As I write, the United States government is shut down. Maybe by the time you read this it will be up and running but right now there’s an impasse that seems intractable.
Republicans, including the Vice President, the President and the Speaker of the House say it’s over Democratic demands for healthcare for illegal aliens. This is as false as were the pet-eating allegations made by candidates Vance and Trump about legal Haitian immigrants in Springfield, Ohio eating their neighbors’ pets. Vance later admitted he was lying to get media attention.
Meanwhile, the shutdown has had a real-world impact on people with disabilities. Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), as well as other benefit payments, will continue. But dollars to states from the US Department of Education for assistance complying with the Individuals with Disabilities Education Act are in jeopardy as are all Health and Human Services programs funded by its subagency, the Administration for Community Living (ACL). ACL funds programs for seniors and people with disabilities.
Perhaps, most frustratingly, the furloughs and permanent firings by the Administration prior to, and in response to the shutdown, will slow the day-to-day work of government. Phones will go unanswered and problems unresolved. The federal government is the country’s largest employer of people with disabilities and of disabled veterans and staff cuts have included them.
Truth Behind the Shutdown
Now the lie is that Democrats shut down the government to get Republicans to agree to give healthcare to people here illegally.
Democrats have two basic demands. The first is that the Affordable Care Act (Obamacare) subsidies, which made health insurance affordable for 20 million working Americans, be renewed or their premiums may double, making their health insurance unaffordable.
The second is that the Medicaid cuts enacted by Republicans in the One Big Beautiful Bill (no kidding, that was it’s name) be restored, at least in part, because people with disabilities and seniors needing personal care services, for example, will find that their local departments of social services are unable to provide the hours of care they need. Federal dollars are a significant portion of Medicaid funded care – nationally, from 50 to over 80%. Poorer states get a bigger share from the Feds. Rural hospitals will be hurt badly, as will those who depend on them.
But it is true that Medicaid does fund Emergency Room Care to persons in the US, legally or illegally, whether they can pay or not. Since 1946, pursuant to the Hill-Burton Act, hospital emergency rooms have had to provide stabilizing care in emergencies. In 1986, however, President Ronald Reagan signed the Emergency Medical Treatment and Labor Act (EMTALA). President Reagan said he was doing it for the people “who pick our crops,” that is, immigrants without health insurance.
The Risk of Skyrocketing Healthcare Costs
Since EMTALA all hospitals that receive Medicare dollars, essentially all hospitals, must receive Emergency Room patients in emergency situations, regardless of ability to pay. Americans overwhelmingly support these laws and the right of everyone to receive, at least stabilizing care in any ER. Reagan was aware that, at the time, the practice of “patient dumping” was rampant. Private hospitals would refuse to treat or transfer patients without insurance to taxpayer-funded, public hospitals. EMTALA outlawed dumping.
If Republicans prevail and premiums do skyrocket, as predicted by not just the Democrats, but the health insurance companies, as well, they will go up for all of us, not just those losing Obamacare premium assistance. That is because when health insurance premiums rise healthy people drop their coverage. That leaves the pool of insureds sicker, and likely to make more claims. Insurers raise premiums in response and the cycle will continue.
None of us want ER personnel making decisions about who can receive care based on perceived immigration status. Emergency rooms should stabilize patients, triage on the basis of need not nationality, and expect to be reimbursed by a grateful citizenry for the care of the poor. That’s what Americans expect.
Opinions expressed are solely those of the writer(s) and do not necessarily reflect the opinions of Able News at The Viscardi Center and/or The Viscardi Center.