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On the Affordable Care Act
By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com
“I’m not sure what’s wrong or what kind of surgery you need, but we have to operate right now.”
If you heard this from your doctor, you’d jump off the examination table and run for the door. Yet that’s essentially the approach the President and Congress used three years ago to pass a bill, optimistically called the Affordable Care Act, which was the largest transformation of the U.S. health care system in our lifetime.
The Debate
During the frenzied debate our elected leaders made many promises as to the amazing benefits this legislation would bestow on Americans. After listening to speeches from President Obama, Speaker of the House Nancy Pelosi, and President of the Senate Harry Reid, I recounted those promises in this blog on March 21, 2010.
The Promises
Let’s revisit those promises.
- All Americans will now receive affordable, or free, quality health care.
- No one will ever be denied coverage.
- No one will ever go into bankruptcy because of the costs of health care.
- There will be increased access to health care for 95% of Americans.
- There will be no decline in the quality of health care.
- Health care costs will go down.
- Health insurance coverage will be affordable to the middle class.
- There will be no decline in Medicare benefits.
- Insurance premiums will decline for the middle class.
- It will unleash unprecedented entrepreneurial opportunity for the economy.
- The deficit will decline, saving taxpayers $1.3 trillion.
- It will cut $500 billion of waste, fraud, and abuse out of Medicare.
- No government funds will be used to fund abortion.
Are these promises coming true? Many of them are pending full implementation of the act in 2014. Others have fallen flat or encountered the law of unintended consequences.
Business Owner’s
I’ve heard recently from several owners of small businesses about their increased health insurance costs. In addition to premium increases of nearly 50% over the past two years, they are seeing increased administrative costs from what one person called the “insanity and complexity” of the new regulations.
Businesses with fewer than 50 employees aren’t required to provide health insurance. The incentive for owners of businesses close to that threshold is to keep employee numbers below 50, which means curtailing growth or even laying people off.
Those without employer-provided insurance are supposed to be able to shop for coverage in new health care exchanges, beginning this October. However, half the states have chosen to rely on the federal government instead of setting up their own exchanges.
This has brought criticism even from former supporters like Democratic Senator Max Baucus of Montana, who helped write the health care bill. He is concerned that the exchanges will not open on time and consumers won’t have the information they need to use them. He told the Huffington Post that Obamacare is headed for a “train wreck.”
ACA Cost Estimates
The proponents said the ACA would cost $938 billion over 10 years. In addition to the promised Medicare savings, this was to be covered by a total tax increase of $562 billion over 10 years. This included a Medicare tax of 3.8% on dividends, rents, interest, and investment income on individuals and small business earning over $250,000.
The Office of Management and Budget, however, places the cost at $1.8 trillion over 10 years, resulting in a shortfall of around $900 billion.
Assessment
Whether Obamacare becomes the wild success the proponents guaranteed is yet to be seen. However, what we’ve seen so far isn’t promising. We as consumers would be well advised to pay close attention and ask tough questions before we accept this drastic surgery.
More
- Take the National ObamaCare Quiz
- With Obama Election Win “Mr. Market” Weighs in on the ACA Equity Winners and Losers
- How Hospitals Can Profit thru ObamaCare
Conclusion
Are these promises coming true? Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
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Filed under: Health Insurance, Health Law & Policy | Tagged: ACA, Affordable Care Act., Harry Reid, Max Baucus, Obama care |
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Rick
Great update and reminder of the “promises” of ACA. My biggest concerns are the loopholes that still exist with ACA – the biggest being that healthy Americans may choose to pay the “tax” instead of pay for health insurance, which could be a sustantially less expensive route. On becoming sick, the individual can then get insurance immediately (no denied coverage for pre-existing conditions under ACA).
ACA will not work if a large population of healthy Americans can opt out by paying the tax penalty. It is also questionable on how aggressive the IRS can get in collecting the penalty tax for those Americans that don’t even pay the tax.
David K. Luke MIM CMP
http://www.CertifiedMedicalPlanner.org
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IRS Policing ObamaCare
I understand that the IRS is hiring more than 1,000 new agents next year to track our HI for the ACA. And, there will be a new line item on our federal tax returns to name the HI that we have, and how much we pay; along with our PHI and our entire e-medical history.
Moreover; there will be no Chinese Wall of separation between your e-MRs and the IRS. And so, will this IRS mess stall the ACA? Any thoughts?
Elliott
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Gov’t Still Hasn’t Explained What Docs Have To Do
Physicians are required to develop and maintain a compliance program in their practice under the Affordable Care Act (ACA), a burden some health policy experts say could be a heavy one for some practices.
http://www.healthcare.gov/law/full/title/vi-transparency-program-integrity.pdf?utm_source=5.31.13&utm_campaign=11713&utm_medium=email
However, the federal government has yet to release guidelines on what these compliance programs should involve.
https://oig.hhs.gov/authorities/docs/physician.pdf?utm_source=5.31.13&utm_campaign=11713&utm_medium=email
Carter
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ACA Security
Will enrollment in Obamacare result in security, tax info, identity theft and fraud breaches to patients?
Russell
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Obamacare is behind schedule … Protect your jewels
“Obamacare months behind in testing IT data security” by HealthIT, August 8, 2013.
http://healthcareitsystems.com/2013/08/obamacare-months-behind-in-testing-it-data-security/?goback=%2Egde_4467744_member_264473529#
Due to foot-dragging by CMS, the go/no go deadline for certifying that the health Exchanges are sufficiently secure has been moved from September 4 to September 30…. 24 hours before the Exchanges are to open on October 1.
Because of potentially disastrous PR consequences for Obamacare should the opening date of the Exchanges be delayed , experts already warn that they are likely to open with possibly huge security flaws. So hold on to your private parts for as long as you can, because once your privacy is breached, you can never get it back.
If it is Americans’ DNA that is fumbled, the liability could last for generations.
D. Kellus Pruitt DDS
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New Obamacare rule delay could really hurt
Insurers are getting a one-year reprieve on a key provision aimed at limiting consumers’ out-of-pocket costs.
http://money.msn.com/now/post–this-obamacare-rule-delay-could-really-hurt
Morton
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10 health care benefits covered in the Health Insurance Marketplace
1.Outpatient care—the kind you get without being admitted to a hospital
2.Trips to the emergency room
3.Treatment in the hospital for inpatient care
4.Care before and after your baby is born
5.Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
6.Your prescription drugs
7.Services & devices to help you recover if you are injured, or have a disability or chronic condition. Includes physical & occupational therapy, speech-language pathology, psychiatric rehab & more
8.Your lab tests
9.Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
10.Pediatric services: This includes dental care and vision care for kids
Source: Healthcare.gov, August 20, 2013
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Uninsured Americans who will be Eligible for Coverage
[56% Of Eligible Uninsured Individuals May Qualify for Medicaid, CHIP, or Tax Credits to Purchase Coverage]
A report released by the Department of Health and Human Services (HHS) shows that of the 41.3 million individuals who are uninsured and eligible for coverage, 23.2 million (56 percent) may qualify for Medicaid, the Children’s Health Insurance Program, or tax credits to purchase coverage for $100 or less per month through the Health Insurance Marketplace.
If all 50 states took advantage of new options to expand Medicaid coverage, nearly 8 out of every 10 people (78 percent) who currently do not have insurance could be paying less than $100 a month for coverage under the Affordable Care Act.
While some states are expanding their Medicaid programs in 2014, other states are not doing so. Under the health care law, states can receive 100 percent federal funding in 2014 to expand their Medicaid programs to cover people with incomes up to 133 percent of the federal poverty level. That’s about $15,800 a year for an individual, or about $32,500 for a family of four.
Source: U.S. Department of Health & Human Services
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Congress
Congress [both houses] should give up the ACA exemption if they think it is so good.
Jefferson
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ME-P friends,
We are seeing the markets react to Congress being unable to reach a deal. Didn’t we see this “movie” before and experience the same market volatility?
The markets posted positive gains following the first showing. So, what do you think about now?
Sean G. Todd Esq CPA CFP MTax
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Health Law Mandate Put Off Again
Most employers won’t face a fine next year if they fail to offer workers health insurance, the Obama administration just said, in the latest big delay of the health-law rollout.
The Obama administration said employers with 50 to 99 full-time workers won’t have to comply with the law’s requirement to provide insurance or pay a fee until 2016.
Companies with more workers could avoid some penalties in 2015 if they showed they were offering coverage to at least 70% of full-time workers.
Changing promises?
Ann Miller RN MHA
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Wheels falling off?
Darrell Pruitt DDS
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Survey: 67% of consumers say the healthcare system is on the wrong track
According to a recent survey released by by Booz Allen Hamilton and Ipsos Public Affairs:
• 34% of administrators think that the healthcare system is on the right track.
• 24% of primary care physicians share the view that the healthcare system is on the right track.
• 10% of specialists share the view that the healthcare system is on the right track.
• 67% of providers are satisfied with their current practice.
• 61% believe that their organization is well positioned to succeed in a changing healthcare environment.
Source: Ipsos-na
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The Unaffordable Care Act
Liberal public health advocates and left-of-center health policy wonks have long thought every American needs health insurance (they don’t, but that’s another discussion). Lefties assume health insurance is the only way Americans access medical care. After all, the purpose of the Affordable Care Act was to insulate Americans from the financial hardship of medical care they couldn’t afford to pay for out of pocket. Moreover, many pundits believe having to reach for one’s wallet during a medical encounter is unacceptable.
http://thehealthcareblog.com/blog/2016/01/21/the-unaffordable-care-act/
So imagine my shock when I read a headline in The New York Times claiming that Obamacare is no guarantee against crushing medical bills.
Russell
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Narrow Network Impact on Premium Rates and ACA Marketplace
[New Research Findings]
Narrow provider network strategies have been increasingly deployed by health plans seeking delivery systems with enhanced potential to provide optimum value based care with respect to cost and quality. Many provider sponsors have pursued development or evolution of narrow network capabilities in response to Medicare ACO and commercial ACO and value based demand. An expectation exists that health plan narrow network offerings should yield a relatively lower premium cost. The question now at hand is to what extent have narrow networks delivered on lower premiums in the marketplace to date?
Previously, studies that have investigated the empirical relationship between narrow networks and premiums have used only a single state. A new study – funded by the Robert Wood Johnson Foundation “Measuring Provider Network Characteristics of Health Insurance Exchange,” principal investigator, Daniel Polsky – examined data from all silver plans offered in the 2014 health insurance exchanges in the fifty states and the District of Columbia to estimate the association between the breadth of a provider network and plan premiums.
The study found that within a market, for plans of otherwise equivalent design and controlling for issuer-specific pricing strategy, a plan with an extra-small network had a monthly premium that was 6.7 percent less expensive than that of a plan with a large network.
via Ann Miller
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