I got your back....SquareBiz.
With all the varying opinions about the ACA, can we at least agree that the old system was not worth keeping, and for now the ACA is not just an idea, but a law?
Okay, whoever is still reading, this article is for you? Most Americans have no clue....still, what is in this law because this law was designed for minimal impact of the masses. In other words, if we are truly a what's in it for me' society than we function on a need to know basis. If I never had healthcare all I need to know is where to get it and can I afford it. If I already have insurance all I need to know is what changes should I expect and when will they occur.
85% of you need to check next year to see if your employer has decided to continue carrying insurance or dump insurance altogether since we no longer need our jobs to get affordable insurance. While this may seem scary for someone who has work insurance (that you hardly use or understand), don't worry. Since incomes have dropped over the past decade many Americans are teetering near the poverty line (What Is A Poverty Line?) , which means you will get free or reduced insurance. This will put some money back into the pockets of most Americans. Some of you don't like to read much so I'm excusing the 85% now, but be back here next year so I can explain the changes in your work insurance.
10% more of you are at or below the poverty line and did not have insurance (even if offered at work) because you simply could not afford it. Most of you probably have already signed up for MediCare. If you have not, stop reading this article and do it right now (Medicare.gov). Open enrollment for MediCare ends Dec. 7th. (for those with insurance at work) if you qualify for Medicate and want to drop insurance to get this free benefit instead.
So who did I miss. Oh yeah. The infamous 5%. These are actually the people that get private insurance because they are either self employed or work for a small business who does not offer health insurance (or a myriad of other unique scenario's). HealthCare.gov, the website, the exchange (whatever term you use for it) is currently targeted at the 5% market who need to shop multiple insurance carriers at once. Healthcare.gov is a website for price competition and to determine your subsidy amount. As it turns out, only .06 percent of Americans carry private insurance but make too much money to qualify for an ACA subsidy.
I have to stop here for a minute because there are those out there who not only do not wish to have MediCare because they do not believe it will cover them as well as private insurance or for other personal reason's. There are also those who don't want the subsidy because they see it as a government handout like foodstamps. If this is you, I am curious if you see tax credits and charitable exemptions each April as government handouts too? (We may have lost a few more just now but I will move on.)
The only tricky part of this website is that it connects the subsidy to the person needing insurance. This means that you have to input your information first (to determine your subsidy amount) before you can shop the exchange. Healthcare.gov is a marketplace intended for competitive pricing. For those who are concerned about website security and are not interested in getting a subsidy, shop as you did before the ACA law. If you shop online, shop online one company at a time. If you shop by phone, make a call. All insurance providers will attempt to make sure that you do not qualify for a subsidy before they sell you insurance these days, so expect this hurdle no matter where you will shop.
For example, I went onto the Kaiser Permanente website and played with some numbers and discovered that a family of 3 that makes $70,000 a year still qualifies for some type of subsidy and has 16 plans to choose from through Kaiser alone. On the exchange, that family will find the Kaiser option alongside multiple other competing insurance carriers.
If you are concerned about MediCare insurance you should know that most of healthcare cost is impacted by MediCare. The reason the cost curve bent on healthcare when the law was inacted is MediCare. MediCare eliminated much of the inflated payments that occurred from hospitals and doctors that knew they could get away with overbilling the government. Those inflated billing tactics impacted all of healthcare. Overbilling may have been a MediCare problem only, but I suspect that providers began to inflate all billing to avoid the impression that only MediCare was being overbilled. Now MediCare has a 'take it or leave it' payment system in which they have pre-determined the cost of most procedures and will only pay that cost.
Now it is true that some doctors and hospitals have dropped MediCare patients in a form of protest against the ACA law, but this is not truly a problem. Why? Because of the famous "provider network". The presence of a provider network list for all insurance policies is evidence that not all hospitals or doctor ever accepted all insurance anyway. For every story of people who might need to change doctors due to the ACA, there will be stories like my family. For us, work insurance changes (aka. provider network) caused us to lose key doctors in treating her pre-existing condition, but we have regained them thanks to MediCare.
If we are also in full agreement about the nature of free market competition, then soon the competitive environment alone will make the cost that all insurance companies pay on procedures the same as it is with MediCare because insurance companies are too greedy to continue paying more for a procedure while hospitals currently accept less from MediCare. At that point (which is really soon), the type of insurance you carry will not matter to any care provider because healthcare costs become indirectly regulated....by MediCare.
One true opportunity with the ACA law is the issue of access. Healthcare can not be outsourced so this law will create jobs...Period. The ACA law included funding to take care of the physical expansion of community health clinics, but even they will need workers. This problem is actually a gift horse that should finally move the needle on our stagnant employment rate.
Many try to compare our future to that of Canada's healthcare. Their concern is that hospitals are busy now and could be twice as busy until we can meet the demand. Overloaded hospitals will be the first sign that people understand the importance of preventative care, which is as much a weapon against the cost curve of healthcare as the insurance itself. Unlike food stamps, health insurance is not something anyone is jumping to use...except sick folk, and even they search for a solution other than a doctor visit. The Chris Rock joke of putting Robitussin on every ailment comes from longstanding widespread LACK of access to affordable healthcare.
Some of the saddest shames become the source of humor, but America should be ahsamed of how many people were able to relate to that joke simply because few could afford the alternative. The ACA has removed the shame, even for those who are trying to dismantle it.
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