For the 150 million workers who have insurance through their employers, the situation is also dire. Deductibles — sums that must be paid out of pocket before the insurance kicks in — have risen nearly six times faster than wages since 2011. Millions more are paying a fine for not having insurance.
While Obamacare made some changes workers don’t want to lose, such as forbidding health insurance companies to refuse an individual coverage because of a pre-existing health condition, millions are being adversely affected by the program’s deepening crisis.
Former President Bill Clinton made headlines Oct. 3 when he described Obamacare as a “crazy system” where more people have insurance, but many “wind up with their premiums doubled and their coverage cut in half.” By acknowledging what so many workers already know, he gave Democratic presidential candidate Hillary Clinton an opportunity to stress that she’ll “fix what’s broken” with the scheme she supports.
Republican Donald Trump says he will scrap Obamacare, and claims he’ll increase competition and lower costs by lifting regulation on companies selling insurance across state lines.
Both are committed to maintaining medical care as a private business.
“Working people need health care, not health insurance,” Socialist Workers Party presidential candidate Alyson Kennedy told the Militant Oct. 25. “The working class and the union movement need to fight for lifetime, universal, government-funded health care for all. The so-called Affordable Care Act guarantees superprofits for the insurance, hospital and pharmaceutical capitalists.
“Through our labor, the working class, in this country and worldwide, produces more than enough wealth to provide education, health care, housing, and retirement to every human being on earth, for a lifetime,” Kennedy continued. “Workers and farmers in Cuba set an example when they took power, pulled medical care out of the capitalist market and rebuilt it on values of human solidarity.”
Workers who have bought insurance on the Obamacare exchanges can expect an average 25 percent rate increase next year. Some state officials, including in Minnesota, Tennessee and Montana, have approved hikes more in the range of 50 percent. While many people should see the increase offset by government subsidies, some 6 million won’t.
Since Obamacare was enacted in 2010 the number of people without health insurance has dropped from 48.6 million to 28.6, according to the National Center for Health Statistics. More than 80 percent of those eligible who have incomes below 150 percent of the federal poverty level have bought insurance on the exchanges. Only 17 percent of eligible workers with incomes from three to four times the poverty level have enrolled.
For insurance tycoons this is a problem: too many people are too poor and too sick to make profits on. Insurance giants United Health, Humana and Aetna quit some exchanges because they “contain too many sick customers who make claims, and not enough younger, healthy ones. This has winnowed profits and in some cases pushed the insurers into losses,” the Financial Times reported Aug. 30. United Health, the country’s largest insurer, pulled out of Obamacare in 27 states after losing $475 million on that business last year.
Of the 23 Obamacare co-ops organized by state governments, 17 have closed down. Tennessee’s insurance commissioner warns that her state’s exchange market is “very near collapse.”
Next year Alabama, Alaska, Oklahoma, South Carolina and Wyoming will have only one insurer, as will one-third of all counties nationwide, primarily those in rural areas. Pinal County in Arizona may end up with none.
The federal government will impose a plan on those who have lost their insurer, unless they opt out or select plans on their own.
Four out of five workers who get health insurance through employers pay deductibles, which rose four times faster than the premiums this year to an average of $1,500. Workers are also paying a greater share of the premiums, averaging $5,277 a year toward a family plan.
A growing number of companies are limiting the choices and services, making it more expensive or impossible to see a doctor outside the plan’s network.
Various proposals have been floated in the election debates and capitalist media on how to “fix” the system. They include a public insurance option to compete on the exchanges, further limits on what the plans cover, increasing subsidies for the poorest and higher penalties for not buying insurance. But none of these change the fundamental problem that health care is a profit-making commodity under capitalism.
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