Olivia Turner knows what it’s like to know your employers: she’s worked for The President’s Commission on AIDS as it promoted what came to be known as “the African American AIDS Epidemic Plan.”
“I was in Washington, DC, the first meeting for the black plague commission, the black AIDS commission,” she recalled, referring to her efforts to “help get a change in the health care system because there was a lot of fear.”
Turner now spends her days leading a Baltimore-based nonprofit that provides care and support to patients who earn between 80-100 percent of the federal poverty level, including parents and their children.
She’s grateful that even after the CBO released a report in 2017 estimating that having that level of income “consigns many poor families to a life in poverty,” the federal government never forced low-income people to pay for their basic necessities by denying them health insurance.
“When you deny people their essential health needs, they will not have access to basic care,” she warned.
Specifically, Turner’s organization did something remarkable: It took a census and found its clients willing to pay the Affordable Care Act subsidies that helped make them eligible for affordable coverage.
“We actually left their paperwork and provided them with their plans,” she recounted. “They were surprised because we told them that they could choose whatever plan they wanted if they wanted to.”
Turner credited many of the staffers at her group for preparing some key beneficiaries for the conversation so the ones who knew were confident enough to change their plans.
“Our main center is a social services community center for families,” she said. “Our center serves the low-income families of Philadelphia.”
In the first months after implementation of the Affordable Care Act, it was estimated that 300,000 people in Philadelphia received care through Medicaid and federal subsidies. Now, those numbers have grown by more than 20,000 due to policies that demand providers of care keep people in their plans longer and require patient co-pays and higher deductibles.
Some argue that the CMS had no choice but to impose the restrictions: Without it, policymakers say premiums and insurance losses would have forced the insurance market to implode even without a heavy public subsidy program.
Nonetheless, some experts worry that without these policies, the poor won’t get care.
Dr. Mark Luscombe, a CPA and partner with CCH, a data analysis firm with offices in Washington, D.C., and Denver, said he’s worried that the cost of the law’s essential health benefits could get out of hand.
“On the whole it’s a good and important thing,” he said. “But it’s probably going to be pretty challenging to get people to buy what’s required with the deductibles and copays and those kinds of things.”
Luscombe said the key to maintaining the law’s cost-saving measures is either finding non-profit providers who are up to the challenge or trying to work with employers.
Meanwhile, Turner remains hopeful that the lack of congressional action to find a permanent fix for the law’s essential health benefits would not hold back low-income Americans from getting the necessary health care.
“People don’t make that big a deal about health insurance if they can afford it,” she said. “It’s only if you have to choose between your food and your health insurance that people make a big deal out of it.”
Chris Hayes is a Philadelphia-based correspondent for “The Cycle” on MSNBC.