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| Many people are unaware of all the benefits of ObamaCare. |
The Affordable Care Act (also known as ACA or
ObamaCare) benefits everyone, not just the 20 million people who have bought
their insurance on an exchange or the millions who were able to qualify for
Medicaid. Its repeal will hurt everyone in one way or another.
It is not a perfect program, but neither was
Social Security and Medicare when they first started. The ACA, like these other
programs, may need a few tweaks.
The individual aspects of the ACA are mostly popular.
The part people don’t like is the mandate that says everyone must have
insurance coverage or pay a fine when they file their income tax return.
Unfortunately, without the mandate, the whole
system falls apart. Take away the mandate, and all of their ACA-provided benefits—and
they are many—will become untenable.
BENEFITS
Young
People Benefit
Young people get to stay on their parent’s insurance
until the age of 26 instead of being cut loose when they turn 19. This is a
great benefit since many young people are in college and don’t have jobs that
would provide insurance.
Medicare
Enrollees Benefit
Are
you on Medicare? If so, the ACA is providing you with many benefits. he ACA
made many changes to Medicare that benefit enrollees.
Dismantling
ACA would likely mean higher premiums and higher deductibles or the 57 million
senior citizens and disabled Americans enrolled in the program. The typical
Medicare beneficiary is paying about $700 less in premiums and cost sharing this
year because of slower growth in costs.
The
ACA slowed the growth of payment rates to hospitals and other providers.
Repealing the ACA would increase Medicare spending by $802 billion over 10
years, according to estimates by the non-partisan Congressional Budget Office.
Obviously, these increased costs would mean higher premiums for enrollees or
for taxpayers in general.
People who are on Medicare are also getting
lower-cost prescription drugs. Additionally, the “donut hole” in prescription coverage
is shrinking and will end by 2020.
The infamous “donut hole” meant that prescription
drugs were covered up to a certain amount and then the person had to pay 100%
of prescription costs. Since
the ACA was enacted .in 2010, more than 11 million people have saved an average
of more than $2,100 a person on prescription drugs. The donut hole would return
if Obamacare were repealed.
Under
the ACA, Medicare enrollees receive free preventative benefits, such as
screenings for breast and colorectal cancer, heart disease, and diabetes. This
provision would be gone if the ACA was repealed.
Slower Cost Increases
The
health reform law has slowed the growth of payment rates to hospitals and other
providers.
Of
course, there is still some increase in the cost of premiums and co-pays each
year. That was happening before the ACA also. The important thing is that the
rise in costs has been slowed.
No More “Pre-Existing
Condition” Exclusions
Formerly
anyone who was sick or who had previously been sick with a serious disease
(like cancer or heart disease) would be refused healthcare insurance. Now they
must be treated like everyone else
The ACA mandates that insurance companies spend 80% of the money they get from premiums on care. Some people get refund checks from their insurance company for excess payment. This keeps costs down because insurance companies can't spend the money they get from premiums on big bonuses and other wasteful "overhead" costs.
No Annual or Life Time Caps
Previously
insurers would only pay up to a certain amount. If you had a very serious
disease you could be forced into bankruptcy because you could not pay the high
costs of the care needed.
The
law also capped the amount of out of pocket expense, Right now after you reach a
certain amount in annual expenses, your insurance pays 100%
Free
Contraceptives and Medical Tests
Many
people are getting free contraceptives, mammograms, colonoscopies and
cholesterol tests.
Free
contraceptives help keep costs down because pregnancy is expensive.
The
free tests help keep medical costs down and save lives because disease can be
discovered at an early stage when it is more easily cured.
Women Are Treated Equally
Previously
women were charged higher premiums than men. Now women and men pay the same
premium.
Older People Are Not Forced
to Pay Super-High Premiums
Older
people can be asked to pay higher premiums than younger people. However, the
amount is capped at three times the cost paid by younger people.
Mental Illness is Treated the
Same as Any Other Illness
Previously
insurers could refuse to cover mental illness or they would charge higher
co-pays. Now all illnesses are treated the same.
Small Businesses Save on
Premiums
A
small business which provided insurance can no longer be slapped with
super-high premiums if their workers are older or sicker.
Also
small businesses who could not afford to provide health insurance can now
receive subsidies for proving health insurance.
Small
businesses can better compete with larger companies for employees because they
can offer health insurance.
Small Business Start-Ups
Previously,
someone who wanted to leave a corporate job and start his or her own business
could not do so because they could not afford to give up the health insurance
benefit provided by their employer.
Your Employer Must Provide
You with Insurance
The
ACA said an employer with 50 or more employees must provide health insurance to
its workers. You benefit from the group rate so your premiums are likely lower.
Without
the ACA, you might not be able to find affordable insurance on your own,
especially if you had a pre-existing condition.
Many of the benefits of ACA, like no annual or lifetime caps on benefits, apply to employer-provided group plans.
Medicaid Expansion for Low
Income People
Before
the ACA, for the most part, only low-income children, pregnant women,
parents, the disabled, and the elderly could be covered by Medicaid. The health
reform law opened up the program to all low-income adults with incomes of up to
138% of the poverty line
Since
Medicaid is a state program, states had to opt in. The District of Columbia and
31 states opted into the program. It is very good for the state’s budget
because the federal government covered the total cost for the first three years
and 90% of costs thereafter.
Subsidies to Low and Moderate
Income People
The
ACA set up health insurance exchanges to allow Americans to shop for individual
policies and created federal subsidies so people with low or moderate incomes could
buy policies for less than 10% of their income.
Another
set of subsidies limit the deductibles and co-payments for lower-income
policyholders.
Higher Income People Also Benefit
If
your income is too high to qualify for a subsidy, you still receive all of the
other benefits.
NEGATIVE IMPACTS
Yes, Some People are
Negatively Impacted
People
who were uninsured may resent being forced to have insurance. If they have a
serious illness, they will change their mind in a hurry.
People
who had “junk policies” now have to buy policies that meet certain standards,
and this policy may cost more than what they had before. If you had one of
these junk policies, you thought you were insured, but if you had gotten sick,
you would have quickly found out that your out-of-pocket costs would have been
very high.
Some
employers who were not providing health insurance now have to provide it.
THE
MANDATE
Unfortunately, without the mandate, the whole
system falls apart. Take away the mandate, and everyone will lose all of their ACA-provided
benefits.
Insurance is often mandated by the government.
If you own an automobile you must have auto insurance. If you have a mortgage
loan, your bank insists that you have homeowners insurance. Why should heath
insurance be different?
Without a mandate, some people might just wait
until they got sick to buy insurance. (Without the premiums from healthy people and
with the added costs of more sick people, insurance companies would collapse.)
Young people especially might feel that they
don’t need insurance. It is true that they are less likely to get sick than
older people, but if they were one of the unlucky ones, they could be forced
into bankruptcy. If they were too sick to work, they could be fired and lose
their employer-provided insurance.
The mandate helps keep insurance costs and medical
costs down. When patients are insured, providers are sure they will be paid. Previously,
the losses incurred because of freeloaders had to be made up by charging everyone
else more.
CONCLUSION
I
think nearly every American is getting some benefits from the ACA. I think people are taking these benefits for
granted or they are unaware that they are getting them.
Dismantling
the ACA would affect the entire economy in a negative way. The health care
industry would suffer the most, but the ripple effects would hurt every aspect
of the economy.
Republicans offered replacement plans. They can be called “The Twice the
Cost, Half the Benefits Plan.” Plus millions will lose their health insurance entirely. Truth is, if there were a better way to do this,
someone would have put forth the plan by now. All that needs to be done is a few fixes to make the ACA work better.
Even some Republicans in Congress don't like these new plans.
Tell Congress:
NO
REPEAL! NO REPLACE!
Here is where you can find the phone number for members of Congress. Click this link.
Call Your Senator: Phone Numbers for Every Office of Every Senator
More Information
Here is some information about how Republicans are sabotaging the ACA to force it into failure. Click the link to read the article.
The book is
divided into three parts. In Part I, Emanuel gives us the history of the
American health care system. In Part II, he reports on the efforts to reform
the system., In Part III, he tries to predict the future for this bill. (The
book was written in 2015.) Some of his predictions were right on, but others missed
the mark. Crystal-ball gazing is always hazardous.
Just a note: You can show your support for my posts
by using the above link when you purchase this or any other book. I thank you
in advance.
©
Catherine Giordano 2017
