ObamaCare Benefits You (Even If You Don't Know It)

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 The donut hole would return if Obamacare were repealed.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.

How Republicans quietly sabotaged Obamacare long before Trump came into office

Democrats had a victory when the TrumpCare bill went down in flames. Now Republicans will attempt to destroy it with Plan B. Trumpcare Plan B for ObamaCare: Destroy It

If you want to know more about the ACA, the best book to read is Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System by Ezekiel Emanuel, an oncologist and bioethicist.  

CLICK HERE

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