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Intimidating at first

November 1, 2013
The Daily News

EDITOR:

The bumpy roll-out of the Affordable Care Act web site has resulted in fear about the program. It may be time to review and recap.

The program is designed to provide a single marketplace wherein a person who does not have affordable employer-provided health insurance can compare policies offered by several private insurance companies, knowing that whichever level is purchased, certain minimum standards must be met.

For those who meet income guidelines, the federal government will subsidize a portion of the premium.

Everyone is required to be insured for health care, so hospitals and doctors will no longer have to write off indigent care, though there will always be some bad debt.

Even if one chooses to avoid insurance, there is still a fine to be paid, so at least everyone is paying something into the system.

There is no reason why someone who trusts to luck and refuses to take responsibility for their own health care expenses should expect the rest of us to pick up the tab.

The ACA also offers a vast expansion in the Medicaid program for those states who choose to avail themselves of it.

Wisconsin has chosen not to, but Michigan stands to gain about two billion federal dollars a year.

The new Medicaid guidelines will cover individuals and families with incomes up to 133 percent of the poverty line. For individuals, it's about $15,000 per year, and for a family of 4, it's about $31,000 per year.

Approximately 470,000 struggling Michiganders will benefit in this way, and of course, the rest of us will benefit as well. Under Medicaid, mental health treatment will save us about $200 million per year in mental health services that are currently paid out from the general fund.

Unfortunately, the Michigan legislature chose not to develop its own marketplace, so the uninsured in our state must use the federal website, or call the federal number, or simply visit your insurance agent.

Patience will pay off in the end with better coverage and peace of mind. Even young people can get cancer or crash a snowmobile.

"Butch Matthews, 61, a small-business owner and lifelong Republican from Little Rock and his wife, too young for Medicare, had been paying over $1,000 per month in the individual market for a Blue Cross/ Blue Shield policy with a $10,000 deductible. The policy Matthews just bought from the Arkansas Obamacare marketplace will cost him nothing after income-based subsidies, and he has a deductible of $750. Doctor visits will cost him $8 instead of nearly $150. He stands to save at least $13,000 a year." (WaPo, Oct.23).

Insurance companies must spend at least 80 percent of your premium on health care, and must publicly justify their actions if they want to raise your premium by 10 percent or more. Many preventive services (flu shots, mammograms, birth control, etc) will have no copay, and the "donut hole" for seniors will be closed gradually over the next few years.

Any big new program is intimidating at first, but I encourage you to check it out if you are not already insured, or if your insurance is really crummy.

Lola Johnson

Kingsford

 
 

 

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