My Obamacare Story

In the Affordable Care Act’s (ACA) first year, my doctor called me for my free annual preventive care exam. A pleasant surprise. I’d gone from employer-provided health care coverage to having it through my retirement program and Medicare. I was in the majority of Americans who wouldn’t be impacted by Obamacare, I thought. Obamacare is what most of us call the ACA, easier to say than Patient Protection and Affordable Care Act, but for now, I’m using ACA.

Let’s demolish Myth #1 about the ACA: No one is making me do anything about my health care. Unless I decide to opt out of my current coverage, it stays. The state insurance exchanges starting October 1 for 2014 coverage are designed to help the 15 – 20 percent of Americans without health care insurance get some they can afford. You can’t use the exchanges if you have Medicare, Medicaid, or an employer provided plan. Fine with me. I’m good.

Myth #2: Uncle Sam is NOT doing your pelvic exam. Government was never going into the medical profession. The public option didn’t pass, and if it did, would work like Medicare does now: when’s the last time a Medicare official was in your doctor’s office with you? The insurers competing for your business on the exchanges are the usual private sector suspects, the likes of Blue Cross & Blue Shield, Kaiser Permanente, and other insurance companies.

The second year ACA was in effect, I got a mammogram with no co-pay. It’s one of the preventive care services insurance now has to cover, like colonoscopies and flu shots. My Silver Sneakers exercise program? Free. No reason any more not to go. (I find excuses anyway.) Godsend benefits have become available to some: being able to keep kids on family insurance to age 26 and not being denied coverage for pre-existing conditions like diabetes.

2014 is a big year for the ACA, when much of it kicks in. Hence, the flurry of resistance among its opponents, I suppose. Once people start getting these benefits, the attempt to kill ACA will be toast. So they’re trying. States opposed to the law, like Florida, are not setting up exchanges and making it difficult for people to get ACA information. That’s harsh. Why keep your citizens from getting less expensive care? Some private companies are figuring out how they can game the ACA system by reducing employee hours or otherwise stopping insurance coverage. Greed. A pox upon them.

A Georgetown University study found that “health insurance offered on exchanges this fall under the ACA will be competitively priced and have offerings that are similar in quality to existing coverage.” (Forbes, 8/17/13) USA Today reported costs will be 30 to 40 percent lower than expected. In Colorado, we’ll see a 34% reduction. A survey showed New York twentysomethings will be able to get insurance for little over $100 per month, when the cost has been averaging $337. Wow, what a concept: you put a bunch of private insurers in a competitive market and prices start to drop.

Who are the “eligible uninsured?” Let’s explode Myth #3. In Colorado, for example, they are 15% of our population, 80% have a full-time worker in the family, and 60% are white. And no, (Myth #4) illegal aliens can’t use the exchanges.

Other benefits begin in 2014, but here’s the one I really like: as of January Congress will only be offered the same insurance offered to people in the exchanges. No more special Federal Insurance for them. Ha! That’s got to be saving us a bundle.

Yes, the ACA costs a lot—at first. But it’s already saving money too. The law includes a better system to stop fraud and has already recovered almost $15 billion, for example. It includes new taxes on pharmaceutical companies (Have you heard about their obscene profits? See my “Bitter Pill” summary on this blog, under Education) and a slight—less than 1%—increase in taxes on people who make over $200,000. It should be more.

“Taking the coverage provisions and other provisions together, CBO and JCT have estimated that the ACA will reduce deficits over the next 10 years and in the subsequent decade.” Did you get that? The Congressional Budget Office and the Joint Committee on Taxation, who study these things for a living, say the ACA reduces our deficits. (www.cbo.gov/publication/44176) That shatters Myth #5.

October is my open enrollment, but I haven’t changed my health care in 20 years and didn’t expect to do so now. I’m happy with Kaiser, always the least expensive option. In 2014, for the first time in living memory—mine, at least—Blue Cross and Blue Shield costs drop while benefits expand, making them cheaper than Kaiser. “The primary reason for these improvements is the change in how prescription benefits are being delivered, resulting from benefits in the Affordable Care Act.” (PERACare 2014 Open Enrollment Guide)

Because of Obamacare, (excuse me, the ACA) I could choose to change my coverage and save myself some money. So I guess I’m in the majority of Americans who can benefit from the ACA after all. Goodbye, Myth #6.