I know a lot of people waiting for help with health care. I have a son who is only insured because the Affordable Care Act (ACA) lets us keep him on our family policy to age 26. I have a brother-in-law, friends and acquaintances with individual policies who want cheaper, more comprehensive coverage. I have many friends with pre-existing conditions who will now be able to get insurance.
But you’d never know it from the daily news. One month into ACA’s initial six-month enrollment period and crisis ensues. Frankly, I’m crisis’d out.
First, did we really think a web site designed to interface with multiple other government AND private organizations’ sites would work seamlessly? How often do Facebook changes gum up its operation, and people threaten to abandon it forever? It hasn’t happened yet.
And, have you ever called your health insurer to get approval for a procedure or medication? How many menus and people did you go through to get an answer? Did we really expect this to be simple?
Second, the web site is not the only way to enroll. People can call to enroll, or print forms off the web site and mail them in. They can also locate a navigator in their area and sit down with a person to go through the process.
But I don’t hear about these options in major media reporting. Instead, they report on the problems with the web site and on individuals whose current policies are being replaced with more expensive (and more comprehensive) plans. Unfortunately, they often leave out the rest of the story . . .
As Joan McCarter writes on Daily Kos: “They're not telling people they can shop around for a better deal. Which is precisely the point of the health insurance exchanges. These insurers are betting that people will go the route of least resistance, and just fork up the money for the plan they're being pushed toward. . . . They're going to squeeze whatever extra money they can get out of people because that's what they do.”
This week’s case in point comes from CBS News. They reported about a woman in Florida, Dianne Barrette, whose $50 a month health “insurance” was replaced with a $591 plan.
Erik Wemple described Barrette’s current policy as a “pray-that-you-don’t-really-get-sick plan” and writes on his blog: “More coverage [reporting] may provide a deeper understanding of the ins and outs of Barrette’s situation: Her current health insurance plan, she says, doesn’t cover ‘extended hospital stays; it’s not designed for that,’ says Barrette. Well, does it cover any hospitalization? ‘Outpatient only,’ responds Barrette. Nor does it cover ambulance service and some prenatal care.”
Yet Barrette, who earns about $30,000 annually, could get better coverage and subsidies to pay for it via the health care exchanges.
Like my friends and neighbors frustrated by the letters they’re getting from their insurers, I’m frustrated by the lack of constructive information coming from media and our politicians. At a time when real people need help, they are rooting for failure. We don’t need shoddy news reports and hearings designed to point fingers. We need information about how to sign up for better, more affordable coverage.
The Affordable Care Act is law like Social Security and Medicare. It is regulation enacted to prevent consumers from being bankrupted by health care emergencies and profit-seeking insurers. Either help or get out of the way.
Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts
Monday, November 18, 2013
Obamacare vs. ACA: What works for you?
Last week as the government shut down and enrollment for the new health care exchanges began, I was amused to discover a friend’s Facebook post. In it, a correspondent from the Jimmie Kimmel show asked people on the street: “Which is better, Obamacare or the Affordable Care Act?”
It became obvious very quickly that many people don’t know they are one and the same thing. Consequently, they also had little idea what the duly passed and Supreme Court-upheld law does.
First, the law has been taking effect gradually. As the Department of Health and Human Services outlines on its site:
• 2010 – A Patient’s Bill of Rights and cost-free preventative coverage for most Americans went into effect. These features protect consumers from the worst abuses of insurers and eliminate out-of-pocket expenses for preventive practices like physicals. Young people up to age 26 can stay on their parents’ insurance.
• 2011 – People on Medicare began to receive no-cost preventative care and a discount on brand name drugs in the donut hole.
• 2012 – Programs like Accountable Care Organizations began work to help doctors, hospitals and clinics work together to provide better health care.
• 2013 – Health care exchanges opened and the enrollment period began, allowing more Americans access to affordable health insurance.
• 2014 – Health insurance plans via the exchanges go into effect as early as Jan. 1, and tax credits and subsidies will help small businesses and individuals afford coverage that was previously unaffordable.
I recommend you visit the site to view the full list of benefits for each year.
Additionally, Ezra Klein outlined 11 facts about ACA in a June 2012 post on the Washington Post’s Wonkblog. Some highlights include:
• By 2022, the Congressional Budget Office estimates the ACA will have extended health coverage to 33 million people who were previously uninsured.
• Insurance companies cannot deny coverage for pre-existing conditions.
• Insurance companies are required to spend 80-85 percent of every premium dollar on medical care instead of advertising, administration and marketing.
As Klein notes in his post, much of his information came from the Kaiser Family Foundation and their excellent summary of the law. I also recommend visiting this site, as Kaiser has done much of the earliest, deepest and best research on the law and its effects.
Finally, myths about ACA have been swirling since before it was passed, and as usual, my old standby, Factcheck.org, does some of the best work sifting truth from fiction on its Obamacare Myths page. For example, Factcheck rates the current rumor that Congress is exempt from ACA as “False.”
Factcheck writes: “Congress isn’t exempt from the law. In fact, members and their staffs face additional requirements that other Americans don’t. Beginning in 2014, they can no longer get insurance through the Federal Employees Health Benefits Program, as they and other federal employees have done. Instead, they are required to get insurance through the insurance exchanges.”
ACA was designed to help people like us, and though it’s far from perfect, it does. To learn more, attend a community conversation on ACA at 5:30 p.m., Thurs., Oct. 10 at the Red Oak Fire Station. Come hear local people, some you may know, share their own health insurance stories and how ACA will affect them.
It became obvious very quickly that many people don’t know they are one and the same thing. Consequently, they also had little idea what the duly passed and Supreme Court-upheld law does.
First, the law has been taking effect gradually. As the Department of Health and Human Services outlines on its site:
• 2010 – A Patient’s Bill of Rights and cost-free preventative coverage for most Americans went into effect. These features protect consumers from the worst abuses of insurers and eliminate out-of-pocket expenses for preventive practices like physicals. Young people up to age 26 can stay on their parents’ insurance.
• 2011 – People on Medicare began to receive no-cost preventative care and a discount on brand name drugs in the donut hole.
• 2012 – Programs like Accountable Care Organizations began work to help doctors, hospitals and clinics work together to provide better health care.
• 2013 – Health care exchanges opened and the enrollment period began, allowing more Americans access to affordable health insurance.
• 2014 – Health insurance plans via the exchanges go into effect as early as Jan. 1, and tax credits and subsidies will help small businesses and individuals afford coverage that was previously unaffordable.
I recommend you visit the site to view the full list of benefits for each year.
Additionally, Ezra Klein outlined 11 facts about ACA in a June 2012 post on the Washington Post’s Wonkblog. Some highlights include:
• By 2022, the Congressional Budget Office estimates the ACA will have extended health coverage to 33 million people who were previously uninsured.
• Insurance companies cannot deny coverage for pre-existing conditions.
• Insurance companies are required to spend 80-85 percent of every premium dollar on medical care instead of advertising, administration and marketing.
As Klein notes in his post, much of his information came from the Kaiser Family Foundation and their excellent summary of the law. I also recommend visiting this site, as Kaiser has done much of the earliest, deepest and best research on the law and its effects.
Finally, myths about ACA have been swirling since before it was passed, and as usual, my old standby, Factcheck.org, does some of the best work sifting truth from fiction on its Obamacare Myths page. For example, Factcheck rates the current rumor that Congress is exempt from ACA as “False.”
Factcheck writes: “Congress isn’t exempt from the law. In fact, members and their staffs face additional requirements that other Americans don’t. Beginning in 2014, they can no longer get insurance through the Federal Employees Health Benefits Program, as they and other federal employees have done. Instead, they are required to get insurance through the insurance exchanges.”
ACA was designed to help people like us, and though it’s far from perfect, it does. To learn more, attend a community conversation on ACA at 5:30 p.m., Thurs., Oct. 10 at the Red Oak Fire Station. Come hear local people, some you may know, share their own health insurance stories and how ACA will affect them.
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