Keeping the Alexander-Murray health care bill in context

October 28, 2017

Keeping the Alexander-Murray health care bill in context
This article sets the record straight regarding the legislation currently being considered by Congress.

Keeping the Alexander-Murray health care bill in context

As the debate unfolds about the bipartisan bill by Senators Lamar Alexander and Patty Murray to repair the Affordable Care Act marketplaces, the public could be just as confused as they have been about the ACA’s marketplaces. That’s why it’s important to debate it in the right context: It’s aimed at an urgent problem affecting a relatively small sliver of the health insurance system, not all of the ACA and not the entire health system.

The bottom line: It’s a limited measure that will never give conservatives or liberals everything they want.

Who will be affected if insurance companies…

Only those who buy

their own insurance

Only those with

employer plans

Everyone with

health insurance

…choose not to

sell ACA plans




…raise ACA





Don’t know/

no answer

Data: Kaiser Family Foundation Health Tracking Poll conducted Oct. 5-10, 2017; Chart: Chris Canipe / Axios

Reality check: Many people will think it affects their insurance when, in actuality, it will have no impact on the vast majority of Americans who get their coverage outside of the relatively small ACA marketplaces.

The chart based on
our new Kaiser Tracking Poll shows the confusion. Just 23% of the American people know that rising premiums in the ACA marketplaces affect only people who buy their own insurance. More than seven out of 10 wrongly believe rising premiums in the marketplaces affect everyone or people who get coverage through their employer.

The public will be susceptible to spin and misrepresentation of the limited goals of Alexander-Murray: a bipartisan effort to stabilize the marketplaces by funding the cost-sharing reduction subsidies, providing more resources for open enrollment outreach, and expediting state waivers.

President Trump has added to the confusion. He recently pronounced the ACA “dead”, adding, “there is no such thing as Obamacare anymore.” Possibly that’s because he wishes it was dead. More likely, he was referring to the problems in the ACA marketplaces, which he has exaggerated.

Like thinking your whole house is falling down when just a part of the foundation needs shoring up, both he and the American people have an inaccurate picture of where the marketplaces fit in the ACA and where the ACA fits in the health system.

A few facts:

  • There are just 10 million people enrolled in the ACA marketplaces.
  • The law’s larger Medicaid expansion and consumer protections are popular and working well.
  • The far larger Medicare and Medicaid programs and employer based health system combined cover more than 250 million people, and are largely unaffected by developments in the ACA marketplaces.
  • Premiums for the 155 million people who get coverage through their employers rose a very modest 3% in 2017.

Some conservatives in Congress will hold out for repeal, and they’ll resist any legislation that they view as propping up Obamacare. But for everyone else, it’s important to understand the problem and get the facts.

Tags: insurance, ppaca
October 27, 2017 at 07:00PM
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In Memory of Dr. Paul Ludwig, 1925-2017

October 15, 2017

Paul Ludwig-physician, mentor and friend-died on Wednesday, October 11, 2017. His obituary is published in Friday’s papers – Paul Ludwig Obituary. John Roberts, the Chief Medical Officer of the Dr. Mary Ludwig Free Clinic , and I want to share our thoughts and memories of Paul on behalf of the entire Montgomery County Free Clinic organization.

Bill Doemel, Executive Director, Montgomery County Free Clinic, Inc.

I knocked on the door of the Ludwig Home in Sycamore Hills. It was 2010 and a number of us were talking about establishing a new clinic. Paul greeted me at the door and welcomed me to their home. I was there to talk with Dr. Mary, his wife, about Christian Nursing Service (CNS), the organization that she helped found. Paul invited me to come into their living room and sit on a sofa across from him and Dr. Mary. Dr. Mary began the conversation by talking about her life with Paul. She met Paul while they were both in medical school at the University of Virginia. She said that Paul “swept me off my feet.” Both of them graduated from the University of Virginia. She was the first woman to receive an M.D. from that institution. As she talked, Paul beamed.

When Paul received an invitation to come to the IU School of Medicine for an internship in ophthalmology, Dr. Mary went too, also hoping to receive an internship in family medicine. She didn’t because she was a woman and “women shouldn’t be doctors”. So Dr. Mary volunteered her services to helping families in Indianapolis and began her career of service.

After completing his internship, Paul imagined going to a large city and establishing a practice. He heard that Dr. Jack Alexander, in Crawfordsville, was looking for a partner. He decided to visit and with Mary came to Crawfordsville. Dr. Mary said that when they reached the corner where the A&P Grocery Store was located (E. Market and Darlington Ave.), she turned to Paul and said that this is where we should establish a home and raise our children.

Paul smiled and told me that Mary was very persuasive. So Paul and Mary came to Crawfordsville and changed our lives for the better. Paul joined with Dr. Alexander to begin his career and Dr. Mary joined with six other women to begin the Christian Nursing Service.

Strange, how I find myself referring to Mary as Dr. Mary and forgetting the Dr. When I talk about Paul. Paul never was my physician although he certainly helped my son. After Dr. Mary died, Paul and I became good friends regularly meeting and having lunch to talk about life and, of course, the Clinic. When my son and wife died, Paul called and we went to lunch. He told me that he was dying and didn’t have long to live. We talked about family, about death, about love and about the Clinic. He comforted me and I hope I did the same for him.

John Roberts, Chief Medical Officer, Montgomery County Free Clinic, Inc.

Paul was in the later stages of his career when I came to Crawfordsville, so I did not know him well in medical circles. However, I was fortunate enough to socialize with both him and Dr. Mary through my acquaintance with his daughter Julie. I have many fond memories of the pool parties he and Mary hosted through the years. He was always interested in what others were doing, especially their children. I also found myself on the other side of the tennis net playing against him and his “older” friends on a number of occasions. He was always a fierce competitor and gracious when beating down his opponents. I understand his golf skills weren’t too shabby either. In the latter weeks of his life, I was fortunate to have end of life conversations with him and listened as he regaled both me and my wife with the adventures both he and Mary had throughout their incredible lives. He and Mary epitomized what all physicians should aspire to be – knowledgeable, caring, compassionate, and strong threads in the fabric of their community. I think the Dr. Mary Ludwig Free Clinic has, and continues to, carry on their legacy.

We , the Board, the staff and the patients of Montgomery County Free Clinic, Inc. will miss Paul as we miss Mary. Both of them changed our lives just as they changed the lives of so many in Montgomery County. We extend our thoughts, prayers and condolences to Julie, Amy, Wendy, Will, and their children. God speed, Paul.