Vol. 98 October 1, 2013 “Today’s The Day” for Obamacare*

hub

Today is the day that Obamacare really begins.

Thirty million uninsured and underinsured Americans can start signing up today for affordable health care insurance through healthcare insurance exchanges. A key factor for the success of the Affordable Care Act (ACA – the real name for Obamacare) is the addition of these new insurance premiums to the national health insurance pool from Americans assumed to be younger and healthier than people already insured by Medicare or Medicaid.

Though government “defunding” is hanging in the balance today, this day is pretty tame compared to that day in 1965 when Medicare was implemented. Several states actually mobilized their National Guard then in fear of the predicted “hordes of people descending on hospitals seeking medical care”. It never happened, of course, and Medicare benefits, as political candidates found out this past year, have become a “political sacred cow”, resistant to most attacks.

Obamacare elements that have already been implemented include requirements that insurance companies cover “essential benefits”and can not reject coverage of pre-existing conditions. As we muddle through this next stage of Obamacare implementation, here are a few things to keep in mind:

1. If you are on Medicare, Medicaid, an employer’s health insurance plan, you don’t have to do a thing. Just sit tight and let the dust settle.

2. You have until March 31, 2014 to buy insurance (“enroll”) through an exchange. The only other deadline is December 15, 2013 if you want your coverage to begin on January 1, 2014.

3. Don’t try to enroll in the first month. Let the glitches in websites get ironed out and wait for “navigators” to appear to help you understand your eligibility for and coverage of the various plans offered. Navigator training funding has been delayed by Congress. Navigators, by regulation, can NOT give you a specific recommendation, but will clarify your choices via internet and even “live chats”.

4. In those thirty-six states which have opted not to set up state exchanges the federal government has taken on the responsibility for providing this service. Unfortunately, the feds have a different name for these exchanges, “marketplace”, but they will offer the same help in finding the right health care insurance for you. Establishment of federal “marketplaces’ has been delayed in some states by “subpeona harrassment” from Congressional Committees trying to distract, or even cripple, the fledgling efforts of healthcare insurance marketplaces.

5 . If you are not eligible for Medicaid or Medicare and have no insurance now you may be eligible for a federal subsidy of your premium. To find out just plug in your own figures at the Kaiser Family Foundation website at http://www.kff.org and see what you could get. The short list of your information the website requests is : 1. income, 2. family size, 3. age, and 4. tobacco use (That last one is really interesting)

6. Verification of income for eligibility (by the IRS) will not be operational until 2015. In 2014 it will be based on the “honor system, so you can count on some tabloid bombshells about individual insurance frauds under the headline of “We Told You So!”.

7. The tax penalty for the individual who can afford health insurance, but opts out this first year is a paltry $95, so don’t sweat it.

8. The state exchanges and the federal marketplaces will be offering comparisons of four levels of insurance (Bronze, Silver, Gold, and Platinum) with increasing premiums and decreasing predicted out-of-pocket costs from different insurance companies. The plans offered in these exchanges will be better than 98% of current policies available to individuals according to www.healthpocket. com, a free website that collects no personal information.

The hoped-for long-range result is less of a tax burden on taxpayers who are currently paying for medical care for the uninsured via state and federal taxes.

During dinner the other night the conversation drifted to Obamacare, gradually became more intense, and with a soupçon of agitation one Obamacare opponent ** blurtd out, “How can anyone vote for a bill that is 3000 pages long?! Who the hell would read the whole thing?” The rejoinder, “How many pages does the Bible have?” was a non-sequitur conversation-stopper, but it got me to thinking.

Like the Bible, Obamacare is open to interpretation, and your view of it may depend on your political party rather than your religion. Both are vulnerable to quoting out of context in support of opposing viewpoints. Both have overall, encompassing goals which can often be lost, or at least obscured, by the minute details of excess verbiage.. Both have, and will continue to have, “unintended consequences” (like the Inquisition or the Crusades) that we mere mortals have to deal with.

Everyone certainly agrees that Obamacare is NOT divinely inspired. Congress has clearly rejected the idea of a central authority (the Pope, or Donald Berwick, MD as “Czar” of CMS). The Bible is no longer chained in the dark in the back of the church, and Obamacare is now out in public, out in the market place. We shall see eventually how well it meets the needs of our citizens for affordable health care.

It’s success or failure will be clear only after Obama is out of office .
What will we call it then?
ACA won’t stick because we have learned to distrust most three letter acronyms like FBI, CIA, and NSA.
“Christicare” might do, but it sounds awfully religious.
“Cruzcare” sounds like an automobile speed controller.
If Hilary becomes President, she’ll probably put up with the name Obamacare as it is successfully implemented during her first term. Then, during her second term, she’ll dust-off her previous plan for universal health care and call it, what else but, “Clintoncare”.

By the time the Republicans win the presidency the Affordable Care Act will have so many beneficiaries (voters) that they won’t dare to kill it, and they will have to rename it.

I wonder WWJD? ***

* This was Mel Fisher’s  rallying cry every day for 16 years when he and his crew set out in boats searching for sunken Spanish treasure in Florida waters. He found the treasure of the Atocha  with the help of an archeologist named R. Duncan Mathewson.

** I call them “opponents” not “critics” because they really do desire Obamacare to die. In my mind “critics” suggest ways to improve plays, films, books, or programs and rarely ask for their abolishment. We should all act as “critics” of Obamacare in the coming years.

*** “What Would Jesus Do?”

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: