American Life Under Trumpcare

Maybe you’re one of the millions of insured under the Affordable Care Act, better known as “Obamacare.” If so, you no doubt are wondering what’s in store for you under the GOP plan, which we’ll just call “Trumpcare” for lack of a formal name (possibly the “Insurance Industry Executive Bonus Act”).

The GOP have made it clear that we need “freedom and responsibility” in our healthcare system. What this means is that you, the American citizen, are now responsible for your own healthcare decisions without the interference of some nanny-state government. So here’s how they envision that working.

First, you’ll get an unspecified tax break, maybe $2,000 a year for the average middle-class person. You won’t see that until you do your taxes, but it might increase your tax refund or decrease the amount you owe by a little. If you get a refund, put that sucker in savings! I know your kids need new shoes, but you have to trust me here. This is what Mike Pence would do.

Second, you’ll get to put an increased amount in an HSA, or Healthcare Savings Account. If you’re lucky enough to have full-time work somewhere, your company will let you take some of your salary, before taxes, and put it in a fund that you can only use to pay for healthcare stuff, like copays, drugs, and MRIs. The GOP will generously raise the amount of your own money that you can sock away, to as much as $5,500 a year or so. This does mean reduced paychecks, but hey, Ramen is good!

So those are your new benefits. To make healthcare more affordable, the GOP won’t require that your insurance cover a bunch of mandatory things, like maternity care, birth control, or yearly physical checkups. So use your HSA to pay for those out of pocket. The second way that they’ll make insurance affordable is to let insurance companies offer high deductibles again. This means that you have to spend $1,000, $5,000, or $10,000 of your own money before they’ll even start paying. Now THAT is freedom, my friend.

I know what you’re thinking, though. How will this freedom and responsibility work in real life? I’m so glad you asked. Let’s say that you start having a heart attack. As a consumer, you have a choice about how you spend your money. During the attack, have your spouse call the local hospitals and get a quote on how much it will cost to treat you. Once armed with this information, you can make an informed choice and choose the cheapest option, maybe at Saint Barney’s Budget Hospital and Auto Shop. Now you can get the treatment you need!

If you find, however, after the treatment and an extended stay, or worse — heart surgery — that the initial cost estimates were off, you do have choices. Freedom! Let’s say that your savings and HSA has $4,000 available, but your bill is actually closer to $80,000. This is where your personal responsibility comes in. Your insurance may pay 100% of the surgery (yay!), but it may not cover the ambulance ride at all, and only 60% of the hospital stay and maybe 80% of the drugs, including anesthesia. So maybe you’ll end up owing around $20,000 from the hospital. Add another $1,000-$10,000 for your deductible. Then you can pay the remaining $17,000-$26,000 over 2 years at 8% interest, or you can start a GoFundMe page! If you have lots of friends who really care, and who don’t have GoFundMe pages of their own for their health bills, then you should be able to raise what you need to pay this off. And once you do, make sure you stick to a low-fat diet!

Of course, some people may end up with ongoing healthcare bills, particularly if they have cancer or any of a number of other diseases that require a lot of care. The GOP has you in mind! If you’re a high-risk patient, you will get insurance from a “high-risk” pool that will give you shoddy care with even higher premiums. But hey, at least you’ll have your freedom!

As a final note, you might want to keep the GoFundMe page going forward. There’s no telling what next year will bring, healthwise!

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