Affordable Care Act Enrollment Help for 2015

With the Affordable Care Act showing success under multiple measures (reduction in number of uninsureds per Gallup, median premium increase of only 4% per McKinsey Center for US Healthcare Reform, dampening of medical cost increases per the Congressional Budget Office and improving US Treasury Bond outlook, as a result, per Invesco, Credit Suisse and Charles Schwab), the second year of enrollment will be kicking off November 15 lasting through February 15. More insurance companies, like United Healthcare, will be entering a greater number of markets which will increase competition and benefit consumers.

The actuary in me is pleased with greater competition, but I want to remind folks to consider coverage, if they have not done so already. To avoid a future train wreck for you and your family, I would encourage folks to sign up for care, select a physician (or confirm which plans include yours, if you have one) and use the preventive services under the program. The Corporate Benefits Manager in me notes that a weakness of the ACA is its complexity making it difficult to communicate. Like employer plans, some of the offerings are high deductible plans to save money on premiums. Yet, the consumer needs to measure in her/ his plan selection what she/ he may pay if a non-preventive service is needed. If you are not comfortable with exploring your options, please work with an ACA navigator in your community who can help.

Finally, as a Board member of an organization that helps working homeless families, the absence of (or poor) healthcare insurance is the leading cause in the US for personal bankruptcy per The American Journal of Medicine, NerdWallet Health and Harvard University in three separate studies. The ACA offers an opportunity to gain coverage at a subsidized rate if your income is from 1 x to 4 x the poverty rate. Note, for a family of four, this means your family income could be as high as $94,000 and some level of subsidy could still be provided. The navigators can help you plan what the subsidy might be, if you need help. Or, you can go to  https://www.healthcare.gov/ to do your own investigation and make your own selections.

I ask for your help in communicating the enrollment, as so many are still unaware of what the Affordable Care Act is and does per the Kaiser Family Foundation survey. Especially those in rural areas, where so many forego coverage and go to the Emergency Room after a healthcare crisis occurs, strong consideration of coverage is needed by more than a few. My family of five has been covered under an ACA plan and it has worked very well for us, even with services for my middle child who is at college in another state. Plus, there is so much campaign rhetoric that accentuates the negative and does little to speak to the many positives of the ACA. When you dig deeper in the survey data, Americans like the many features of the ACA, but their opinion sours when you use its nickname, which is wielded like a weapon.

Truth be told, people would benefit from the ACA and many do not understand it or have discounted it because of political machinations. And, that is unfortunate. Please help spread the word about the opportunity and let people make informed judgments and not rely on political chess maneuvers. Like in chess, it is the pawns that are sacrificed. Kaiser noted in a survey this summer, that of the people who did not like the ACA because it was too expensive, almost two-thirds of those folks were unaware they had a subsidy to reduce the cost.

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14 thoughts on “Affordable Care Act Enrollment Help for 2015

  1. Your last paragraph nails it. Even in this region where many are barely making it or living hand to mouth, the mere mention of Obamacare drives these tea baggers nuts, but when you ask them if they need reasonable health care, they all say yes. We have sporadic health fairs where medical providers come in for a day of free care, and the lines are always out the door. So the political attacks have been successful in turning people away from a service they desperately need.

    Well done

  2. Note to Readers: An attorney friend of mine noted that the GOP has offered a repackaged version of the ACA with some tweaks on their website, to replace the ACA if repealed. This is consistent with what Senator Richard Burr put together, after the party was chastised for not having a plan. The reason the GOP waited is ACA is largely a GOP idea dating back to some elements offered by Senator Bob Dole when he ran for President against President Clinton and elements of Romneycare. Romneycare was even actively supported by Tea Party leadership (Senator Jim DeMint and others) as late as 2009, until the ACA was passed. DeMint, in particular, was very active in his support, so when Romney ran for President, DeMint was extremely hypocritical when he called both Romneycare and the ACA unconstitutional. Please feel free to Google “Jim DeMint and Romneycare” to confirm.

    The key is to not repeal something that continues to show success. Improve it yes, but repeal is not an option Americans want or need. And, it would be a shame, especially as it is taking footing.

  3. Very good points. If uninsured people have contacts with community organizations, hopefully someone will navigate or refer them in the right direction (i.e., toward ACA coverage). Would I be too cynical if I thought some of the community orgs (including faith-based ones) have links to the GOP or share its values, and therefore they discourage their clients from applying?

    • I would think that would be the exception, yet I am sure some if it goes on. The sad part is many in rural areas would benefit, yet they me be dissuaded by the political rhetoric. Thanks for your comment.

  4. Note to Readers: I have been doing some window shopping on http://www.healthcare.gov and it is much easier to use and see the impact of the subsidies. This part last year was ill-conceived and some people did not make it deep enough in the site to ascertain the value of the subsidies and left thinking the cost was too high. Now the shopping asks you upfront your estimated income. So, people need to give it a look.

  5. Note to Readers: I read that Colorado is experiencing some premium reductions in the major locations with a year of experience and more competition. This is being witnessed in some other metro areas as well. More competition can only help. Yet, it is the more rural areas that would benefit from seeing at least two carriers. Here in NC, we are a good example of this with three carriers in about two-thirds of the counties, two in another ten counties, but only one in the remaining 20 or so counties.

  6. Note to Readers: I just renewed my enrollment for my family and will be helping my adult son sign up for coverage for the first time on his own. There are many more options available, which is great, but they can confuse. The shopping and comparison experience is much easier, but when the President said last year it would be like selecting airline tickets, those were a poor choice of words.

    Please do use a navigator to help if confused. or, go through the phone line at 1-800-318-2596 where someone from the ACA Marketplace will help you. If you want to do it yourself, think of different healthcare purchasing experiences – wellness visit, sickness visit, needed brand name prescription drug vs. listed brand name or generic, small emergency costing $5,000. In-patient hospital visit costing $25,000 or $50,000. See what the plans will pay. Your cost is more than the premium less the subsidy.

    And, please ignore all of the other noise from politicians and pundits who heighten negative information. This imperfect law can always shed negative information. But, on the whole it is a good for Americans. Getting more folks covered is a very good thing for them and our economy. And, seeing doctors for wellness visits, prescriptions and minor issues, can mitigate bigger ones down the road.

  7. Note to Readers: Bloomberg News reported on a survey that said 65% of Americans want the ACA to continue with some changes or no changes. This is directionally consistent with other surveys. It should be noted that the exchange enrollment this time has launched pretty successfully and the first week’s numbers are very good. My hope is the enrollment website’s ease of use and better shopping tool, will help spawn greater participation than had been predicted.

    • Note to Readers: The first two weeks of enrollment on the Healthcare.gov site has gone pretty smoothly, with about 800,000 people signing up with applications. About 2 1/2 times that have been shopping. I cannot speak for the state run exchanged, but the news is encouraging.

      • The extremes want to keep pushing on it. Boehner is in an unenviable position of keeping the attack dogs at bay. A lot of what he publicly says is window dressing to placate. With the website working pretty well and greater competition, the numbers should be better than Obama’s lowered expectation. I have seen people like Charles Krauthammer rewriting history saying the healthcare system was working pretty well for the middle class before. First, it was not as ours was the most expensive and 38th best in quality system. Second, the CFOs were demanding change to moderate costs. Third, the people in the bottom half of the middle class and below had no legitimate access to care. I cannot see the Supremes ruling against the subsidy in the federal exchange, but if they do, there are work arounds that can be explored.

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