Kansas State University


Issues in Health Reform

Month: November 2013

Obamacare enrollment numbers

This federal report includes up to date enrollment numbers for the marketplace. While all of the numbers are extremely low (just over 100,000 enrolled through federal Exchanges), what most of the media is missing is that there are almost one million who have signed on and are no doubt taking the time to make plan choices, as good consumers would do.  AND there are ~400,000 who have been enrolled in state’s Medicaid programs.  It is interesting that about 4 times as many have been enrolled in Medicaid than in the private plans on the Exchanges.  This may suggest that the most vulnerable population is clamoring for access to health care in ways that those with a bit more resources, including the young healthy adults, are not as yet.

Delinking health insurance from the workplace

I’ve been speaking to one main advantage of Obamacare being the lifting of job lock, where folks get to choose to work where they want and not be afraid of being cut off from health insurance. Thomas Friedman’s opinion in the New York Times adds a particular urgency to this issue…that new jobs being creating are going to be less and less those that will come with insurance as a fringe benefit, so that the new economy dictates the need for delinking insurance from the workplace or at the least, having affordable options for workers and their families.

Job lock is lifted because now no one can be denied health insurance because of pre-existing conditions, there is place to purchase health insurance that offers large group level premiums similar to those in workplace (that’s what the Exchanges are about), and where feds operate similarly to employers by helping folks pay for those plans.  With the feds, they help those with less than 400% of the federal poverty line pay for insurance by way of the tax credits.  Employers usually paid a portion of the premium as well but rarely based on salary level of employee.

The media hype vs the truth: What about the cancellation of insurance policies

  • True, President Obama promised what was never possible in the individual market BUT
  • Policies were always cancelled and often at times of high medical need and expenses
  • With ACA that can no longer happen BECAUSE
  • No one can be denied health insurance
  • There are many options for insurance AND
  • The new policies are much more substantial than the ones being cancelled.  Lots of policies were almost worthless AND
  • The costs, especially with the subsidies are much more affordable for real coverage AND
  • All of the consumer protections are in place: no one can be denied a policy, no lifetime or annual limits AND
  • No more job lock.  With options for group insurance outside of working for an employer who offers insurance, options where no one can be denied a policy, people can choose to work where they want.  This is a boon for entrepreneurs who want to open their own businesses.  There is now a Marketplace Exchange where they can purchase policies in a  group rated fashion.  Imagine people leaving jobs they hate but only stayed with because they needed the insurance.  Farm wives heading back to the farm because they don’t need to work away to get insurance.  Families being able to move closer to loved one.

So the media hype that policies are being cancelled clouds the truth of the story. Yes people are scared because they are not yet aware of what their new options really are, they are afraid of change.  They are afraid of losing their doctors.  The unfortunate reality is that insurance companies have been for years changing networks of doctors annually.  One could never be certain of of which doctors were going to be in their plans from year to year.  Insurance companies negotiate with doctors and other health care providers annually to find the best fit and prices for the needs of their insured clientele.  Obamacare didn’t change that.