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Time to Close the Red State Doughnut Hole

Thursday, 02 January 2014 14:21 By The Daily Take Team, The Thom Hartmann Program | Op-Ed
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Medicare form(Image: Medicare form via Shutterstock)Republicans sure love their doughnut holes.

Back in 2003, Republicans in Congress, with help from President Bush, passed the Medicare Modernization Act, and created Medicare Part D.

Medicare Part D helps lower the costs of prescription drugs for Americans enrolled in Medicare through government subsidies.

Unfortunately, there's a gap in how much the government is willing to pay for prescription costs under Medicare Part D, and that gap is known as the Medicare "doughnut hole."

For example, if you spent up to $2,700 on prescriptions in 2009 under Medicare Part D, the government paid for most if not all of your expenses.

But if you spent anywhere between $2,700 and $6,451 on prescription drugs in 2009, those costs came straight out of your pocket. The government didn't pay a dime, and you were in the "doughnut hole."

If you hit $6,451 or more in prescription expenses, the government again picked up most of your tab.

Fortunately, Obamacare addresses the Medicare Part D doughnut hole, and is helping make prescription drugs under Part D more affordable.

Thanks to Obamacare, Americans who fall into the doughnut hole will receive a $250 rebate within three months of reaching it to help pay for prescriptions.

There's also a discount on covered brand-name drugs when you buy them at a pharmacy or order them through the mail and some additional discounts for other brand-name and generic drugs.

The Medicare Part D "doughnut hole" is being slowly phased out, and will be completely closed by 2020.

But as one "doughnut hole" is closing, another one is opening up: The Red State Doughnut Hole.

When the Supreme Court ruled on Obamacare, Chief Justice Roberts and the rest of the right-wingers on the bench left it up to the states to decide whether to expand Medicaid under Obamacare.

Thanks to that decision, 25 states, which are either controlled by a Republican governor or a Republican legislature, have refused to expand Medicaid coverage to their citizens under Obamacare, in what are purely political moves.

After all, the federal government is paying 100 percent of the costs of Medicaid expansion through 2016 and 90 percent of the costs after that.

As a result of the Republican refusal to expand Medicaid, around 5 million Americans won't have access to healthcare in 2014, and will find themselves in the Red State Doughnut Hole.

So what does that Red State Doughnut Hole look like?

Let's take a look at Texas, where Gov. Rick Perry has refused to expand Medicaid.

In Texas in 2014, Medicaid will cover the healthcare expenses of Texans who have a family of three, and who make up to 19% of the Federal Poverty Level, roughly $3,700, per year.

But Texans whose annual income falls between 19% and 100% of the Federal Poverty Level will be without access to healthcare under Medicaid, and make up nearly 1 million of the 5 million Americans that fall into the Red State Doughnut Hole.

However, Texans who make more than 100% of the Federal Poverty Level per year (more than $19,530) will be able to get healthcare coverage under Obamacare.

So if you make between $3,700 a year and $19,530 a year, and you live in a blue state, you get free healthcare through the Medicaid expansion.

But if you make more than $3,700 but less than $19,530 a year and live in Texas, you're screwed. The government won't give you a penny to help with your medical expenses because Rick Perry won't take that federal money.

And pretty much the same is true in every other Republican-run state in the country.

Thanks to partisan politics, five million Americans are being left without healthcare coverage in 2014.

Five million Americans won't be able to afford routine physicals, life-saving medications or healthcare of any kind.

More importantly, five million Americans are being denied services from their own tax dollars.

It's time for Republicans across the country to put politics aside, and to put the interests of the most vulnerable of Americans first by fully expanding Medicaid coverage under Obamacare.

Let's close up the Red State Doughnut Hole once and for all.

Call your lawmakers, and tell them that saving lives is more important than playing politics.

This article was first published on Truthout and any reprint or reproduction on any other website must acknowledge Truthout as the original site of publication.

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