Despite all the fake horror stories being spread by conservatives, the vast majority of people in this country are benefiting significantly under the Affordable Care Act. Some benefit due to being able to obtain health insurance when they were not able to in the past due to pre-existing medical conditions and/or cost. Many also benefit due to receiving heath care coverage which cannot be cancelled, cannot have rates increased due to medical problems, and which do not have limitations in coverage which previous polices had. There are three winners which you might not have thought of before–Medicare patients with terminal illnesses, people who bought insurance without subsidies but still came out ahead, and Republicans who benefit from Obamacare.
In contrast to false claims of Medicare cuts, the Affordable Care Act increases benefits for Medicare beneficiaries such as phasing out the donut hole on prescription drugs and covering preventative services which were not previously covered. There are a number of additional aspects of the Affordable Care Act which have not received much attention. One is a demonstration project to consider allowing Hospice patients to receive both curative and palliative care.
Hospice offers extremely valuable services for dying patients, but currently Medicare does not cover Hospice services if a patient continues to receive treatments aimed at attempting cure of a disease. Quite often I have had patients who are terminally ill who could benefit from Hospice services to increase comfort but do not qualify because they want to continue medical treatment. Under this demonstration project, patients will have the option, for example, to both receive chemotherapy and to receive Hospice services aimed at enabling them to die more comfortably if the treatment is not a success.
This is just one of many areas where the Affordable Care Act provides more choice than patients had previously, and I hope that Medicare does make this change for all Medicare patients.
Andrew Sprung discussed another group of winners who are “satisfied unsubsidized.” We have surpassed five million people receiving insurance on the exchanges and it now appears likely that the number will surpass six million due to the surge in people signing up this month. An estimated six million additional are signing up directly through insurance companies, which can be done if not applying for subsidies. Sprung began:
About half of the 12 million Americans buying health insurance on the individual market are subsidy-ineligible, according to the Urban Institute. Are they all fuming and lining up to appear in anti-Obamacare commercials?
Chances are not. As veterans of the individual market, many are accustomed to its shocks and uncertainties. About a quarter of them received cancellation notices last fall, and others face substantial premium hikes. Some will be forced to pay more than in the past, in some cases in part because they are covered for services they don’t want, like childbirth or mental healthcare. But many are finding their options much better and their status less precarious than in the pre-ACA market.
I spoke recently to several people whose family income disqualifies them for subsidies and who bought insurance on the individual market for 2014. All had family members with preexisting conditions, which means they benefited from the ACA’s prohibition on basing price or eligibility on medical history. All had been paying above-market rates or faced limited choices because of a family member’s medical history…
This special category is huge, though. The percentage of Americans with preexisting conditions is anywhere from 19 to 50 percent, according to an HHS report overviewing various studies. And that’s just individuals—in households with more than one person, the chances that someone will have a medical condition that jacked up the price of insurance in the pre-ACA world multiplies.
Sprung gave some specific examples who are far more representative of the changes under the Affordable Care Act than those shown on television by conservative groups with fake horror stories. The satisfied unsubsidized also includes an additional group, people such as myself who did not have to pay higher rates in the past due to medical problems and are paying more now, but still benefit because of now having a policy which cannot be cancelled due to changes in medical condition. Sprung acknowledged us in concluding:
It’s worth keeping in mind, though, that those untroubled by preexisting conditions or by the need to find insurance in the individual market can lose those advantages at any moment—as well as their financial status. Uncertainty is the universal preexisting condition—and thanks to the ACA, such changes should no longer threaten financial ruin or lack of access to medical care.
When listening to the fake horror stories being spread by Republicans, keep in mind that before the Affordable Care Act medical expenses were a major cause of bankruptcies in this country, and three fourths who declared bankruptcy did have medical coverage at the time they became sick or injured.
Last month I looked at Republicans who have benefited from Obamacare and learned to love it. Scott Brown learned about this last Saturday:
Brown found that out on Saturday, when he stopped by the home of Herb Richardson, a Republican state representative. Sitting in Richardson’s home, Brown called Obamacare a “monstrosity” that members of Congress didn’t even bother to read before they passed. At that point, according to the Coos County Democrat, Richardson chimed in to explain that the law had been a “financial lifesaver” for him and his wife. From the the piece (page 14):
Richardson was injured on the job and was forced to live on his workers’ comp payments for an extended period of time, which ultimately cost the couple their house on Williams Street. The couple had to pay $1,100 a month if they wanted to maintain their health insurance coverage under the federal COBRA law.
Richardson said he only received some $2,000 a month in workers’ comp. payments, however, leaving little for them to live on.
“Thank God for Obamacare!” his wife exclaimed.
Now, thanks to the subsidy for which they qualify, the Richardsons only pay $136 a month for health insurance that covers them both.
With so many people benefiting from Obamacare, many Democrats are making a huge mistake by failing to run for reelection based upon this. As I wrote earlier in the week, Democrats need to go on the offensive on health care reform. Explaining these benefits is the only way to counter negative ads and negative polling results based upon misinformation.
Cross posted at The Moderate Voice