Before I start writing on my topic for today, let me say in advance that this is a real hot button issue for Americans. I want to remind all readers and participants on LiP to please keep the discussion civil. No name calling. Please, let’s just focus in on how expats are affected, and not the debate of the issue itself.
Health care. It has been a major issue in the United States for decades now. There was a big rush of activity in the early 90’s when President Bill Clinton tried to push through a National Health Care plan, with the effort being headed up by his wife, Hillary. After the proposal was shot down in the early 90’s, the issue of a nationalized health care system kind of faded for a while, although issues like the cost of health care and such continued to be ever present.
With the new administration of President Obama, there has been a renewed push to get a National Health Care system in place in the United States. In the past 24 hours, the U.S. House of Representatives has passed their Health Care Plan by a very slim 220-215 vote. One Republican crossed to vote with the Democrats, so it can hardly be called a bipartisan effort. The debate over health care now shifts to the U.S. Senate, where a bill has yet to be passed. If the Senate passes Health Care legislation, the next step will be for the two houses to meet in a conference session to wrangle out the differences in the two bills that are passed. After that, the final bill would be presented to the President for his signature.
I know what you are thinking…
But, Bob, you don’t live in the United States, why would you really care, and what does it have to do with Living in the Philippines? Why are you writing about this?
Well, as the bill sits right now, it would seem that it might have an impact on expats living anywhere in the world, even in the Philippines. Why? How?
Under the House version of the bill, there is language that says that every American must have health care coverage. In fact, if you do not purchase a health insurance plan, you are subject to a fine of $15,000, and if you do not pay that fine, you can be put in jail. Yes, if the Health Care plan is signed into law as it is now written, you may be put in jail if you do not have Health Insurance.
What about expats?
The bill does not say “All Americans who live in the United States must have coverage.” It says that “All Americans must have health insurance.” So, what if you do not live in the United States? I am an American, but I have not been in the United States for nearly a decade. I do not have any kind of US Health Insurance coverage, because I have no plans to go to the USA for any kind of health care treatment. I feel perfectly safe with the health care that is available to me in the Philippines.
There are only a few (actually I know of only one) Health Insurance plans available in the USA that will cover you for treatment in the Philippines. The one that I am aware of is Tri Care, a plan for US Military Personnel and Retirees. Other plans will cover you for emergency care in the Philippines, but not for regular health care for those who live here. I am not saying that there are no such plans, only that I know of none.
Now, there are health care plans that you can avail of here. If you have a Philippine spouse, you can get PhilHealth, the Philippine Government Insurance plan for your health. It is very inexpensive (P1,200 per year!), but the coverage is also limited. If I have PhilHealth Coverage, I wonder if the US would consider me to be in compliance with the proposed law? I sort of doubt it.
So, will I, and others like me, be required to purchase Health Care Insurance coverage from a US company, even though we don’t live there? If we don’t buy it, will we face a stiff fine, or jail time? Frankly, I think that is crazy. I also think that it is something that has not been considered by those who are considering the law. There are tens of thousands (possibly hundreds of thousands, I’m not sure) of Americans who do not live in the USA, so this is a real issue that needs to be checked out.
So, what do you think? When or if you move to the Philippines, what are your Health Insurance plans? Do you have any plans? Do you plan to self-insure, since health care costs here are actually quite low?
Give me your thoughts, but please remember, let’s only talk about how this legislation affects expats. No name calling, it’s just now what we do here! 😉