Foster: Threats and realities of cuts in health care – Longview News-Journal

Donald Trump’s confrontation with North Korea’s missile program isn’t the only saber-rattling he’s doing these days. Despite promises to do away with government subsidies to insurance companies underwriting Affordable Care Act policies, payment was made in August, The Associated Press reported.

Trump has repeatedly threatened to end the payments, which help reduce insurance copays and deductibles for people with modest incomes. The so-called “cost sharing” subsidies total about $7 billion this year and are considered vital to guarantee stability for consumers who buy their own individual health insurance policies.

“State insurance commissioners have warned that abrupt cancellation of cost-sharing subsidies would cause premiums, copays and deductibles to increase and more insurance companies to leave the market,” said Sen. Lamar Alexander, chairman of the Health, Education Labor and Pensions Committee.

“Congress now should pass balanced, bipartisan, limited legislation in September that will fund cost-sharing payments for 2018,” the Tennessee Republican added.

The bipartisan Congressional Budget Office reported in August that premiums for a popular type of individual health care plan under the Affordable Care Act would rise sharply and that more people would be left without options for coverage if Trump cuts off payments. Moreover, the AP reported, ending the payments would only increase federal deficits because it would trigger a rise in separate health law subsidies for premiums, wiping out any potential savings.

The subsidies are disputed by some members of Congress over whether the Obama health care law properly approved the payments to insurers. Adding to the confusion, other parts of the law clearly direct the government to reimburse the carriers. House Republicans sued the Obama administration and the lawsuit is being reviewed by the U.S. appeals court in Washington, D.C.

For months Trump has raised the prospect of terminating the payments as a way to trigger a crisis to get Democrats to negotiate a health care bill. After the GOP’s efforts to repeal “Obamacare” collapsed in the Senate, Trump tweeted he wants to see the program “implode,” which would be catastrophic for consumers.

It’s estimated that nearly 18 million people purchase individual health insurance policies. About half of them pay the full cost themselves and would risk the biggest disruptions from a spike in premiums.

In a different vein, I want to reply to the Aug. 16 letter to the editor from Caleb Epnett, who challenged the validity of a study I cited in my column on the impact of the state of Texas cutting funding for women’s health care since 2011.

Dueling academics may offer differing statistics, but Epnett’s statement that “contraception … actually increases abortions as the frequency of sex and unintended pregnancies rise with contraception use” defies logic. Please email to me a reliable source for this conclusion.

Modern contraceptives are 99 percent effective in preventing pregnancies, not even considering the “morning after” pill for use after unprotected sex. Simple logic dictates that contraception decreases unintended pregnancies and, therefore, the need for abortions.

As I recall from educational psychology, Maslow’s hierarchy of needs places sex just below the need for food and safety. People have been engaging in sex since the beginning of the human race and will continue to do so with or without contraception. Consider this: Between 1940 and 1950, the population of Europe actually increased despite the holocaust and millions of military personnel and civilians killed during World War II.

What’s important to remember in this argument is that millions of Texas women lost access to their only health care provider, Planned Parenthood, since Republican lawmakers cut hundreds of millions of dollars for women’s health care at the behest of former Gov. Rick Perry.

Another consequence of these cuts is that Texas’ maternity death rate is the highest in the industrialized world, a fact that should be shameful to every Texan. In 2010, the maternity death rate was 18.6 per 100,000 births. By 2014, the rate jumped to 30 per 100,000 births. This compares to 2.1 in Italy, 3.3 in Japan and 5.5 in France.

These figures come from the medical journal “Obstetrics and Gynecology” should anyone wish to verify. In this case, the facts speak for themselves.

— John D. Foster, a Carthage resident and former editor of the Panola Watchman, is a regular contributor to the Saturday Forum. Email


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