Obama Care Pros and Cons
Tens of millions of uninsured will get access to affordable quality health insurance through the marketplace. In order to get the money to help insure tens of millions there are new taxes, mostly on high-earners. The taxes that may affect you directly are the individual mandate and employer mandate. Over half of uninsured Americans can get free or low cost health insurance using their State’s Health Insurance Marketplace The individual mandate says you have to obtain health coverage by January 2014, get an exemption or pay a fee if you can afford it. Medicaid is expanded up to 15.9 million men, women and children below 138% of the poverty level. Medicaid is expanded using Federal and State funding. Not all State’s have to expand Medicaid. CHIP is expanded to cover up to 9 million children.
CHIP also uses Federal and State funding. You can’t be dropped from coverage when you get sick or make an honest mistake on your application. You also can’t be denied coverage or treatment for being sick or charged more for being sick. You can’t be charged more for being a woman either. Insurance companies must cover sick people and this increases the cost of everyones insurance. Small businesses can get tax credits for up to 50% of their employees health insurance premium costs. The employer mandate says that in 2015 businesses with over the equivalent of 50 full-time employees must provide health coverage. In anticipation some businesses have cut employee hours. Young Adults can stay on parents plan until 26. 82% of uninsured adults will qualify for free or low cost insurance. Young people tend to be healthy and not to need coverage as often as older Americans.
Medicare is improved for Seniors including eliminating the donut hole, keeping rates down and expanding free preventive services. Some Medicare payments to doctors and hospitals have been limited. (Medicare pays doctors more than any other type of coverage and the rates have led to very complex problems that are driving the costs of health care up for everyone). All coverage starting after 2014 must include new preventative services and essential health benefits. Insurance premiums have increased due to insurers having to provide covered services. ObamaCare helps to curb the growth in healthcare spending.
ObamaCare focuses more on making sure people are covered than it does on addressing the cost of care in the first place.
Average American The Average American (those making under 400% FLP) will most likely see a reduction in their insurance premiums and 30 of the 44 million without insurance will gain access coverage via the “ObamaCare” exchanges, Medicare or Medicaid. ObamaCare offers a number of protections and benefits to all Americans. Beyond the 10 essential health benefits mandated by ObamaCare, additional benefits range from chipping away at pre-existing conditions to expanding health services. Overall, the quality of health care is increased, while the cost, in theory, will be reduced. Middle income Americans (those making between 133% – 400% of the federal poverty level), and employees will be able to use tax credits and out-of-pocket subsidies on theexchanges to save up to 60% of the current cost of premiums making insurance affordable for up to 23 million Americans.
Affordable insurance is defined as costing less than 8% of your annual income. Tax credits cap cost at 9.5% for sliver plan for those making between 300 – 400% FPL. One of the cons of ObamaCare is that since many Americans work for larger employers, some employees may have the new costs involved with insuring their workforce passed onto them. Other workers will see a decrease in quality of plans offered by employers, to avoid the employer paying a excise tax on high-end health insurance plans. These cons will affect less than 1% of businesses, and only a small fraction will deal with the new challenges by cutting worker hours and benefits or not hiring new workers.
When it comes to women, ObamaCare offers many pros and few cons. 47 million women will gain access to women’s health services, including preventive and wellness services. Many of ObamaCare’s new benefits for women are required by law to have no out of pocket payments. There aren’t many cons for women beyond those of the Average American, however there is the issue of contraception and it’s availability. ObamaCare expands contraception coverage but this “mandate” is one of the most contested aspects of the new health care bill and can easily be seen as a con depending on one’s viewpoint.
Essay The Obama health care legislation known as the Affordable Care Act (also known as Obamacare) has received mixed reviews over the last couple years. On March 23, 2010, President Obama signed the Affordable Care Act into law, putting in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices (Health Reform in Action, 2012).
Many people dislike the idea of Obamacare because of misinformation obtained from the press, political candidates and by those who refuse to seek the information themselves and go on hearsay. The new health reform law provides security to the hardworking citizens of the United States. Obamacare holds insurance companies accountable, lowers health care costs, gives Americans more freedom and control in their health care choices and improves the quality of care (Health Reform in Action, 2012). With Obamacare, insurance agencies cannot create limits on care and the yearly limits will no longer exist in a couple of years. More than 5.1 million people on Medicare have saved over $3.1 billion on prescription drugs, including a one-time $250 rebate check to seniors who fell into the prescription coverage gap or “donut hole” in 2010, and a 50% discount on brand-name drugs worth an average of $604 per person in 2011 (Health Reform in Action, 2012).
In every state and for the first time ever, insurance companies must publicly justify their actions if they want to raise rates by 10% or more and more states have the authority to reject unreasonable premium increases (Health Reform in Action, 2012). President Obama has stated on several occasions that the new health legislation would start out slow but pick up over time to compensate for the initial loss. Advocating for health care will ensure that American citizens…
1. ACA allows young Americans to stay on their parents’ insurance plans Because of ObamaCare, which allows kids to stay on their parents insurance plans until age 26, 3.4 million young Americans now have coverage. The percentage of uninsured young people (ages 19 to 25) fell accordingly, from 48% in 2010 to 21% in 2012. According to polling, three-in-four Americans support this part of the Affordable Care Act including, yes, over two-thirds of Republicans. 2. ACA bans insurance companies from denying coverage for pre-existing conditions Another aspect of ObamaCare that has already taken effect is the ban on insurance companies denying coverage to patients based on pre-existing conditions.
That means an end to insurance company horror stories like four-month-old Alex Lange being denied health insurance because he was too chubby. This is why the conservative allegation about death panels is so ironic; while the actual ACA law does not contain death panels or anything remotely like them, the fact is that prior to ObamaCare, insurance companies were effectively operating like death panels in denying life-saving coverage to anyone with a pre-existing condition and by applying life-time spending caps on coverage. The ban on pre-existing condition limits, which will apply to every single American by 2014, is supported by 83% of Americans. 3. ACA offers tax credits to small businesses to buy insurance The Affordable Care Act expands tax credits to help small businesses provide health insurance to their workers.
Companies with fewer than 50 employees do not have to provide insurance, but even for these businesses, ObamaCare will make it easier and cheaper if they choose to do so. According to polling, 88% of Americans think these small business tax credits are great, including — wait for it … yes, 83% of Republicans. That’s right, over eight-in-ten Republicans support the provision of ObamaCare that helps small businesses afford and expand their health insurance offerings to employees. 4. ACA requires companies with more than 50 employees to provide health insurance Over 96% of companies with more than 50 employees already provide health insurance to their employees. And contrary to Republicans claiming otherwise, studies show the vast majority of those employers do not plan to drop or reduce that coverage because of ObamaCare. Also, there is no evidence that ObamaCare has led to companies slashing full-time workers. In fact, since ObamaCare passed in March 2010, over 90% of the gain in employment has been full-time positions.
Still, we know that companies that can afford to provide health insurance to their workers and yet fail to do so off-set the costs of care onto the rest of us — whether the cost of emergency room treatment that gets passed on to other consumers, or Medicaid coverage that we pay for as taxpayers. In Florida alone, more than 50,000 workers at companies like McDonald’s and Burger King are on the state’s Medicaid rolls. Especially with tax credits available to small businesses, there is no excuse for companies to pass the buck. And 75% of Americanssupport this element of ObamaCare. 5. ACA provides subsidies to help individuals afford coverage Many of the 45 million Americans who lack health insurance simply don’t have enough money to afford coverage. ObamaCare will lower the cost of premiums but also provide subsidies to help low- and middle-income Americans purchase insurance. Americans who earn $45,000 per year (about 400% of the federal poverty level) will qualify for some form of subsidy. The amount of the subsidy will be based on income as well as the cost of health coverage in a particular state but, for instance, according to a subsidy calculator created by the Kaiser Family Foundation, a 27-year-old living in Houston, Texas, who earns just $15,000 a year could sign-up for a mid-level plan for about $300 per year with the help of subsidies.
Without subsidies, that plan would cost $2,400 per year. The few Americans who think subsidizing care is a bad idea should, again, note that we already subsidize health care to a far greater degree in the form of Medicaid and also when the uninsured rely on free emergency room care and pass those astronomical costs on to the rest of us. But most Americans — 76% to be exact — support the individual subsidy. That includes 61% of Republicans. There’s even more aspects of ObamaCare that the American people already support — including the employer mandate, the increased Medicare payroll tax on higher-income Americans and the expansion of Medicaid. And then, starting October 1, here’s one more:
6. State-based health insurance exchanges Americans of all political stripes like choice and competition, which is precisely what the ObamaCare health insurance exchanges will create. So it’s no wonder that 80% of Americans — including 72% of Republicans — support the health insurance exchange program in ObamaCare. And that’s even before the exchanges have taken effect! Plus, a new report shows that health insurance premiums will beeven lower under ObamaCare than originally projected. Personally, as someone who pays through the nose for individual insurance in New York State — a state where, historically, few individual insurance options have even been available — I can’t wait to enroll in ObamaCare and see my premiums plummet, as they are expected to by at least 50%. Again, all this is why Republicans are in such a desperate rush to try and defund ObamaCare before October 1 — even if it means holding our economy hostage and even if most voters, including Republicans,oppose the repeated and wasteful defunding attempts. After all, the law is already popular when it’s not fully in effect and most people haven’t felt its benefits.
We all know what will happen when ObamaCare takes effect — and works! Republicans who are throwing temper tantrums over sour grapes need to grow up. Congress passed the Affordable Care Act, President Obama signed it into law and the Supreme Court upheld its constitutionality. The cost of doing nothing on health care reform was too great and the cost of repeatedly refighting the political battles of the past is obscene.
But then again, it makes perfect sense why Republicans refuse to just give up and shut up — because the minute they do, there will be no more distractions from all the good things about ObamaCare. Three years ago when I was shopping for insurance, there weren’t that many options to choose from. And the plan I ended up with is expensive and, to put it bluntly, crappy. Currently, I pay $965 per month for family coverage that includes: • a whopping $7,000 deductible;
• $36,000 out-of-pocket max per year; • an annual coverage limit of $2,000,000; • a $35 co-pay for doctor’s visits ($55 for specialists); and • a $15 co-pay for generic prescriptions. All this plus the plan has very limited out-of-network coverage that, I found out the hard way, is subject to such a gauntlet of procedural hurdles that my family has spent thousands of dollars in so-far-unreimbursed out-of-network expenses. I’m not going to tell you who my current provider is, though I’m inclined to purely out of loathing and spite. But for the record, for over a year I paid for their version of “gold” coverage that had a $3,000 deductible, only a $25 doctor’s co-pay and a $6,000 out-of-pocket max. But that plan didn’t process any of my reimbursements either and cost a whopping $1,687 per month.
That’s over $20,000 per year! You can see why, regardless of what party I vote for, I was excited to have some more affordable options. So I logged onto the New York State health insurance exchange website. Yeah, I had a few false starts — the website was down a lot early on either because of service glitches or overwhelming traffic. For a few days, I couldn’t do anything at all on the website. Then for a day or so I could “log-in” but not complete registration. And then for a day, I could answer the questions to complete my registration but not actually complete the process. On one occasion, I got so frustrated at the stalled exchange website that I actually shook my computer. Not pleasant.
But finally, early on the first Saturday morning following the launch of the exchange site — probably because the rest of the state (unlike my five-year-old) was still asleep — I was able to log-in and complete my registration and check out all my options for insurance. There were literally 50 plans that were better than my current insurance — both with lower premiums, lower out-of-pocket costs and better coverage. And there were ten plans with a higher premium than my current insurance, but with lower deductibles.
So — and here’s an important point — the reason that more people haven’t signed up for coverage yet is probably that, just like me, they needed to take some time (and first, find some time!) to weigh all the options. While the exchange site was user-friendly and explained my options in a clear and simple way, picking an insurance plan isn’t exactly like ordering a hamburger. It took a minute to find my calculator and think about the options. Within a week, I had settled on a “gold” plan offered by Empire Blue Cross Blue Shield. The plan includes: • a $2,000 total deductible;
• an out-of-pocket max of $12,500 for the year; • a $30 co-pay for visits to our primary care doctor; • a $15 co-pay for generic prescriptions; • NO annual coverage limit — because that’s now prohibited thanks to the Affordable Care Act; plus • an added bonus: the plan I selected includes child dental. This option will cost my family $931 per month — $408 per year less than my previous crappy plan and a $5,000 savings in deductibles. A big win for me and my family financially and in terms of what’s covered. Plus in the past, I spent several days looking for and comparing insurance options. Under ObamaCare, even with the slow and sticky website, I spent a total of four hours — to save over $5,400.
That kind of return on investment would make Warren Buffett drool. Counter to wild stories about the government taking over health care, the exchange was simply a public portal to a range of all-private insurance options. I went with a “gold” plan for lower deductible and out-of-pocket costs. And I chose Blue Cross Blue Shield because my current primary doctor is in-network. But one of the most exciting things is the new companies providing private insurance through the exchange; I’ll be watching the reviews over the next year and might change plans when re-enrollment comes around. As of October 20, the Associated Press reported that 476,000 Americans had filled out insurance applications through the federal and state exchanges. Not bad, considering the poor performance of the sign-up websites.
But it’s only been 20 days since the exchanges launched, and folks have 60 more days (through December 15) to sign up for coverage to take effect on January 1, 2014. And people have 60 days after that (February 15) before the individual mandate penalty kicks in. In other words, there’s still plenty of time to fix the websites and for more Americans to enroll — and save. Meanwhile, we know that in a state like Oregon, ObamaCare has already reduced the number of uninsured individuals by 10%. Glitches aside, that’s a great start. We’ve suffered through four years of outlandish attacks against ObamaCare — that it will kill our grandmothers, or at least just kill our economy. But the fact is that ObamaCare has created a private marketplace so that millions of American families like mine can get affordable, quality health insurance while keeping more of our hard-earned money. Ideologues may not like ObamaCare, but my wallet and my family’s health sure do.