By skyforbes 
The particular Senate bill that included this language — the “Better Care Reconciliation Act” (BRCA) of 2017 — was voted down yesterday.
However, considering that the “repeal” efforts are still a work in progress, I’m going to put up this information about a sneaky little provision of the BCRA that I would not be surprised to see reappear in future versions of these bills.
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Included in the BCRA was a tiny little provision that would alter the “retroactive Medicaid eligibility” provision that exists in current federal law. What is that? Let’s talk about it.
Let’s say you’re currently uninsured for whatever reason. You don’t have the money, you’re taking your chances on being uninsured for a short period between jobs (which, let’s face it — a lot of us have done)…whatever.
And let’s say that you’re walking to work at your low-paid job on Monday(July 31, 2017), and you fall into a manhole, smack your head, and break every bone in your body. Someone sees you fall and calls 911. You’re unconscious and rushed to the hospital, where the ER evaluates you and rushes you to surgery. You have extensive surgery and are unconscious all weekend. Finally on Thursday (8/3/17) you’re conscious and able to communicate, so the hospital’s social worker comes to see you. They have figured out you’re uninsured, but they’re going to help you apply for Medicaid coverage.
It takes a couple of days to get the application in order, so your application doesn’t get sent in until Monday, 8/7/17. You get out of the hospital on the 10th, and after about 30 days your application for Medicaid gets approved.
Under current law, your new Medicaid coverage can be backdated by 90 days from your date of application.
Since you sent in your application on August 7th, then, your new Medicaid plan will be placed into effect from May 2017 onward. So your ambulance ride and ER visit in July gets covered by Medicaid, along with your week in the hospital. You can even call the doctor that you saw at the end of May for strep throat, and they can bill Medicaid for your treatment with them too! Thanks to Medicaid, you get to concentrate on getting better and getting back to work. You aren’t hit with hundreds of thousands of dollars in medical bills once you can get home. You don’t have to go bankrupt.
Yay! Medicaid is your safety net, as it’s supposed to be.
(Keep in mind, it doesn’t just work this way for weird accidents. If you have a heart attack or get diagnosed with cancer while uninsured, the hospital can help you apply for Medicaid — if you qualify — and backdate your coverage by 90 days as long as your income wasn’t dramatically higher back then. Any doctors you saw during that 90 day period can then submit their bills to Medicaid for payment.
I can tell you from my experience in this industry that this is a thing that happens a lot. Most commonly, it happens when young people have a freak accident and need sudden surgery. Because almost everyone is healthy until they’re not.)
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Now let’s talk about the Senate bill. Tucked away in Section 128 of the bill (p. 44) is this bit of text:
“(1) STATE PLAN REQUIREMENTS
. — Section 1902(a)(34) of the Social Security Act (42 U.S.C. 1396a(a)(34)) is amended by striking ‘‘in or after the third month before the month in which he made application’’ and inserting ‘‘in or after the month in which the individual made application’’.”
(You can see it here (p. 44): https://www.budget.senate.gov/…/BetterCareReconcilistionAct… )
In practical terms, this means that if you make an urgent application for Medicaid on August 7th in our scenario above, your coverage COULD NOT be backdated to May. If the Senate bill passed, your coverage would only start on 8/1/17…missing your whole first day in which you had the ambulance ride, ER visit, and several surgeries.
(Oh, and note the “OR AFTER the month” part there. That language seems to make it possible for the state to start your coverage on 9/1/17 or later, if they wanted to.)
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I guess this is supposed to be a cost-saving measure or something? But in practical terms, in the world where we all live…what it will do is saddle people with huge medical bills that they have no hope of paying.
Because let’s be real. People who can qualify for Medicaid aren’t going to be able to pay the tens/hundreds of thousands of dollars that ER visits, ambulance rides, and surgeries cost out of pocket. Those bills are going to go to collections, ruining the patient’s credit and finances.
So the patient’s finances are ruined, and the doctors and hospitals aren’t getting paid for that treatment. Which means that (trust me — they do this), the doctors and hospitals will raise their prices. Then we, insured people, get to pay more for future visits to help them recoup their costs from those uninsured patients they saw months/years ago.
So we pay more, doctors/hospitals earn less, and patients with a bout of bad luck are thrown into financial ruin.
……How is this going to make America great?