03/18/2010 05:12 am ET Updated May 25, 2011

The Human Face of Health Care Affordability

The most important event to happen in Washington lately wasn't a back room meeting of U.S. Senate heavy weights, a press conference by House of Representatives leaders or even a speech by President Obama. Yesterday, more than 200 grassroots and faith leaders from across the country held a National Affordability Summit on Capitol Hill with members of Congress to stress the importance of including strong affordability protections in the final health care reform legislation. This same coalition released a letter signed by 765 elected officials, clergy, small business owners, health practitioners, health care providers and heads of organizations representing more than 100 million people calling for those protections for low- and middle-income Americans.

This was a critical event not merely because it was attended by major press such as the New York Times, key congressional leaders like Rep. John Dingell (whose father introduced the first national health insurance bill in 1943), grassroots networks like the PICO National Network and the Health Rights Organizing Project. This was a critical event because it brought grassroots representatives to the table to put a real face on the debate over how much people should have to pay for health insurance.

The affordability debate has been dominated by important arguments such as the anonymous statistical reality that if Senate/House negotiators give into the obstructionists in the Senate, a family with a sick child could end up paying $5,000 a year for health care rather than $1,800. To a family struggling to get by, that difference really matters.

We've also heard important political arguments with poll after poll showing affordability is the number one concern of voters (much higher than fears about overall costs to the government treasury) or the sobering fear that requiring people to buy health insurance they ultimately cannot afford is going to result in a huge voter backlash.

Missing from the debate has been the faces and voices of the people who will be directly impacted by these momentous choices. Yesterday's summit brought stories like those of Reverend Keith Mayes of the Allen Chapel African Methodist Episcopal Church in Murfreesboro, Tennessee, to the forefront:

Today I am here not only as a minister but also as a man whose family is facing a health care emergency. I am a father of three. My wife recently became seriously ill with a muscular disorder. She lost her job as an auto claims adjuster. Our health insurance only covered 14 days of intensive care but she needed hospitalization for close to three months. We are now facing over $175,000 in medical debt. Since my wife is now out of work, our family income has dropped to around $50,000 a year. There are big differences between how the House and Senate approaches families in our situation. We would pay about $2,100 more in premiums and co-pays (each year) under the Senate provisions then the House provisions. We are counting on the members here today, Speaker Pelosi and other House leaders to insist that the final legislation has strong affordability protections. We are fighting hard to win reform. We believe health care reform will be an incredibly important and historic change in how our country values human dignity. As you finish the job, we are counting on you to fight hard to make sure that the new insurance exchange will offer affordable coverage to families like mine.

Another voice was that of ROSALIA PINON from Santa Ana, California:

My son makes $20,000 a year and has no insurance and has a kidney problem. Under the House version of the legislation, my son would get health care, thankfully, and would be expected to pay up to $1,800 a year in premiums and out-of-pocket expenses. This is definitely a lot, but something I'm sure he's willing to do in order to take care of himself. Under the Senate version of legislation, however, my son could be expected to pay up to $5,000 a year for health insurance -- 25% of his yearly income!

Some 90 million Americans -- nearly one out of every 3 people in our country -- are living in families earning less than 200 percent of the poverty line. That is 90 million Americans who get a better deal if we improve affordability along the House lines.

The solutions and asks of these Americans are simple:

  • Extend Medicaid eligibility to 150 percent of the Federal Poverty Line (that is about 27,000 for a family of three) while providing standard benefits to newly enrolled families and increasing primary care payments.
  • Adopt the House affordability subsidies, for premiums, out of pocket costs and actuarial values for lower-income families.
  • Adopt the Senate subsidy schedule for middle-income families in the health exchange.
  • Adopt the House approach to protecting part-time workers.

As we cross the finish line toward historic health care reform, let us remember that behind the numbers are real people with sick family members who are struggling everyday to avoid massive debts and even bankruptcy.

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