Who is getting the subsidies?

The more I think about my conversation with the Blue Cross broker, the more upset I get. I’m not attacking her. She was just doing her job.

But really, the conversation just highlighted how businesses manages to double-dip and finagle subsidies from government.

The essence of my conversation with her was this: She sold a 22-year-old restaurant worker an $80-a-month high-deductible policy. If this restaurant worker got pregnant, she would first be rolled into a higher-deductible plan, and ultimately referred to a public program — Access for Infants and Mothers, which caps the cost of pregnancy-only coverage at 1.5 percent of an individual’s income. Read the full blog here.

What this really means is that Blue Cross would have been able to collect the $80-a-month premium for the young person buying the high-deductible coverage. But when time came to pay out — someone who is too poor to afford the $3,000 or $5,000 deductibles (mostly likely someone young and in the restaurant business who had no businesses buying the plan in the first place) — would be referred to the state — who would shoulder the cost and risk of pregnancy and child birth.

That would give Blue Cross a subsidy of tens of thousands of dollars because the company — which paid its executives millions in salary and bonuses during its merger with Wellpoint — would be free of having to pay for their enrollee’s pregnancy.

This is not the only way that businesses tacitly receive subsidies from the government.

Consider another conversation I had last week with a county welfare director in a nearby rural county. One of his new county supervisors, a farmer, takes a very dim view of all the ‘socialized programs’ that the county runs and essentially would rather see them go away.

This county welfare director then asked his boss:

“Do any of your seasonal workers use Medi-Cal or food stamps?”

Well, the farmer/supervisor said, I don’t know?

Well, the welfare director said, if they do, then we (the county) provide those services to them.

Let me point out here, that that means part-time, seasonal workers for this farmer (who makes money off their labor) receives benefits through public programs.

The staff at this county office also took the supervisor on a tour showing him exactly the services they provide and who they help. The workers in this county office say they have now planted enough questions in the mind of this supervisor to force him to admit that their county needs a “safety net” for workers who don’t earn much money and don’t receive much from their employers (like himself).

What the farmer/supervisor isn’t willing to admit yet, though, that this safety net is subsidizing his business. for him to have healthy workers who can buy enough food to feed themselves, they need social programs — such as Medi-Cal or food stamps. Without these social programs helping these workers, they wouldn’t have the wherewithal to work for him.

Don’t get me wrong. I think Access for Infants and Mothers is a wonderful program. It saves new mothers tons of heartache and ensure their babies are healthy. It also saves the state money by ensuring poor women can get prenatal care and have healthy babies (which are less expensive to care for.) I also think Medi-Cal and Healthy Families and all public programs need to be expanded.

In addition to helping millions stay healthy, we also need to be honest and acknowledge how they keep businesses, such as Blue Cross, farmers, anyone whose workforce depends on public programs (That means you too, WalMart, Safeway and Target with your high-deductible plans and waiting periods)– healthy as well.

Health Access California promotes quality, affordable health care for all Californians.
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