Wednesday, April 24, 2013

Health Care Reform Confusion

If you think you are confused about ObamaCare and what it will mean to you and your family, you are not alone.  Confusion is rampant and open enrollment for the health exchanges is supposed to start October 1.   Yes that is a mere 6  months from now!  Despite this looming date, the various States still don't know what they will be offering and doctors and hospitals also have no idea how it will work.  There seems to be no plan on how to get the word out to the uninsured public.
Most uninsured people don't even know they will have new insurance options under the Affordable Care Act.   If you have insurance now through your employer, not much will change.

Here are some basics that we do know:

  • The exchanges will start covering patients on Jan 1, 2014.  Each state will have its own exchange for people who don't have employee coverage.  There will also be a plan for small businesses to offer to employees.  The vast majority of people who have health insurance from their jobs will not see a change.
  • There will be three types of exchanges to start: those run by states, those run by the federal government and private partnerships. 
  • Patients will be able to pick from a range of private plans and the government will help eligible people with the premiums.  We have no idea what those premiums will be but if the last few years of rising health insurance cost is any indication, it will not be affordable.  Low income people will be steered to safety-net programs like expanded Medicaid.
  • Only legal residents of the United States will get help with premiums.
  • There are confusing formulas for different plans.  All of the proposed plans have deductibles and co-pays on top of the premiums and people will need to choose their plan based on premium price and deductible.  
  • It is unknown which doctors or hospitals will be within the various exchanges or networks because they aren't even formed yet.  Providers are just as confused right now as the general public.
  • Insurers will be forbidden to deny health insurance for pre-existing conditions or other health status.
  • It is predicted there will be a vast shortage of doctors and clinics to care for the new patients with insurance and the new demands for health care.
  • 48 million Americans (15% of the population) have no health insurance now.
Stay tuned over the next few months.  Hopefully some clarity will start to be revealed.

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