Report on the TAIPD Forum: The Affordable Care Act (Obamacare): How Will It Affect You?

Gar Byrum

To paraphrase Winston Churchill, one should treat a sickness as if a fire started in your neighborhood and the fire brigade is sent in to put it out.. The Affordable Care Act is a step forward in the effort to put out the fire of illness by having more of our fellow citizens insured.
On October 13,
The American Institute for Progressive Democracy held a public forum on the ACA. For a report what was learned about the Act read on.

The Institute thanks all of the program participants: our Featured Speaker, Gerald F. Kominski, PhD: Director, UCLA Center for Health Policy Research, Professor of Health Policy and Management, UCLA School of Public Health; and our discussants: Stephanie Ramirez, Marcia Davalos, Christina Vera, Katie Roemer, William Fletcher, Chris Aldeworth and Beverly Speak.

Now that several months have passed since the ACA has begun to enroll people into new insurance, it is time to once again ask the question: How will the Affordable Care Act affect you? What have been the positives and the negatives of the ACA?
For many Americans who did not have health insurance, the ACA has been a huge help. The peace of mind that individuals and families now have knowing that if they get sick, they will have insurance has an incalculable value.
With the ACA, many changes have taken place that have changed the private insurance market for the better.
It standardizes insurance in the individual and small group markets. The standardization has made comparing health insurance plans much easier to understand so that the consumer may comparison shop.
What has been of great benefit to all Americans is that the ACA has outlawed the use of  pre-existing conditions by insurance companies as a reason for denying health insurance.  The use of a person's health status eliminated a lot of people from being able to get insurance and for those who had a health condition and were still able to keep their insurance, the fact the insured had a health condition raised the cost of insurance substantially.   Pre-existing conditions no longer matter when it comes to health insurance under the ACA.

Bankruptcies are now less likely to occur as a result of homeowners’ illness – having to pay either the mortgage or health insurance premiums is no longer a choice faced by many many Americans.

For many Americans help will come in the form of Medicaid. The program expands Medicaid eligibility to a single income threshold for everyone. The previous ‘existing asset test’ is no more, except for those individuals who are seeking nursing home care.

The fact that many more Americans will be insured will have several long term positive affects. For many people who were without insurance the emergency room became their mode of care and often that was only when the illness had become most severe. Yearly wellness checkups will act as a means of preventing illnesses. Our average life expectancy as a nation should thereby increase. The ACA is predicted to slow down the ever-increasing cost of care. Only time will tell if that prediction is true. The law has built into the system consumer protections by requiring standards of coverage.

Increased preventive care will have other benefits as vaccines will be made available.

Gender discrimination was is dealt with in the new law as women will be charged the same as men from this point forward.

There are mental health aspects of the law as well, which provide protections where there were none before.

Prescriptions will be a covered expense under the health insurance plans that are being made available.

There will no longer be any lifetime caps on coverage and you cannot be dropped from your plan.

Children are going to be insured which will be a comfort to parents who have been living in fear that their child might get sick.

Tax credits are available to small businesses, so that owners will benefit by being insured and their employees as well.

The following facts are useful: If you as an individual make under $11, 490 you pay zero under the ACA. If you earn as a family of 4, $23,550, you pay zero. And if you have a family of 3 and your income is $20,000 you pay zero.

But, and this is a big but, help is phased out at $94,200 for a family of 4, $78,000 for a family of 3, $62,000 for a married couple and $45,960 for a single head of household.

With the positives of the Affordable Care Act, come negatives as well. Like Social Security and Medicare, the implementation of the program has had problems, some of them computer glitches.

For some Americans, December brought with it cancellations of coverage. While the ACA has made insurance affordable for many Americans, for others whose income is above a certain level, the ACA is not the answer. They are left with the option of obtaining private insurance. In some cases the insurance premiums of private insurance have been raised above what they were before the rollout of the ACA.

Another problem is that for those individuals, whose doctor will not accept HMO's. They are left with a difficult choice. They can leave the doctor that they have a close relationship with and take an HMO under the ACA, or be left with only an option of private insurance that will cost them more money and in some cases the cost might be more than they can comfortably afford. The reason for this that under the Covered California options for PPO's they are more expensive by far as compared to the cost of an HMO. If your doctor does not take HMO patients you are out of luck.

When you looked at the nation as a whole, 28% of households back in 2009 made $25,000 or less, with 35% of persons falling at and under the $25,000 earnings level. For the income grouping of $25,000 to $50,000, those numbers were 23% for households and 36% of persons. These income groupings are the citizens who will be most helped by the Affordable Care Act.

For Californians, who have the exchange entitled Covered California, their median income is higher than the average for the nation and as a result more residents of California are more likely to face sticker shock if their incomes are above the phased out levels.

What therefore can we conclude? We as a nation are much better off with the Affordable Care Act than we were before. How it affects you depends on your income and where you live. For if you live in a state where the standard of living is lower, then many more people will benefit. How can we not be better off as a whole if millions of people who weren't insured before, now have protection and coverage? Real people and real lives are involved and affected when through no fault of their own they get sick. We should all have the opportunity to have the protection necessary to protect each and every one of us against the inevitability of getting sick.