Wednesday, November 14, 2012

My opinion on the Affordable Care Act, or Obamacare

I think there has been a lot of confusion about what Obamacare is actually about, so I thought I would give a summary here, with the help of Wikipedia and discussions I have had in classes, other students, and doctors. I think I'll just continue to call it Obamacare because the PPACA or the Patient Protection and Affordable Care Act is just a mouthful to say. And President Obama said that he also likes the name, so I don't think it's disrespectful.

Just in case you're curious, this is the entire 974 pages of the entire act.

Basically, Obamacare is the biggest overhaul to medical insurance since Medicare and Medicaid were passed in the 60s. They made a whole bunch of rule changes to make health insurance more affordable overall and decreasing the number of uninsured Americans.

(FYI: 20-27% of Americans were uninsured in 2009 in Texas, California, New Mexico, Georgia, Florida, and Nevada, with many other states falling close behind.[source].

So what did Obamacare actually change? There are a lot of changes made there were gradually put in place, starting in 2010 and will continue to go into effect in 2014.

Here are some of the changes that have already occurred:

  • The FDA can approve more generic drugs
  • A non-profit was organized to research more effective methods of treatment and management
  • Chain restaurants have to display how many calories are in their foods
  • 10% tax on tanning salons
  • Children can stay on their parent's health insurance plan until they're 26
  • Can't exclude children (under 19) from health insurance due to preexisting conditions
  • Only 20% on profits earned by insurance companies can be used for administrative fees (reducing the amount they can charge on premiums)
  • Certain preventative screenings are done without a deductible, like well-women visits, gestational diabetes tests, human papilloma virus test, HIV tests, and domestic violence screening.
Starting January 2013:
  • A tax increase of 0.9% on those making $200,000 or more who are filing as a single individual, or $250,000 when filing as married-filing-jointly.
Starting January 2014
  • No more preexisting conditions for anyone anymore. Everyone will be charged the same regardless of their gender or medical history (except for tobacco use).
  • A penalty (or tax) is given to those who are not on health insurance. This penalty is either $95, or 1% of income over the filing minimum. The penalty will increase in 2016. (There are some exemptions given so you don't have to buy insurance, such as for religious reasons, or if the least expensive option is still over 8% of their income.)
  • Medicaid is extended to all those who are within 133% of the poverty line. (This is $31,000 for a family of 4).
  • Companies who employ over 50 workers are required to offer health insurance to their full-time employees, or they will face a fine.
Starting January 2015
  • Doctors will be paid differently now. Larger payments will be given to physicians who provide high-quality care compared with cost.
Starting January 2017
  • States can apply for a "waiver for state innovation," meaning they can use an alternate health care plan (without the penalties and forcing people to get insurance) as long as the replacement plan is as comprehensive and affordable as Obamacare.  
Starting January 2018
  • All existing health insurance plans must provide preventative care and check-ups without a co-payment. 
An finally, in January 2019
  • Medicaid will extend to former foster care youth who were in foster care for at least 6 months and are under 25 years old.

This plan will be pretty expensive to run initially, but it will actually save money in the long run. It will cost 1.7 trillion dollars to implement (between 2012 and 2020) but it will actually reduce the deficit by by $210 billion during that same time frame.

I think the biggest issue that people have with it is the individual mandate, meaning the government forcing you to buy health insurance. This is what the whole Supreme Court case was about. The Supreme Court upheld this law, saying that the government can "force" you to buy health insurance, because what they are actually doing is just implementing a tax on those who do not have health insurance.The reason why the government wants everyone to buy health insurance is because it will make it cheaper for everyone. If you didn't have to, only sick people will buy health insurance, and then it will be really expensive.

Also, you do not have to switch health insurance if you like the one you have. You can keep it. You don't have to use Obamacare if you don't want to.

All in all, I think this is pretty good. It's not perfect, but I think this is better than what was in existence before. One thing I would change if I could would be the requirement that companies offer health insurance. I think it is totally weird and archaic that our places of employment are also the sources of our medical insurance. These two things have nothing in common! They only started doing this during WWII when there was a government restriction issued on how much companies could pay their employees, so companies started offering other benefits beside salary (like health insurance and retirement benefits) to attract new employees.

Anyway, that is all that I know about Obamacare. I learned some new things while researching this, and hopefully you did to!

1 comment:

Kathy Haynie said...

Bryan, thank you. This is the clearest and most comprehensive summary I have read to date on the legislation. i am very much in favor of making health care more affordable to all. I appreciate this post!