E. Court Street in support of maintaining the Affordable Care Act, Medicaid and Medicare. The group acted because of the threats to those programs posed by actions of the Republican controlled Congress. Republicans have begun the process of repealing the Affordable Care Act. They’re also working to turn Medicaid into straight block grants to the states and convert Medicare to a voucher system.

The goal of the event was to send a message to newly elected Congressman Vicente Gonzalez that many of his constituents rely on various parts of our current healthcare insurance system and drastic changes will be unwelcome. Doctor Sarah Typhair held a sign stating “This M.D. proudly supports the A.C.A.” Many in attendance have children or grand-children covered through the provision that allows them to stay on their parents insurance until age 26. Some rely on the fact that A.C.A. forced insurers to drop the lifetime cap that meant people like my wife who have had multiple serious health issues no longer lose coverage after $1 million dollars of healthcare.

Congressional Republicans have been using the phrase “Repeal and Replace” for quite a while now so you’d think they’d have most of the details figured out but you’d be wrong. While Republicans have the repeal part down they can’t agree on the replace part at all. The Congressional Budget Office analyzed one of the more widely accepted proposals and found that if enacted it would increase deficit spending by $171 billion or force a 26% cut in the subsidies available to those who get their insurance through the exchange meaning that many would once again find health insurance unaffordable.

Turning Medicaid into a block grant is sure to fix the number of dollars spent and therefore further limit the number of people who benefit from it. Texas has the highest rate of uninsured in the nation at 17% due to Governor Greg Abbott’s failure to expand Medicaid which the federal government would have paid for 90%. That’s 4.6 million Texans whose only option for healthcare is the emergency room and no follow up care or prescription coverage. Converting to block grants means our rate of uninsured will climb higher still.

The proposal to convert Medicare to a voucher program would mean that seniors would get a fixed amount of money to use in order to purchase health insurance on the private market. There are a host of problems with that not the least of which is insurers don’t want to insure seniors in the first place because of their numerous and expensive health problems. Another problem is that there’s no guarantee that the voucher would cover the entire cost of the insurance premium so those seniors who are already struggling to pay their bills or for their prescriptions will have an even greater costs shifted onto them.

Rally participants urged Congressman Gonzalez to come out strong as a defender of the Affordable Care Act, Medicaid and Medicare. Every there understands that those programs aren’t perfect but the Trump Republican proposals to abolish or dismantle them are moves in the wrong direction. Gonzalez would do well to become a champion for improving those programs.

Published in the Seguin Gazette March 3, 2017

Failure to Expand Medicaid in Texas hurts all Texans

The failure of Gov. Perry and Sen. Campbell to expand Medicaid in Texas does a shameful disservice to Texans whether or not they currently have health insurance. Obviously those without health insurance suffer most directly. Those with insurance are also affected by the higher cost imposed when people visit the emergency room for problems that could have been treated in a doctor’s office for one third the price according to the Texas Medical Association. Those uncompensated emergency room visits are subsidized through higher bills from hospitals and higher property taxes.

Expanding Medicaid would create $19.6 million in direct economic activity in Guadalupe County alone, according to the Center for Public Policy Priorities, which is enough to pay 290 additional Registered Nurses and 107 additional Doctors. Imagine how adding nearly 400 high paying jobs would affect businesses large and small in just one county. What would be the impact of adding nearly $7 billion a year to the Texas economy?

We’ve already paid the taxes to make this happen and because Gov. Perry and Sen. Campbell refused to accept that money other states will be using our tax dollars to improve the lives of their citizens and their economies.

We need new leadership in Senate District 25 and in Texas that’s why I’m excited that Dan Boone is running for state senate and Wendy Davis is running for governor. They won’t let our tax dollars go to other states and leave our hard working people to fend for themselves.