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Obama Health Law Unlikely to Stem Medical Bankruptcies
When President Obama kicked off his health reform push, he highlighted our research finding that 2 million Americans suffer medical bankruptcy each year, promising to end this disgrace. Our latest figures warn that his reform won’t stanch the flow of medical debtors.
The Affordable Care Act (ACA) passed by Congress in March 2010 was modeled after Massachusetts’ 2006 health reform plan – a plan that’s now been up and running for more than three years. So Massachusetts offers a preview of what to expect when the ACA is fully implemented in 2014.
Unfortunately, medical bankruptcies haven’t dropped much – if at all – in Massachusetts. When we surveyed bankruptcy filers there in August 2009, 53 percent cited illness or medical bills as a cause of their bankruptcy, a percentage that’s statistically indistinguishable from the 59 percent figure we found in early 2007. Indeed, because the total number of bankruptcies soared in 2009, the actual number of medical bankruptcies increased from 7,504 in 2007 to 10,093 in 2009.
Why are so many people still suffering medical bankruptcies despite Massachusetts’ health reform? While only 4 percent of the state’s residents remain uninsured, much of the new coverage is so skimpy that serious illness leaves families with crushing medical bills.
For instance, the cheapest (and most commonly purchased) coverage available to a 56-year-old Bostonian through the state’s health insurance exchange costs $5,616. Yet, if you’re sick the policy doesn’t start paying bills until you’ve paid a $2,000 deductible. And even after that you’re responsible for 20 percent of the next $15,000 in medical expenses.
Little wonder that many insured families hit by illness are pushed over the edge financially by the double whammy of lost income and medical bills; 89 percent of Massachusetts families who suffered medical bankruptcy had coverage.
The insurance required under the federal ACA is no better than Massachusetts’ bare-bones plans. And as employers emulate this inadequate coverage, the race to the bottom leaves an increasing number of Americans UNDER-insured. Public workers are just the latest group to see their coverage downsized. What used to be called “health insurance” is now labeled “Cadillac coverage” – and reserved for those who drive Mercedes.
Because the ACA left private insurers in charge, it can’t offer Americans real protection against financial disaster due to illness. Too much is squandered on insurers’ overhead and the bloated bureaucracy they impose on patients, doctors and hospitals. Hence, even if reform works as planned, millions of families will continue to purchase private insurance in good faith, only to discover, too late, that it’s a defective product – an umbrella that melts in a downpour.
And the administration is weakening the modest consumer protections the bill imposed on private plans. It’s waived the minimum coverage standards for 1,040 plans covering 2.6 million Americans, including thousands of McDonald’s workers whose insurance covers only $2,000 in medical expenses annually. (The worker pays a premium of $728 for this faux coverage.) Meanwhile, insurers in Maine have already been exempted from the ACA’s paltry requirement that they spend at least 80 percent of premiums on medical care, with eight more states in line for similar exemptions.
While the ACA can’t live up to its “affordable care” moniker, a single-payer reform could save $400 billion annually on administrative costs, enough to offer every American first-dollar, comprehensive coverage. While U.S. insurers fight tooth and nail against the 20 percent limit on overhead, Canada’s single-payer program runs for 1 percent. (U.S. Medicare’s overhead is 3 percent.) Bureaucratic savings are a key reason why Canada can cover everyone and provide care at least as good as that received by insured Americans, while spending half as much per capita as we do.
We’ve lectured at seminars attended by hundreds of U.S. bankruptcy judges, where our medical bankruptcy findings are greeted by nods of recognition and an avalanche of heart-wrenching anecdotes confirming our statistical findings. The reaction was quite different at a bankruptcy seminar in Toronto early this year. None of the Canadian judges in the room could recall a single case.

36 Comments so far
Show AllThe goal of Obama-care was never to reduce costs to the consumer. It was to increase profit for the insurance industry. It has.
Yes, and in his September 9, 2009 speech promoting Obamacare, Obama told the world that "we must preserve insurance company profits".
The number of medical bankruptcies will continue to grow as long as insurance companies (that are legally required to meet the needs of shareholders, not their policyholders) are the only game in town.
During his first year in office, Obama reminded us each week that "a public option was necessary to keep insurance companies honest". Unfortunately, more than a year after Obama signed the Obamacare legislation sans public option, neither he or anybody else has told us how we will keep insurance companies honest since no public option will happen.
Obama is just a pig, plain and simple. Obamacare is just one example of this
NObama in 2012
NObama in 2012
NObama in 2012
NObama in 2012
I agree. Little more discussion is required.
nolo(gic) sez: ..many predict, the U.S. Supreme Court rules that the Congress exceeded its constitutional authority in the individual mandate.."
No matter what "Drug Rush" Limbaugh, Sham Sannity and "You're a Mark" Levin say, many aren't predicting this, only a few right-wing ideologues and their foundations.
WTF! Are you saying that opposition to the odious ObamCare is strictly a right wing matter?!
Are you saying that it's "right wing" to oppose the mandate? This mandate requires people to purchase junk insurance in order to guarantee insurance company profits.
These days whenever a liberal brings up Drudge, Limbaugh and company's opposition to Obama, you can bet it's because that lefty is are a fearful Obamabot.
Okay DJH, show me someone' other than right wing talkers and foundations (and yourself), who opposes Obamacare on the grounds it's unconstitutional - the same grounds they'd use against single-payer.
"These days whenever a liberal brings up Drudge, Limbaugh and company's opposition to Obama, you can bet it's because that lefty is are a fearful Obamabot."
You apparently missed my other post in this thread, "Obamacare, keeping Insurance Companies healthy since 2010!"
You're right. I forgot to mention Republican Governors. Add them in with the talkers and foundations.
There was much to dislike in Obama's gift to the insurance industry. What is being debated in the courts isn't the merits of Obamacare, but the constitutionality.
Your assertion that "Obamacare requires the young to pay for the old" is grossly inaccurate (it sounds like a FOX/GOP talking point).
Obamacare will require Americans of all ages to pay for insurance and drug company windfalls to fund stockholders' dividends, multimillion dollar executive compensation packages, corporate jet upgrades, and more lobbyists to keep sweetening their corporate welfare pots.
Your assumption, nolo, that Obamacare will deliver much health care to ANYBODY needs to be examined with respect to Obamacare empowering and funding the IRS to enforce the individual mandate while requiring each state to make sure insurance companies actually deliver (another unfunded mandate). By 2014 most states will be bankrupt and won't be able to enforce anything.
Considering the supreme court's pro-corporate bias, I will be surprised if the court rules against Obamacare's individual mandate since it is such a lucrative corporate welfare program.
And a lot of NM Democrats criticized Harry Teague for voting against it; some suggested he was pandering to the rightwing who didn't support health care! No matter, he was defeated by a Republican Tea Party favorite.
Judge Henry Hudson who found in favor of the Cucinelli challenge made a public comment a week afer the opinion was rendered stating that in his view a Single Payer System does pass constitutional muster.
Why would they do that? It's a law that benefits the corporations at the expense of the people, and you're claiming that the Supreme Court of the USA would overturn it?
I'm very glad that my coffee cup was on my desk when I read your statement. (young supporting the old, isn't that a bit like social security? and what do you have against the idea of helping the elders in their last years?)
Stutter post.
Obamacare, keeping Insurance Companies healthy since 2010!
If we vote out all the Conservative Democrats, we will have Single Payer.
You have more faith in democrats than I do :)
I think we will have Universal HealthCare when a threshhold # of Americans really put ourselves on the line for it, and keep going until we make it so.
yeah, good on Canada, but watch them! A huge majority of Canadian ding-dongs just sent the execrable Stephen Harper back to head the goverment. Harper's corporate errand boys may just try to put health care on the chopping block. The great armies of fact-starved, insular, uncurious, resentful, oblivious wingnuts in the US and Canada seem hell bent on destroying everything worthwhile in their own lives and communities. If only they could find a way to do it without harming the rest of us.
Fortunately, the Canadian system is not a winner take all system like the US has.
Such changes are therefore more difficult to make in Canada.
Canada is even more of a winner take all system than yours is. The Prime Minister up here has nothing but the thought of the next election, which must be held 5 years after the last one, to constrain him (or her). He rules in the name of the Queen and can get away with just about anything now that he has a majority.
That being said, he doesn't have that much of a majority and a lot of his backbenchers are old and have health issues from smoking, drinking and whoring for so many years... (and some things even socialized medicine can't cure...)
A possible remedy to the health insurance crisis may be community-initiated/community-based health care/health insurance co-ops such as the League of Uninsured Voters (http://www.luvpower.org/) advocates, & another remedy involves making Obama & congress enact Medicare For All! http://www.healthcare-now.org/
"the cheapest (and most commonly purchased) coverage available to a 56-year-old Bostonian through the state’s health insurance exchange costs $5,616. Yet, if you’re sick the policy doesn’t start paying bills until you’ve paid a $2,000 deductible. And even after that you’re responsible for 20 percent of the next $15,000 in medical expenses."
Constitutional or not, it is criminal to force families to absorb up to about $11,000 in direct out of pocket health care costs during a time of major illness. This is just another forced transfer of wealth out of ordinary people's pockets into the insurance industry. It would be just plain WRONG to force people to buy such an expensive, inferior and deceptive product.
It is a typical "liberal" program that in a guise of doing good, hits already struggling wage earners hardest. It is so flawed it causes a rebellion among working people, which makes them prey to right wing critics who want no social programs whatsoever. On the surface, the right wingers seem more honest about what is happening. Although their honesty disguises an even deeper contempt than that shown by wealthy liberals. The right has an attitude that "you are on your own bud, and I couldn't care less whether you make it. I have stock in insurance companies and bought and paid for associates in Congress".
The response to criticisms of this program by practical people should not be "You are a right winger" but "You are right, this program sucks. We need single payer, Medicare for all." And nobody but nobody is going to hand it to us. We need to fight for it and make sure some of the pain is felt by the President and Congress.
With America's untaxed filthy rich Medical Bankruptcies are only for the poor and middle classes.
Are they not trying their hardest to close off the loophole in the bankruptcy law that lets those sick and poor people get out of paying their bills? (I'd be very surprised if they weren't)
This is an excellent article, crystal clear. I will use it while doing public education in my community. The authors have been inspiring me for years.
I am so happy that I voted for NADER. The USA is the only industrialized country where a person can go bankrupt if he needs a root canal. Remember the little school boy who died because he had an infected tooth and his Mom did not have money for a dentist. (It happened in the south a few years ago. There are many who have life shortening health problems because of lack of dental care.)
It is abhorrent that the US version of unrestrained capitalsim causes so much needless sufferring and death, both at home and abroad.
Yes, I remember that story. I'm glad that I did a write-in vote instead of voting for Obama.
The MA plan = The Nit OnMe Plan
Nits, like Mitt, grow into lice.