Down and Dirty

Some fifteen years ago I purchased a Blue Cross/Blue Shield single policy for $134 per month which I thought was fairly reasonable. Each year after that the premium went up $100 or so per month until it hit some $600 per month at which point I bailed out. I have been without insurance since then until my last birthday at which I became eligible for Medicare. Obama or Obamacare had nothing to do with those price increases. They were due to exploding medical costs, advancing age and the profit motive. The same is still true today but now the anti-Obama crowd places the blame on Obamacare because that is what many health care providers and insurers are telling them in order to pressure them to lock in a private insurance plan that is not subject to the same restrictions on cost that the public plans will be. Most of those claims are deceptive at best and downright dishonest at the worst.

In just a few days the Affordable Care Act, euphemistically referred to as Obamacare, will begin to operate the insurance exchanges allowing people without insurance to become insured. Insurance companies and health care agencies, along with a myriad of other groups, are using scare and pressure tactics to misrepresent what is going to happen and it is just aggravating to try to tell people that those crying wolf are being either malicious or just uninformed. I know it is of little consequence to many folks but I would like to try to address a few of the crazy things that are being said.

• You are not going to be forced into Obamacare if you have your own insurance. You are exempt. There is a requirement that everyone be insured with some exceptions. You will be penalized if you don't pick up coverage and are not exempt. Why should the general public be required to pay for your health care if you don't have insurance? That is what happens when insurance and treatment rates are increased to cover those losses. I don't like this part but that is what happens when you have to keep the insurance companies happy so they will let their Congressmen vote.

• Costs to you may go up in some circumstances. If you have a gold plated policy that gives you bumper to bumper coverage you may see some increases. The Affordable Care Act is designed to discourage unnecessary procedures that are often done just to make more money. If you insist on having those unnecessary tests it will cost you. Everyone agrees there is too much of this except those making money from it. If you have basic coverage there will be options available for more bells and whistles but at a higher cost. For most, insurance and medical costs should begin to trend down.

• If you do not have insurance there are several affordable options. If even those are out of financial reach there will be subsidies to help you pay for insurance premiums. Below a certain income you may be exempt from the requirement for coverage. That is not a good thing. The ACA was designed at the outset to insure practically everyone but the Supreme Court decision that prevented the Federal Government from using the money provided to the states for Medicaid as leverage made that impossible. Blame your state government.

• The Feds will be paying for practically every dime of increased costs to the state. If you live in a state that is crazy enough to turn down this deal because of Obama then things are not going to be so easy for you. Fortunately Kentucky is not one of those states. Check out www.kynect.ky.gov. In those other states the Feds will operate insurance exchanges through which one may purchase insurance.

• Some doctors and medical providers are not going to like this because it is going to restrict the exorbitant prices they can charge for procedures. The Feds, who will be paying for this, will be able to negotiate prices that they will reimburse insurers for in the same way that Medicare and Medicaid now do. How is that not good? Why should you pay 1/3 more for a colonoscopy in Somerset than you would in Lexington? Family Practitioners will be more important while specialists will be reigned in a bit.

• It is going to cost us jobs and drive up costs to the employer. Maybe. Some companies are lowering staffs to get below the 50 person employer mandated insurance quota. That won't last. Then those people who are uninsured now will be able to pick up insurance just like other people and the company will have to kick in. It will give companies a way to level off their health care costs and project costs for the future. Many companies have been wanting to unload health care costs and will take advantage of this all the while bad mouthing Obamacare.

There is a lot more. This is a big deal and it will not be implemented without people being upset and there being humps and bumps in the road. But it will be a good deal and people will like it. I know many don't believe it but give it a little while and you won't be able to tear it away from people with both hands.

That is my take on the Affordable Care Act, Obamacare. But you already knew that. Nothing I can say will change the minds of the detractors, only time.