Affordable Care Act – remind folks to sign up by February 15

The Affordable Care Act continues to build its resume, even though there are some who try to ignore this growing success for political reasons. That is unfortunate as many who have not considered the ACA are shortchanging themselves due to available subsidies, which are favored by the majority of Americans per the Kaiser Family Foundation. More on this later.

It troubles me when I see people who are part of fundraising events to raise $150,000 or more to pay for medical bills for an injured or sick child because they lacked healthcare insurance. If these folks had signed up for the ACA, the only money they would need is for the out-of-pocket limit which usually run in the $5,000 to $20,000 range depending on the plan selected. As I have noted before, the number one reason for personal bankruptcy in the US is no or poor healthcare insurance. Yet, it is not too late, as they can still sign up for care since coverage is guaranteed, which previous policies did not offer.

With three weeks to go in the ACA’s current exchange enrollment season, exchange enrollment has hit 9.6 million passing the President’s expectations. The exchange enrollment will likely push toward the Congressional Budget Office (CBO) target of 12 million by the middle of next month.  It should be noted this does not include enrollment under Medicaid in the majority of states who did expand Medicaid, which will only improve with more states considering such expansion.

Further, the non-partisan CBO has for the second time reduced its projections of future medical costs as a result of dampening costs due in part to the Affordable Care Act. As an actuary and former benefits consultant and manager, having more folks covered will help further dampen costs as they seek treatment and get medications before they become eventual train wrecks. Plus, by seeing doctors and nurses in advance, the long term costs are further dampened as they are being served in the more cost-effective place and not in an Emergency Room in a crisis.

But, back to the Kaiser Family Foundation survey from January. Many may not realize that some strident opponents have brought a lawsuit that questions the ability of the federally run exchanges to offer the subsidy. The federal exchanges had stepped up to cover 37 states, when some states asked them to do so. The US Supreme Court will rule on this later in the year. I do not anticipate that they would rule unfavorably, but stranger things have happened. If they did about 10 million Americans would be screwed, sorry for the use of the most appropriate term. Yet, per Kaiser, what would Americans want in that case:

  • 64 percent say Congress should pass a law making subsidies available in all states;
  • 40 percent of Republicans favor such a law, with a solid majority of Democrats and Independents supporting such legislation;
  • 59 percent of residents in the states say they would want their state to act to operate its own exchange;
  • By party declaration, 61 percent of Democrats, 63 percent of Independents and 51 percent of Republicans favor a state exchange in those now served by the federal exchange.

Given the fact there is a cost to running an exchange, many of the states asked the federal government to take the lead. In fact, a significant number of state attorney generals have written to the US Supreme Court to not rule against the subsidy.

With all of its complexity and communication challenges, which is partly due to Americans not understanding healthcare insurance, in general, the ACA is building a resume of success. This Congress should heed Americans wishes to improve it where possible, but accept that it is showing success. And, the remaining state legislatures should expand Medicaid as it would help many residents in need, help their economy even further, and keep rural hospitals afloat to serve.

10 thoughts on “Affordable Care Act – remind folks to sign up by February 15

  1. You may be one of the very few people in this country who knows what the ACA is all about. And this includes members of Congress who will doubtless continue to target the plan out of ignorance — their own and that of their constituents.Thanks for the helpful post, BTG.

    • Many thanks. I will never win over the folks who blindly call it akin to Nazism or Apartheid, but I did like that 40% of GOP voters want the subsidies to continue.

  2. Working in the healthcare field it boggles my mind daily how many people have NO CLUE about the rules and regulations regarding their own healthcare plans….the ones they hand picked and pay for out of pocket. Yet these same people will make uneducated remarks about “Obamacare” because they also have NO CLUE that it is one and the same as the ACA.
    As if that weren’t bad enough, throw in a doctor who walks around as if he is a hair away from begging on a corner due to ALL the cuts Obama is making to his fees. He suddenly has no recollection of all the patients he had to see for F R E E because they had NO coverage.
    All day every day I am subjected this negative, uneducated banter about the ACA!
    Maybe you could come to my office and just lecture the truth for a few days… keep my blood in check.

    • Thanks for your comments. I think you summed up nicely why I have been consistently trying to describe what the ACA is and isn’t, including its pros and cons. Yet, people who need to hear these points dismiss them as untrue, as that is not what they heard or saw. One of the greatest misnomers is Obamacare is a government takeover of healthcare. It is not. The response is why did insurance company stock values increase when it was announced?

      The negativity around the name is amazing and does far more harm than warranted. In Senators Mitch McConnell and Rand Paul’s home state, people love Kynect, but hate Obamacare. They are the same thing. The fact that Kynect is working pretty well should be a telling item. And, then there is Massachusetts, the home of Romneycare which Obamacare was patterned after in many respects. Mortality numbers are down and the reason is directly traceable to more people being covered.

      Please feel free to guide people to my website and tell them it is written by an Independent voter who is a retired benefit consultant and actuary. Thanks for your comments and best wishes for your diplomatic skills and patience.

  3. Note to Readers: Two quick updates. Indiana became the 28th state to expand Medicaid. There are three more states with definite considerations and others discussing it. Medicaid enrollment is up 17.5% as of November from the previous July – September 2013 enrollment period crossing into 10 million sign-ups. This increase is largely due to more states expanding Medicaid to cover adults in poverty under the ACA.

    And, while this is happening, our Republican led Congress has ignored most Americans and voted for the 56th time to repeal the act. The rationale was to let new members of Congress a chance to vote against it. It should be noted the ACA largely borrows from Romneycare which was strenuously advocated by Tea Party leadership for the whole country in 2009. If you do not believe me, Google “Jim DeMint and Romneycare” and read until your heart’s content.

  4. Note to Readers: A week later, the count for enrollment in the exchanges is up to 9.9 million. Also, the GOP has come out with their own plan, which borrows several of the features from Obamacare, including subsidies. But, the plan falls down in three areas and would not be sustainable or very effective. First, it foregoes the mandate for coverage, which means the better risks will go without coverage and the insurers companies would see a significant decline from the Obamacare enrollments. Second, it pushes an initiative that GOP has touted as some panacea and that is to let carriers cross state lines. Well, they do that now, but must meet the requirements to be approved by the state insurance commissioners. Unless they are repealing the McCarran Ferguson Act, offering a state’s citizens coverage without permission by the commissioner office is not permissible. Third, they want to change the Medicaid paradigm, which would put a burden on people in poverty. What bothers me about the 56th vote to repeal Obamacare, is this is not what Americans want and it shows where this Congress’ priorities are.

    Finally, the issue with the mandate is ironic to me. The Tea Party leadership supported Romneycare for the entire country before Obamacare was passed and patterned many features after it. In fact, the Tea Party leadership liked the mandate saying it required personal commitment. Once Obamacare was passed and Romney ran for president again in 2012, the Tea Party leadership said BOTH Romneycare and Obamacare were unconstitutional. For those who do not believe this, please Google “Jim DeMint and Romneycare” and read all you want.

  5. Note to Readers: The final tally for enrollees is 11.4 million in the exchanges. This does not count Medicaid ACA enrollees. I know in NC, we had a 56% increase with about 560,000 enrollees and SC has a 77% increase taking them above 200,000. Well done to the all of the navigators who helped people.

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