His arm still in a sling from rotary cuff surgery, State Rep. Kevin Wilson (R-Neosho) talked fiscal and practical applications of healthcare reform Tuesday at Crowder College.
Predicting elections that will be a referendum on March’s Patient Protection and Affordable Care Act, which he dubbed “Obamacare,” Wilson said he expects deep cuts in Democratic territory in the U.S. House of Representatives, but thinks it unlikely Republicans will gain a majority in the Senate.
“This will have a direct impact on elections in November,” Wilson said.
Although he said healthcare reform was necessary, Wilson said the bill will be costly and leave loopholes for abortion coverage.
“For the first time in our history you’re going to be required to buy something just because you’re breathing,” Wilson said. “I call it the breathing tax.”
He predicted a slew of court cases, lawsuits, protests and that some states could simply choose not to fund the bill.
Missouri’s protest against the bill will appear in the state’s Aug. 3 election in Proposition C, also dubbed the “Health Care Freedom Act,” which asks if the Missouri Statutes should be amended to undercut federal mandates requiring health insurance.
Wilson addressed members of the public, the Area Nurse Executive Council, and insurance and health care professionals on Tuesday.
For seniors like Billy Millender, money is a concern.
“I’m getting older and it’s costing me money and I don’t have money,” Millender said.
He feels he’s pretty well covered already between the U.S. Department of Veterans Affairs, and some supplemental Medicaid and Medicare. Although the system needed to be changed, tweaking it, Millender said, would be better.
“Congress has to do it all at once and that’s not the way to run a railroad,” he said.
With the added increase in not only baby boomers, but the newly insured, healthcare workers are concerned that they will not have the numbers to help patients.
Sherry Lopez, chief nursing officer at McCune Brooks Regional Hospital, said that evolving application will result in changes to the delivery of health care.
She believes nurse practitioners will move into a larger role as doctors retire. The requirements on nurse practitioners are also changing. Currently, they must have a master’s degree level of education but to sit for their boards after 2012 they will need a doctorate.
“The role of the nurse will change,” Lopez said.
She sees an increase for nurse navigators, people who will connect the dots for patients making sure they get from the hospital, home and to their primary care physician, which will, she hopes, lower hospital readmissions.
Progressives have railed against the federal act because it does not fulfill their expectations, but conservatives also have found plenty to dislike.
People will benefit from the program, Wilson said, but no one has counted the cost.
“You’ve got people on the far left worried that it did not go far enough,” Wilson said, “And, of course, you’ve got a lot of us worried about what are we doing and why are we mortgaging our families’ futures, our kids’ futures on paying for something that maybe doesn’t solve the problem.”
There are some positives with the bill, Wilson said.
The program will not benefit illegal immigrants and those with pre-existing coverage will be able to find coverage.
But that can backfire if people delay insurance until after they are diagnosed with a disease.
“What we’ve done is we’ve put 32 million more people on a system that is already failing,” Wilson said.
The theory of spreading the risk, Wilson said, is not logical because young people and healthy people will opt out and pay the fine instead.
The act requires U.S. citizens to have health coverage, but those who opt out will pay a fine – not to exceed 2.5 percent of their income – ranging from $695 to a maximum of $2,085.
Wilson said and he expects young families to pay the price. Employers will face a similar situation.
The choice of paying insurance or a penalty, Wilson said, will doom the entire process and bring America closer to a federal healthcare system.
“This is set up and designed to fail,” Wilson said. “We’re one step away from a national one-payer system.
“Nobody really wants to address the cost side of it.”
New fees will be implemented for pharmaceutical companies and in the health insurance sector. Families with incomes between 133 and 400 percent of the federal poverty level will get help with medical expenses and Medicaid will expand to 133 percent of the federal poverty level instead of 25 percent.
That expansion will initially be funded by federal subsidies of the program, but that, Wilson said, is debt passed on to future generations and the state cannot fund the difference.
This year, Wilson pointed out, the state budget was cut by $500 million and next year that number will double.
“We have estimated that for the state of Missouri it will cost $400 million each year,” Wilson said of the Medicaid expansion.
Estimates for the full price of the program range from the federal estimate of $938 billion over the next 10 years to as high as $2.5 trillion.
“You can find just about any estimate that you want,” Wilson said.
Although the bill has passed, its application is still uncertain as civil servants implement the bill’s measures and judges interpret the law.
“The people that write the rules have the power,” Wilson said.
