So by now many of us have probably gone to the Healthcare.gov site to sign up for the Affordable Care Act. This is a law that was signed into law on March 23, 2010, by President Obama. I tried the web site and I didn't find it all that difficult to work. There is a chat button on the bottom of the screen and if you have problems you can chat with a live person. It took me to a point where it said you've been verified and it wouldn't allow me to go any further. So the person that I chatted with gave me a phone number to call, which is 1-800-318-2596. I have not called the number yet because I use a cell phone with limited minutes and I didn't want to burn up my cell phone minutes this month. The White House web site gives the following information, these are the pro's to the Affordable Care Act, but there are others out there with the cons too.
This law was designed to put in place reforms that are supposed to improve access to affordable health coverage for everyone. It is also supposed to protect consumers from abusive insurance company practices. For Americans who already have health insurance, the only changes that should take place under the new law are better protections from insurance company abuses. In addition, they say you will get more value for your dollars spent on health care. If you have a plan and you like the plan you have you can keep it and you do not have to change anything under the new law.
For Americans that do not get their health insurance coverage through work, the component of the Affordable Care Act that took effect on October 1, is the Health Insurance Marketplace. It is open for business and it allows Americans to comparison shop for different quality, affordable plans that will meet your health care needs. In addition, 105 million Americans will not have lifetime dollar limits on their coverage. More than 17.6 million children with pre-existing conditions can not be denied coverage. Any one that has ever had any type of insurance knows that there have been cases where insurance companies took advantage of people. We saw the insurance catastrophe at 911, Hurricane Sandy, Hurricane Katrina, not health insurance, business insurance, and home owners insurance. Recently, I heard that there are people that have still not settled with their insurance companies over damages from Hurricane Sandy, and that the insurance adjusters were not giving adequate estimates for repairs to people's homes, shorting them, so they did not have to pay the full amount of the insurance claims.
On the health care side, in the past insurance companies could deny coverage to children with asthma, or children born with heart defects, and they put a lifetime cap on the amount of care they would pay for, or cancel your coverage when you got sick. They do this by looking for a loop hole in your policy, or they find an accidental mistake in the paper work. This new law means a new Patients Bill of Rights and it protects you from these and other insurance company abuses.
It will bring an end to pre-existing condition discrimination insurance companies can no longer deny coverage to children because of pre-existing conditions like asthma or diabetes. Starting in 2014, no American can be discriminated against due to pre-existing conditions. It also ends the limits on care. In the past people with cancer or other chronic illnesses ran out insurance coverage because they went over the lifetime limits on the insurance policy. Under this new law insurance companies can not impose lifetime dollar limits on health benefits. In addition, annual limits are being phased out by 2014. More than 105 million Americans will no longer have lifetime limits under the new law, in addition, insurance companies will not be able to drop your coverage when you get sick due to a mistake in paper work during the application process.
The claim here is that this new law will help bring down health care costs by making sure that your health care dollars are spent wisely. Insurance companies will be held accountable to their customers for how they spend premium dollars, and how much they are raising rates. In addition, they initiated new tax credits and market places so that insurance companies now have to compete for your business.
The Affordable Care Act has a 80/20 rule. This means that insurance companies will have to spend at least 80 percent of your premium dollars on medical care and quality improvements instead of advertising, overhead, bonuses for executives, they will have to provide you with a rebate. In 2012, they say 8.5 million people received half a billion dollars in refunds.
In every State, insurance companies are now required to publicly justify their actions if they want to raise your rate by 10% or more.
The Affordable Care Act offers small business tax credits, small businesses have paid 18% more than larger employers for health insurance. This tax credit will benefit an estimated 2 million workers who get their insurance from approximately 360,000 small business employers. Small businesses will receive the credit in 2011 alone. This law is supposed to build on what works and fix what is broken in the health care system by providing more health insurance choices and better access to health care.
Insurers will be required to cover free prevention benefits, such as cancer, diabetes and blood pressure screenings, at no cost sharing such as copay's or deductibles. Approximately 54 million Americans with private coverage have gotten better preventive services as a result of the Affordable Care Act.
Under this law, most young adults who can not get coverage through their jobs can stay on their parents' plans until age 26, this has allowed 3.1 million young adults to get health care coverage. Before the law, many Americans with pre-existing conditions were priced out of the health insurance market. More than 50,000 Americans with pre-existing conditions have now gained coverage through the new pre-existing condition insurance plan. This temporary program makes health coverage more available and more affordable to individuals who are uninsured and have been denied health insurance because of pre-existing conditions. In 2014, insurance discrimination against anyone with a pre-existing condition will be illegal.
Affordable insurance exchanges are one stop market places where consumers can pick a private health insurance plan that fits their health needs. Beginning in 2014, these exchanges will offer to the public the same kinds of insurance members of Congress will have, exchanges will select health plans qualified to offer coverage, assist with shopping, enrollment, and co-ordination of eligibility for the Exchange and possibly premium assistance. Thirty three (33) States and the District of Columbia are building Exchanges, they have received approximately $670 million in Exchange Establishment Grants.
The Affordable Care Act makes Medicare stronger for Americans with disabilities, it adds benefits, fights fraud, and improves health care for patients. The Medicare Trust Fund will be extended to at least 2024 due to reducing fraud, waste and abuse and slowing cost growth to Medicare. Over the next ten years, the law will save the average person $4,200 in Medicare. People that have Medicare and the prescription drug coverage that hit the donut hold will save an average of $16,000. In addition, it will lower prescription costs. One in every four seniors go with out necessary prescriptions every year because they can not afford them. This law provides relief for people in the donut hole; the ones with the highest prescription drug costs. There was a $250.00 stimulus in 2010, nearly four million people received. In 2011, 3.6 million people with Medicare received a 50 percent discount that was worth $2.1 billion dollars, an average of $604.00 per person, on their brand name prescription drugs when they hit the donut hole. The gap is closed in 2020 and seniors will see additional savings on covered brand name and generic drugs while in the coverage gap.
Preventive services for seniors includes flu shots, diabetes screenings as well as a new annual wellness visit, free of charge. More than 32.5 million seniors have already received one or more of these new benefits for preventative services.
The new health care law helps stop fraud with tougher screening procedures, stronger penalties and new technology. From this effort the Government recovered $4.1 billion in tax payer dollars in 2011. Total amounts recovered over the last three years was a record breaking $10.7 billion dollars. Prosecutions are up, the number of individuals charged with fraud increased from 821 in 2008 to 1,430 in 2011, a 75% increase.
It is designed to improve care co-ordination and quality with the newly established Center for Medicare and Medicaid Innovation. This is testing and supporting innovative new health care models that can reduce costs and assist with strengthening the quality of health care. Between 2010-2012, the number of seniors that joined Medicare Advantage plans increased by 17 percent and the premiums for these plans dropped by 16 percent, seniors across the nation now have a choice of health care plans.
So all this sounds good, what are the down sides to the Affordable Care Act? While ObamaCare has many benefits, especially for low and middle income families, it also contains obstacles. The obstacles affect high earners, larger firms that do not insure their workers and sectors of the health care industry. Your health insurance costs will most likely go up, but they say your health insurance just got better.
From the Kaiser family foundation, we get the following cons to the Affordable Care Act:
The individual mandate says that you have to obtain health insurance by January 2014, get an exemption or pay a fee if you can not afford insurance, basically you as an American are being forced to purchase health insurance, even if you can not afford it. They say because of the market place you should be able to get coverage at an affordable price, or it will be subsidized by the Government.
Medicaid is expanded using State and Federal funding, not all State's have to expand Medicaid, I read that 26 States have still not expanded Medicaid, maybe it is because they do not need to or maybe it is because they are not in agreement with the Affordable Care Act.
The Childrens Health Insurance Program also uses Federal and State funding.
Insurance companies are expected to cover sick people and this increases everyone's insurance costs, so who is going to pay for this increase in insurance costs, the taxpayer. Basically the issue here is that President Obama said that taxes would not be raised on middle class Americans, but according to Betsy McCaughey. She says that doctors will now be forced to ask you intrusive questions about your sex life. They want to know who you are having sex with, one partner, multiple partners, or same sex partners. She says be ready to answer these questions and more the next time you go to the doctor whether or not it has anything to do with why you are seeking treatment.
“Doctors and hospitals that do not comply with the federal government's electronic health records requirements will be penalized in the way of incentive payments now, and starting in 2015, the will face financial penalties from Medicare and Medicaid. The Department of Health and Human Services has already paid out over $12.7 billion for these incentives.
The employer mandate states that in 2015 businesses that have over or the equivalent of 50 full time employees must provide health coverage. In anticipation of this businesses will cut employee hours. Just like now we see all these companies that hire people and keep them in a part time status, they do this so they do not have to pay health insurance costs, more companies will now be hiring people on a part time basis, to get out of the employer mandate.
Young people tend to be healthy, so they do not need coverage as often as older Americans, but now they will be forced to get coverage whether they need it now or not. In essence, young people will now be required to carry the cost of insurance for the elderly, whether they themselves need it or not. This is where the increase in taxes comes from on middle class America.
Medicare payments to doctors and hospitals have been limited. Medicare pays doctors more than any other coverage and the rates have led to complex problems that are driving the cost of health care up for everyone. Insurance premiums have actually increased, they say they will decrease, but I read somewhere that some people by a certain time could be paying as much as $20,000 a year for health care coverage. The reason premiums have increased is because now insurers are having to provide for covered services, they pass this cost on to you the consumer. This new law is defective in that it focuses more on making sure people are covered than it does on fixing the cost of care in the first place.
“Dr. Richard Amerling, a nephrologist, also an associate professor at Albert Einstein Medical College, explains that your medical record should be a story created by you and your doctor solely for your treatment and benefit. The new requirements are turning into an interrogation and the data will not be confidential.”
“Lack of confidentiality is what is concerning the New York Civil Liberties Union in a 2012 report. Electronic medical records have enormous benefits, but with one click of a mouse, every piece of information in a patient's record, including the social history, is transmitted, disclosing too much information. The social history questions include whether you have ever used drugs, including IV drugs. As the NYCLU cautioned, revealing a patient's past drug problem, even if it was a decade ago, risks stigma.”
“Patients need to defend their own privacy by refusing to answer intrusive social history questions. They say to ask your doctor to keep two sets of books so that your secret stays in the doctors office. Doctors take the Hippocratic Oath seriously and will not be offended.”
“The assumption that all Americans will inevitably consume health care is almost true for seniors but they are not subject to the mandate. For Americans younger than 65, the premise is false. According to yearly reports from the federal Agency for Healthcare Research and Quality, 50% of Americans are non-consumers or near non-consumers.
They account for 2.9% of the nation’s health expenditures. Their mean annual expenditure is a tiny $238 a year, indicating that many spend $0 on healthcare. Yet the individual mandate would compel them to sign up for an estimated $5,000 annual health plan.”
Betsy McCaughey was the former Lieutenant Governor for the State of New York. She refers to the Affordable Care Act as the mouse trap, and says it is the one piece of legislation that will raise taxes on the middle class, but the Government is as usual hiding this from the people of the country.