Two of my more frequented posts have been around trying to set the record straight on Obamacare, an imperfect, but needed law. The earlier features of the law have already made the following changes: eliminated lifetime limits on medical benefits, eliminated the underwriting limit on pre-existing conditions for children, permitted adult children under age 26 to remain on a parent’s plan (before you had to be in college), limited the amount of profit an insurance company could make on your fully insured premiums (with two refunds the past two summers to many policyholders) and a few other items. Yet, the main body of the changes will be coming 2014 with enrollment in the exchanges and expanded Medicaid (where possible) available next month. A few odd and ends might be of interest:
Exchanges which will be available to many
If not covered by a suitable corporate plan, you will have the opportunity to go into the exchanges. The exchanges actually are a pretty cool idea and in many states, the Blue Cross Blue Shields have been running their own exchanges pretty successfully for several years. So the Obamacare exchanges are similar with more insurance carriers in the mix. And, if your pay is beneath 4 times the poverty level, there will be a declining subsidy. The exchanges are one area where the GOP is out of sorts, as the exchanges are, in essence, a Republican idea. So, there is some hypocrisy here when the GOP tries to discredit them. Also, three separate surveys have indicated the prices in the exchanges will be pretty reasonable. So, once the kinks are worked out, this is a pretty neat feature in Obamacare. By the way, I have been in a BCBS exchange for over two months and it has been very easy to enroll and use.
When the Supreme Court said Obamacare was constitutional, they unfortunately added a ruling that said states could opt out of the Medicaid expansion. What does this mean? For people making less than 133% of the poverty level, the Medicaid expansion was supposed to be the place where lowly paid citizens could gain access to free care. The US government will subsidize the expanded care 100% for three years and then phase down to 90%. Right now 25 states have opted to expand Medicaid, including several states with GOP leadership. There are several more thinking about it. The Ohio governor said we are talking about $13 Billion coming into our state over the next seven years and I would be foolish not to support this.
The key for doing this is each state has hundreds of thousands or more people who would benefit from the Medicaid expansion. My home state has 500,000 people who would benefit, yet North Carolina is one that has declined at this point. I should add a rural North Carolina hospital announced yesterday it will have to close if the state does not expand Medicaid. These hospitals have to chase too many unpaid bills or have too many uninsured patients and needed this funding of Medicaid coverage. The Rand Corporation said Medicaid expansion is truly a win-win for the citizens and the state economically. The key reason for not expanding Medicaid is highly political. It is very frustrating to me to see GOP leadership in these states make a political decision as they want to defeat the other person’s idea. The pawns in this chess game are the ones that get screwed and the state will be harmed economically.
Access to healthcare and poverty
We have a poverty problem in this country which is an equal opportunity offender. It impacts people of all political parties, genders, races, ethnic groups and ages. A key reason for people in poverty is the absence of medical coverage. It is the primary reason for personal bankruptcy at around 62%. To many people live paycheck to paycheck and cannot afford healthcare. I am deeply troubled when I see people “who have theirs” act so cold-hearted to those who do not have similar access to healthcare or have access, but cannot afford it. I had one former retail client where only 20% of their employees were signed up for the company medical plan. That means 80% could not afford it or were on their spouse’s plan.
Not having access to healthcare greatly hurts the individual and his or her family. It also hurts the economy. With more people without care, that puts a huge amount of pressure on the charitable and government-funded agencies to step in and do what they can. When someone loses their home or apartment because of an uninsured healthcare claim that costs $250,000, then that puts honest, hardworking people in harm’s way, where they cannot spend in our economy, but have to accept services to make ends meet.
Folks, I know Obamacare is not perfect. It is complex and the President has made some changes to make it less so or give folks more time. To hold the country hostage over a debt crisis and budget season when Obamacare is largely a Republican idea is harmful to people, harmful to our economy and is hypocritical. On this last point, Jim DeMint, the former Senator and now President of the Heritage Foundation, who now thinks Obamacare is the devil incarnate and is quite vocal of late, was praising in writing and in person the key elements of Obamacare that were represented in Romneycare as late as 2009. His flip-flop is almost as bad as Newt Gingrich’s two televised flip-flops on global warming, where he changed his mind twice.
Let’s move forward with Obamacare. It is not perfect, but it is a strong step forward.