ACA moves into its 3rd Enrollment with tailwinds

The Affordable Care Act (ACA) continues to move forward building on its successes. While imperfect and needing some improvements, it has made huge strides in reducing the number of uninsureds and providing affordable coverage to many. And, this is in spite of it not being fully implemented in twenty states that did not expand Medicaid.

A recent Kaiser Family Foundation study noted that of the remaining uninsured people, almost half (49%) are eligible for a subsidy to buy coverage. That means almost half of these people are leaving money on the table. Plus, all uninsureds are one accident away from needing a “Go Fund Me” page.

As a former actuary, benefits manager and consultant, I am all about measuring and managing risk. Insurance is principally designed to help you avoid catastrophic financial risk, which healthcare insurance does. It does this with out-of-pocket limits which prevent further costs above these amounts. But, healthcare insurance is also designed with a preventive care mission to get people to see doctors to manage their health before they become a train wreck.

This preventive care mission is important as each of us should have a doctor to watch our back. We should be seeing a doctor before we need one, so that our history is known and we can make lifestyle changes and take medicines to help us maintain our health. I use the “Go Fund Me” page with intent, as people who do have an actual or figurative train wreck will need money to pay for the high cost of care.

I think of this every time I see a motorcyclist without a helmet. In Florida, which abandoned a required helmet law, the state saw their motorcycle deaths and head injuries increase significantly. And, one hospital said the cost of healthcare for a helmetless, motorcycle accident survivor is $1.2 million. Riding a motorcycle without a helmet is risk not worth taking, as it does a disservice not only to the rider, but the family members who have to step in along with the state and county to help with care and money, if no insurance exists.

So, in my view as a former actuary, parent, and volunteer to people in need, everyone should have some level of healthcare, as to do otherwise is not a wise move. The current uninsured people should consider coverage, especially if eligible for a subsidy which provides support for people with income as high as $95,000 for a family of four. I would also encourage folks who are not insured to not listen to politicians and pundits who have a political bias against Obamacare because of the name and author. An attorney in my city spends a lot of time with Republican voters who did not sign up for coverage for these reasons and hurt themselves financially when something happened to them or a family member.

The new enrollment season begins November 1 and end January 31. Please go online and explore at http://www.healthcare.gov. Or, seek out a navigator in your state.

Advertisements

3 thoughts on “ACA moves into its 3rd Enrollment with tailwinds

    • Thanks Hugh. Even, Mitt Romney is taking some credit for the success of Obamacare. While he has some merit in so doing, he has changed his mind on his position on Obamacare six times. Personally, if it will help us get over the Republican zeal to repeal, he can claim all the credit he wants.

  1. Note to Readers: Per Kaiser Family Foundation surveys, Americans like the features of Obamacare, with the exception of the mandate, which is needed. Americans also want the ACA to continue but be improved.

    I have written this before, but expanding Medicaid is a must in the remaining twenty states. This will help people in need, rural hospitals and the state’s economy. Extending the hours worked threshold to 32 or maybe 36 hours would help with retail and restaurant workers. And, making sure the pool is well funded to stabilize premiums for an insurance company taking on too much risk initially would help. Other changes should be considered and measured. But, my key message to Republicans is to cease the repeal BS. The ACA is helping people in need and in the middle class. Doing away with it would be harmful.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s