I have yet to get to all of my tabs and the proto-tabs waiting in my email, but I read this article from Vox yesterday in real time: I voted for Donald Trump, and I already regret it. With a title like that, how could I resist?
The writer, Sherri Underwood, says she's in her 50s, in a small town in the Midwest, now unable to work because of fibromyalgia after what sounds like a lengthy career in law enforcement, corrections, and social service work.
Underwood says she voted for Trump because she was angry the Affordable Care Act didn't make her health care affordable enough. Her husband makes too much money for her to qualify for subsidies, his employer doesn't cover spouses, and her coverage would cost about $900. She is vague on specifics, though, and I have questions for her on all of this. She seems to think her preexisting condition makes her care more expensive, which is not true (unless she's a smoker, the only thing that increases your cost is age). I obviously don't know her market, but until 2017 there were no plans in Minnesota that cost anywhere near $900 a month for one person at her age. And hey, what would it have cost to buy into her husband's plan? Don't employers generally allow that?
Aside from arguing with whether her specifics are real or imagined, I also believe Underwood needed to think a bit harder about why she was in that predicament. Employer-based coverage gives way too much power to individual companies over a key part of our lives, and they don't always have our best interests at heart (since profit is their fiduciary responsibility). The ACA couldn't fix that because Republicans blocked better ideas, such as a public option, and they've refused to work on improving it, such as by raising the income cutoff for subsidies or changing the way high-risk folks affect everyone else's costs.
(By the way, I love that she describes the reason for her high premiums under the ACA this way: "This happened because I had to declare my husband’s salary as part of our household income, which put me in an earning bracket too high to qualify for any financial assistance." That language implies it's unusual to use household income to determine benefits. Yet she claims to have worked "helping to distribute food stamps and other services" in her earlier career? I think she's familiar with the way household income is used and shouldn't act so shocked.)
Underwood writes that she hated both candidates (though she never gives any reasons for hating Clinton), but that "In the end, I voted for Trump because he promised to repeal and replace Obamacare, and that was the most important issue to my own life." Somehow, she didn't look into what he said he would replace it with. Trump never had any policy statements on that, so if it's the most important issue in your life, you'd think you might see if he had anything to say but hot air.
She also claims to be a news and politics junkie, but she's woefully under-informed... or maybe she just lacks critical thinking skills. The thing that turned her against Trump was his 60 Minutes interview, just after the election, where he said he wouldn't prosecute Hillary Clinton. She writes,
...as I watched the interview, I saw with my own eyes who Trump really was as a person. He backtracked on one of his signature campaign promises: pursuing an investigation into the Clinton email scandal. It’s not that I want Clinton to be crucified or “locked up” — it’s the nonchalance with which he went back on his word after hammering it repeatedly during the campaign. The ease and quickness with which he reversed his position shook me to my core. I realized in that moment that I had voted for a demagogue. And it was sickening.For someone who supposedly watched a lot of election coverage, how did she miss the obvious fact that Trump lies all the time? That he has cheated innumerable people out of money he owes them?
She also has just noticed Trump's
retaliatory and impulsive behavior, which I think I assumed was a campaign tactic, have carried over into his actions as president-elect. He now has the power to reward companies or countries that flatter him and destroy those that don’t with a simple tweet — just look at how he praises L.L. Bean and criticizes Boeing, causing their stock values to swing like yo-yos. His tweets about foreign powers lack restraint, and his treatment of the press whenever they say something he doesn’t like shows his vengefulness. He promised that he would be a president to all Americans, but all he has done is divide us.Underwood still thinks Congressional efforts to repeal the ACA are a step in the right direction, by the way. Somehow she trusts that they will replace it with something better, based on no evidence whatsoever. Even though she has just figured out that Trump
doesn’t seem to be showing any interest in the mechanics of a new policy — he’s just out there making promises to the public with nothing to back it up. It doesn’t do much to offer me faith that he really wants to fix the problem.All of this was completely obvious before the election to anyone who spends "much of my day reading news and watching C-SPAN."
I'm glad Sherri Underwood has realized some of the truth we face with this president who was elected by 46 percent of voters, including her. I just wish she had thought about all of this a little sooner. But welcome, Sherri. Keep learning new things.
I spent some time on the Kaiser Family Foundation health insurance calculator trying to see if I could reconstruct Underwood's ACA coverage price. I've already said I don't know where she lives; she just says a small town in the Midwest, so I tried out smaller cities and towns in six states.
These rates are for 2017 Silver plans, which are likely significantly higher than they would have been back in 2014 or 2015 when Underwood first looked into rates and found this outrageous $900 number. I set her age at 53 (60 is the age break for a premium increase, so it doesn't matter what year in the 50s I used) and assumed her husband's income was $60,000 per year. The calculator only has consistent data for nonsmokers (and again, I wonder if that's part of the problem with the rate she says she was quoted).
Canton, Ohio. $341 per month. The subsidy cutoff for a two-person family in Canton kicks in just above an annual income of $44,000, which is 275 percent of the poverty level.
Princeton, Iowa. $481 per month. In Princeton, the subsidies start kicking in just below $60,000 annual income.
Cullom, Illinois. A plan costs $636 per month, but with an income of $60,000, she would get a subsidy of $150, so the cost would be $485.
Royal Center, Indiana. $484 per month. As in Iowa, subsidies start to kick in just below $60,000 annual income.
Tekonsha, Michigan. A plan costs $576 per month, but she would get a subsidy of $91, bringing her cost to $485 per month.
La Plata, Missouri. A plan costs $746 per month, but her income nets a $261 per month subsidy, bringing the cost to $485.
Again, I realize I have no idea what her household income is, so picking $60,000 is arbitrary. But for a two-person household, that seems like a decent income (well above the median for a family of four, for instance).
And even if her husband's income is much higher and subsidies would never be available to her in any market, I found no plans even close to $900 per month.
To test the accuracy of the Kaiser calculator, I ran my own family of three's stats (with one person each in their 20s, 50s, and 60s). Our monthly cost is just over $1,800, unsubsidized. The calculator came back with $1,787, which is within $50 of what we are paying, and the difference is attributable to specifics of my plan, especially the deductible I chose.
I have two thoughts on Underwood's claimed $900 monthly payment: maybe it was that high because she smokes (though even that seems unlikely for 2014 or ’15 rates) or she's misrepresenting her own history.
A few other folks have commented on Underwood's confessional. Wonkette tells us all to give her a break and welcome her to our side. I do, I really do, I just want some more information about the background of her story.
Kevin Drum at Mother Jones points out that repealing the ACA means the maximum 3:1 age ratio on premiums goes away, which will do Underwood no good. (I had forgotten about that provision myself. Gee, thanks for reminding me, Kevin.) As he puts it, "Trump and other Republicans think this [ratio] ought to be 5:1. If it were, Underwood's premium would be over $1,000. Obamacare probably saved her something in the neighborhood of $2,000 per year." And, he reminds that the ACA means her obvious pre-existing fibromyalgia gets covered at all.
He also points out that the average annual health care cost for someone 55 years old in the U.S. is $10,000... so it's kind of amazing that the rates I found are as low as they are.
Drum ends with this:
If Republicans want to cover people like Underwood, they're going to have to spend more money than Obamacare. If they want to reduce deductibles, they're going to have to spend more money than Obamacare. If they want to increase subsidies for the middle class, they're going to have to spend more money than Obamacare. This is an iron law, and no amount of blather about state lines or tort reform or anything else changes it more than minutely. But Republicans want to spend less, not more. Even if Trump had been sincere, there was never any chance that Underwood would do better under his plan than under Obamacare.