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Affordable Health Care

Posted on 14 June 2013

By Ellen Frankman

 

At the start of next year, the Affordable Care Act will swing into full effect. Though the law has already begun rolling out, many questions remain for Americans unsure of how they will be affected.

In an effort to shed light on the complex law, the League of Women Voters of the Hamptons gathered Monday evening to host Mary Dewar, president of the Long Island Coalition for A National Health Plan, in a discussion titled “Patient Protection & the Affordable Care Act: What’s Ahead?”

Dewar, a registered nurse and retired health educator, covered deadlines, changes and the notable benefits and challenges of the administration’s new health care law.

“The health care system before Obamacare was a non-system,” said Dewar. “It was a little bit of this and a little bit of that.” (Though initially employed as a derogatory term, the moniker Obamacare has since been embraced by those on both sides of the aisle.)

The American public will see significant gains under the Affordable Care Act, said Dewar, some of which have already been put in place. Children aged 19 to 26 years old may now remain on their parents’ insurance. Tax credits of up to 35 percent will be given to small businesses to help cover health insurance for their employees, and as of 2014, both children and adults may not be refused coverage because of a pre-existing condition.

“Insurance companies can no longer say ‘bye-bye’ and drop you if you have an illness they don’t want to pay for,” said Dewar.

Health insurance exchanges are another major component of the Affordable Care Act. For those who are uninsured, have overly expensive individual policies, or for small businesses struggling to provide employee insurance, exchanges will operate as marketplaces where individuals can buy less expensive health plans under group policies best suited to their needs.

Anticipating the concerns of many, Dewar posed the questions, “How are we going to find out about the exchanges?  How are we going to know what they offer?”

Health insurance “navigators” will be the answer, Dewar explained. Open enrollment for the exchanges is set to begin October 1 of this year and the federal navigators will step in to help consumers understand the nuances of the law and make informed decisions on purchasing insurance. The ACA’s individual mandate will impose a fine on those who refuse to enroll in health insurance in an effort to reduce the number of the nation’s uninsured from 50 million to 23 million.

“It’s very important that the big states have exchanges that work, so the rest of the country, the doubting Thomases, can see that it works,” said Dewar.

The Affordable Care Act does present challenges, Dewar noted.  Millions will be left without insurance, particularly in states that have refused to set up insurance exchanges and will lose federal funding as a result.

Cost-containment is another sore spot for the law.

“There are almost no cost regulations in Obamacare,” said Dewar. “There is nothing to prevent companies from raising co-pays, premiums or out-of-pocket expenses.”

Perhaps the biggest drawback to the Affordable Care Act, however, is that it’s complicated, said Dewar. Amidst the law’s many stipulations and limits, insurance companies have already succeeded in finding loopholes to cut costs.

Furthermore, many people are unaware of the full extent of options that will be available under the law, she added. Attendees at Monday’s meeting raised questions on subsidies, exchanges and what to do if they are currently covered under Medicare. Dewar’s response was “stay right where you are.”

“Unfortunately, the broader public is not that aware of the law because there are a lot of misconceptions about it,” said Ursula Lynch, a League of Women Voters of the Hamptons board member.

“If it’s going to work, healthcare leaders need to make it work,” said Mike Anthony, a retired hospital administrator who attended Monday’s meeting.

But for the most part, Anthony says he’s pleased with the law.

“One third of Obamacare is all about the delivery of healthcare,” said Anthony. “Everything under the sun that we’ve been working toward to improve healthcare delivery is being addressed.”

“This is very real for us,” said Dr. David Posnett. “It’s not an academic endeavor.” Posnett explained that some of his colleagues are against Obamacare because of the likelihood it will cut into their salaries. Nevertheless, he finds there to be a fair share of doctors both against and in support of the ACA, and personally feels optimistic about it.

“The ACA seems to give us the framework for states to experiment,” said Posnett. “If Vermont goes to a single payer system, and it works and it’s less expensive, then that’s a great experiment.”

 

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