The difference here is that the President yelled “Heathcare for everyone!” and the bill is coming to all of us including the financial hangover that will last for decades. The full impact of the law is still a couple of years away but suffice it to say that every working taxpayer and municipal budget will feel a hand very deeply in their pockets.
As more people qualify for ‘state sponsored healthcare coverage’ (Medicaid) there will be less reimbursement for EMS calls. Several employers have already identified that they may ‘encourage’ employees to opt out of corporate paid health plans which will save the employers money but increase the burden on the rest of us.
If this happens the reimbursement currently received from relatively full price commercial insurance payers will be reduced, those trips would now be paid at Medicaid rates, creating a hole in the budget of EMS agencies…same call, just less money for the trip. This will eventually force EMS agencies to look to their municipalities for increased tax support.
The second impact is that, under the law, the States are currently on the hook to pick up 10% of the cost beginning in year four of the law. So a larger Medicaid system, increased cost to the State’s taxpayers and then local municipal taxpayers being hit again to fill the leaking budget for EMS service.
The real kicker of the program, as if those two components aren’t enough, is that for people who fail to get on the Medicaid program, have insurance through their workplace or purchase it privately, will now be taxed for NOT having coverage.
I recently spoke to an EMT in Massachusetts, where this model plan is already in place. He paid just under $4,000 in taxes to the State for not having coverage…his rationale…the tax was cheaper than the $9,000 it would have cost him for actual coverage. He was not eligible for the State sponsored program since he is a self-employed small business owner.
I’ve said it before but it bears repeating…many of our nation’s EMS systems are stressed to the limits, underfunded and basically already in critical condition. This law (I mean tax) will not help, it will force several out of business and I still firmly believe that 20% of the EMS services in this country will cease to exist by 2020. Those that do not adapt…will perish.
There is no doubt that healthcare system needs to be overhauled and that EMS needs to be properly funded. In my opinion, this law does neither it simply adds complexity and expense.
Today’s decision has just shifted the argument to the November elections and it will be interesting to see if the bulk of the voting public side with the Courts or if they really want the plan repealed and the players in Washington replaced. Make your votes and voices heard loud and clear in national and local elections…the service you save may be your own.