This is how one sad story begins:
May the justices please meet my sister-in-law. On Feb. 8, she was a healthy 32-year-old, who was seven and a half months pregnant with her first baby. On Feb. 9, she was a quadriplegic, paralyzed from the chest down by a car accident that damaged her spine. Miraculously, the baby, born by emergency C-section, is healthy.
This is what follows that terrible moment:
My brother’s small employer — he is the manager of a metal-fabrication shop — does not offer health insurance, which was too expensive for them to buy on their own. Fortunately, my sister-in-law had enrolled in the Access for Infants and Mothers program, California’s insurance plan for middle-income pregnant women. AIM coverage extends 60 days postpartum and paid for her stay in intensive care and early rehabilitation. But when the 60 days is up next week, the family will fall through the welfare medicine rabbit hole.
And here is what those people will have to deal with for the rest of their lives:
When the AIM coverage expires, my sister-in-law will be covered by Medi-Cal, California’s version of Medicaid, because she is disabled and has limited income. But because my brother works, they are subject to cost-sharing: they pay the first $1,100 of her health costs each month. Paying $1,100 leaves them with a monthly income of just 133 percent of the federal poverty level. If my brother makes more money, their share of the cost increases.
They must also meet the Medi-Cal asset test: beyond their house and one vehicle, they can hold $3,150 in total assets, a limit last adjusted in 1989. They cannot save for retirement (retirement plans are not exempt from the asset test in California, as they are in some states). They cannot save for college (California is not among the states that have exempted 529 college savings plans from their asset tests). They cannot establish an emergency fund. Family members like me cannot give them financial help, at least not officially. If either of them receives an inheritance, it will go to Medi-Cal. Medi-Cal services that my sister-in-law uses after age 55 will be added to a tab that she will rack up over the rest of her life. When she and my brother die, the state will put a lien on their estate; their child may inherit nothing. Even my brother’s hobby runs afoul of the asset test: he enjoys working on old cars, which he can no longer keep.
This is what this story reminds us: for too many of our fellow citizens, our health care system, when it delivers care at all, turns families permanently poor.
This is what “Repeal” means. Welcome to the Republican vision for health care.*
Oh — and, yes, of course, this is what the case before the Supreme Court is alll about. Which is why the willed and faux-naive ignorance of Scalia, Alito and others earns the name of evil.
Go read the whole piece. Get angry, then angrier. If you live with GOP representatives, send this column to them. If you have friends or family or acquaintances who might be able to make the same leap John managed, pass it on to them too. Pressure is a daily accumulation of little taps and nudges, and there is no time the present.
*I won’t insult you by adding the reflexive “and Replace,” as there is no replacement on offer; vouchers are not a health care system, and would, as now proposed, do for this family that quantity of good that asymptotically approaches zero.
Image: Gustave Doré, A Couple and Two Children Sleeping Under the London Bridge, 1871.