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THE OBAMA HEALTH CARE REFORM LAW

4/29/2013

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According to a survey performed by a New York based research firm called Commonwealth Fund, in 2012 there were 55 million US citizens (30%) without health insurance and another 30 million US citizens (16%) who were underinsured.  Underinsured being defined as having a plan that offered too little coverage while exposing them to high out of pocket cost. 
These were adults who fell between the ages of 19-64 and therefore were not eligible for government health programs.  Given that for 2012, the poverty level was established as earning an income less than $11,490 for an individual, it was no surprise that while conducting their survey the Commonwealth Fund learned that those who earned less money were more likely to be uninsured or underinsured.  In fact, in their survey they found that if they placed all those who they surveyed who had incomes less than $46,000 (4 x the poverty level – a number which will be important later in this discussion), it became apparent that about 45% were either uninsured or underinsured.  (Of interest, in this same survey, 5% of those making $92,000 a year were uninsured – which makes one wonder if a certain percentage of the population just prefers to go without insurance – even if they could afford it).

Beginning in 2014, ‘Obamacare’ will finally arrive.  It requires all US citizens to have health insurance.  If a person opts out of having health insurance then they will be fined.  Currently, there are 300 million people in the US.  For those of working age, 150 million obtain their health care through their workplace.  Only 15 million purchase their own health insurance.  As mentioned above, there are 55 million uninsured.  The remaining 80 million in the US represent the young, old, military and immigrants who are on government healthcare programs (Medicare, Medicaid, VA, county health).  Here are some of highlights …

1) It establishes a Patient Bill of Rights which includes …
  • insurance companies cannot discriminate because of pre-existing condition
  • insurance companies cannot discriminate because of sex
  • insurance companies cannot discriminate because of age
  • insurance companies cannot discriminate because of smoking
  • more …

2) It establishes extensive coverage …
  • maternity
  • prescription medications
  • more …

3) It allows those who earn less than 133% of the poverty level ($14,856) to qualify for Medicaid

4) It offers financial assistance in the form of tax credits for those individuals who earn less than 4 x the poverty level ($46,000).  This tax credit goes to the individual or the small business – whoever is responsible for paying the premium.

Immediately, Big Health insurance companies have predicted huge increases in premiums in the range of 25-110% for the calendar year of 2014.  They argue that this will be necessary to meet the new demands created by the Health CareReform Law.  According to the federal government’s own predictions, they estimate an increase in premiums between 10-13%.   The government further points out that 57% of consumers will earn less than $46,000 so will be eligible for tax credits which will – on average – cover 2/3 of the cost of the premium.

As of today, there are a number of states (8 – including Idaho) that do NOT want to automatically extend Medicaid to all those who earn less than $14,856.  In addition, there are still many states that are not prepared to go live with Obamacare on October 1st, 2013 as they do not have Healthcare Exchanges in place.  Washington and Oregon have Healthcare Exchanges in place and do want to include Medicaid.

One IMPORTANT question that the Health Care Law completely fails to address – the rising costs of healthcare.   I suppose it’s one battle at a time for a president.

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