The House GOP version of Trumpcare that they managed to cram through with a slim 217-213 vote is a threat to millions of Americans. The focus has been on the millions of Americans who will lose their insurance through the exchanges, reduction in funding to Medicaid and of course, the millions of Americans who can now lose coverage because of pre-existing conditions.
Many Americans feel insulted from the effects of this monstrous bill because they have employer supported health insurance. They are wrong.
The Wall Street Journal is reporting that a little noticed provision of the AHCA allows insurance plans to base their plans out of state. This allows them to shop for states that exempt pre-existing conditions. This means that the lowest common denominator of state regulations could conceivable be the base for all Americans with employer provided insurance. (The same way that credit cards are all based in Delaware because of the high interest rates that the state allows banks to charge).
Larry Levitt, a senior vice president of the Kaiser Family Foundation, tells the Wall Street Journal “The real question is would employers do this? Many wouldn’t. Many employers offer quality benefits to attract employees. But employers are always looking for ways to lower costs.”
This quote should give us all pause. It means that the majority of Americans- those who receive health insurance through their employers- are trusting that their benefits will remain the same because their employers want to keep them happy.
Does anyone who works in corporate America (or non-profit or academia) really believe this to be true?
How many of us have seen our premiums rise and our benefits cut over the last 10 years as employers ask us to pay higher proportions of healthcare costs?
How many of us have seen our employers lay off staff and increase the workload of current employees in the name of cost-cutting and greater productivity?
How many of us have seen our industries move to a business model that cynically relies on contract employees so as to avoid having to pay benefits?
Does anyone really believe that the best interest and well being of employees is at the heart of the business model of American enterprise?
The ethos of the gig economy has taken over. Gone are the days when companies felt loyalty to their employees. They cut costs and demand more, seeing their employees as losses on the ledger and not as assets. When viewed not as “human capital” but as lost capital, employees become more willing to sacrifice the health of their workforce. Even those workers with good jobs have become expendable.
Our economy is changing in a way that makes the reliance on employer supplied healthcare deeply problematic. The “gig economy” leaves workers vulnerable. Without the safety net of Obamacare, that vulnerability may be life threatening.
This is an administration that is systematically destroying the American safety net and undermining the rights and livelihoods of American workers. We have a labor secretary hostile to labor, an education secretary hostile to public education and special education, and a health and human services secretary who is hostile to patient protection and care.
Everyone should be calling their Senators. This is the beginning. With the repeal of Obamacare, the Republicans are signaling an all out assault on American workers. You may not be on the official list of those affected by Trumpcare, but make no mistake you will be.