By Van P. Keele, Hamilton
Obamacare is law. The conservative US Supreme Court recently ruled that Obama’s Affordable Care Act (ACA) is in fact constitutional. Despite tens of millions of Americans now benefiting from Obamacare, it remains controversial, misunderstood, and disliked by many–many who already benefit from it. Having passed constitutional muster and now 2 years in, it’s a good time for everyone, even disgruntled Bitterrooters, to revisit the law’s provisions and benefits, some of which don’t start till 2014.
Starting in 2010 the ACA provided cost-free preventive health services to millions, like mammograms and colonoscopies. It provides strengthened patient rights by prohibiting denial of insurance to children due to pre-existing conditions and prohibiting insurers from rescinding coverage, once illness strikes, due to innocent errors on one’s application.
ACA eliminated lifetime coverage limits. Millions of small businesses were eligible for tax credits to help them provide insurance to workers. About 4 million seniors got a tax-free $250 rebate check to help plug the Medicare Part D “donut hole.”
In 2010 Obamacare wisely provided incentives to increase the number of primary care doctors, nurses, and physician assistants, with emphasis in underserved areas (think Montana). Likewise, payments increased to rural healthcare providers. Thanks to the ACA there’s new efforts fighting Medicare fraud, with $4 billion recovered.
Last year Obamacare required at least 80-85% of all health insurance premium dollars to be spent on benefits and quality improvement; otherwise rebates must be provided to customers with notification by 8/1/2012. Because of Obamacare $billions will be rightfully returned to customers this year and not pocketed by overly greedy insurance CEO’s.
More benefits came to seniors in 2011 with further “donut hole” shrinking, and more free preventive services like wellness visits.
Unfortunately there’s a blatant lie that Obamacare cuts Medicare by $500 billion. It doesn’t. What it does is gradually eliminate the almost $1000/person overpayment by Medicare to Medicare Advantage insurance companies. This levels the playing field between Traditional Medicare and Medicare Advantage by ending this wasteful, budget-busting $1000/year discrepancy while still guaranteeing all Medicare benefits. This cuts the overpayments which have raised the premiums on all Medicare recipients. It doesn’t cut Medicare! So call out your politicians, Democrat or Republican, when they claim Obamacare cuts Medicare by $500 billion.
Beginning in 2013 primary care doctors will get increased Medicaid payments (equal to Medicare payments), fully funded by the federal government, preparing providers to cover more patients in 2014.
Major Obamacare provisions commence in 2014, including expansion of small business tax credits. In 2014 you can’t be denied coverage for pre-existing conditions, or be charged higher rates due to gender. Tax credits will be provided to middle class folks (between 100% to 400% of poverty line) to make insurance more affordable. Come 2014 state Insurance Exchanges will be up and running, where individuals and small businesses can evaluate different affordable plans and buy them.
Medicaid will expand to cover millions of uninsured. To support the expanded coverage, states will receive 100% federal funding for the first 3 years and 90% funding in subsequent years; much higher federal funding levels than normal, to reduce the states’ financial burden and to insure many millions for the first time.
For too long most of us have paid over $1000/year extra in premiums to cover those uninsured. Many uninsured are freeloaders. Obamacare imposes a tax penalty of $695/year on individuals who can afford basic coverage, but who choose not to (Governor Romney’s “tax” was $1200/year). This helps offset the costs of caring for the uninsured. If affordable coverage is unavailable, individuals are eligible for exemptions. No one pays a penalty if you already have any kind of health insurance. If you run a business with 50 or more full time workers and fail to provide insurance by 2014, then you’ll also pay a penalty.
So what to make of all the hubbub about a $500 billion tax hike?–Blather and fear mongering. Let’s be honest. No “tax penalty” if you have insurance. If you’re not insured there’s tax credits, Insurance Exchanges, expanded Medicaid. What other new taxes are there in Obamacare?–A medical device excise tax of 2.3%, an indoor tanning tax, an annual fee on big pharmaceutical companies, and a 0.9% Medicare tax increase on income over $200,000/year.
Obamacare’s far from perfect. Changes can and should be made. But it’s a decent start to a gargantuan problem that’s stymied many Democratic and Republican presidents. When you strip away the myths, lies, and distortions perpetrated by radical naysayers, you have a constitutional law that’s benefiting many millions; many more in 2014. As people experience the new benefits, patient rights, and services, they’ll cry foul if politicians try to take it all away. Obamacare was the right thing to do. Now let’s move forward.