If you’re seriously ill with the coronavirus and don’t seek treatment because you lack health insurance, you’re more likely to get even sicker or die.
That’s why Obamacare, which is credited for lowering Colorado’s uninsured rate from about 16% to 7% over the past ten years, could save lives in Colorado during the current health crisis, say health experts.
“We know that people who lack insurance are much less likely to go to the doctor, even when they are sick,” said Joe Hanel, a spokesman for the Colorado Health Institute, in a statement. “The 2019 Colorado Health Access Survey shows that 52% of uninsured Coloradans skipped care they needed because of the cost, compared to 16% of people with job-based insurance and 13% of people on Medicare.”
Without Obamacare, said Sue Birch, who helped oversee the implementation of the Affordable Care Act in Colorado, “hundreds of thousands of uninsured Coloradans might not seek care and might be very vulnerable to becoming sick or even dying.”
She’s referring to the 400,000 people in Colorado who gained health insurance here, mostly due to Obamacare’s expansion of Medicaid, the state-federal health insurance program for low-income people.
Beyond potentially saving lives, Obamacare, more broadly, leaves Colorado better equipped to fight the coronavirus and maintain a strong health care system at the same time, say experts.
“Higher levels of insurance help doctors and hospitals, too, because their patients are more likely to be able to pay their bills,” said Hanel. “All this matters greatly when thinking about a virus that potentially could lead to a surge in demand for medical care.”
With more people on the insurance rolls, the medical system can process patients more easily, as well.
Birch told the Colorado Times Recorder that the increased number of people with health insurance under Obamacare means people will be more likely not only to get care but get it quickly from a system that’s working more smoothly.
As a practical matter, said Birch, when people have health insurance, it allows for more expeditious care in a crisis, because required enrollment and other information is already in place.
“By expanding Medicaid appropriately, we are less worried in times like this about enrolling people or backing up and doing paper systems,” said Birch, who directed Colorado’s Department of Health Care Policy and Financing from 2011 until 2017. “Can you imagine what that would do to staff who are already having to respond to current health needs?”
With no vaccine or drug to counteract coronavirus, which causes respiratory problems, treatment for severe cases involves hospitalization and support, including IV fluids, oxygen, and breathing machines.
The disease can progress rapidly, from a dry cough and shortness of breath to acute respiratory distress, lowering blood oxygen and requiring hospitalization.
Hence the need to act quickly if your symptoms are severe.
If they aren’t severe, however, there isn’t a lot that doctors can do for you, except give you commonsense advice about rest and fluids–and about how to avoid spreading the virus (quarantining yourself).
With respect to testing for the virus, President Trump, who’s crusading to repeal Obamacare, leaned on the health care law to cover coronavirus testing.
“With regard to the cost, let me be very clear: [The Department of Health and Human Services] has designated the coronavirus test as an essential health benefit,” Mike Pence said March 4. “That means, by definition, it’s covered in the private health insurance of every American, as well as covered by Medicare and Medicaid.”
An essential health benefit is a provision of Obamacare, and Pence could not have taken this action if the ACA was not in place.
“The ACA also created consumer protections, like essential health benefits that policies must cover and a ban on discrimination for pre-existing conditions,” said Hanel. “The federal government recently declared Covid-19 tests to be an essential health benefit, and insurers have to cover them. This is important because if someone might have the virus, you don’t want cost to stand in the way of them getting tested. Public health officials really need to know where the Covid-19 cases are so they can try to contain the outbreak.”
Since Pence’s announcement, U.S. Rep. Diana DeGette (D-CO) has been pushing a bill, that’s apparently now been folded into broader coronavirus legislation, that would define the coronavirus test as a preventative health service under the ACA, making it completely free for patients. The bill is co-sponsored by U.S. Rep. Donna Shalala (D-FL), a former health and human services secretary under Obama.
Even as Obamacare is enjoying record-high approval ratings, Trump has launched an executive action to convert Medicaid to a block grant program, giving states a fixed amount of health care money–along with more flexibility on how to spend it–and undermining Obamacare in the process.
Democrats have denounced the idea, while Colorado Republicans are mostly mum. Most Republicans, including Colorado’s congressional delegation, oppose Obamacare, and Democrats support it.
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But the country’s medical needs in response to the coronavirus, demonstrate why block grants could force states like Colorado to absorb huge medical costs after a health crisis, advocates say.
“Medicaid fills an essential role as a safety-net insurer because of its special flexible design made possible by its open-ended federal funding base,” writes Sara Rosenbaum in the Commonwealth Fund’s To the Point blog. “This sets it apart from all other sources of health insurance and allows the program to fund major, unexpected health care costs other insurance plans are structured to avoid.”
