For the past three years we’ve been hearing about “Obama-care,” the healthcare reform act that is intended to overhaul our current healthcare system. I’ll admit I’m at the point where my eyes glaze over when I hear the words “healthcare reform,” but it’s time to start listening again. (Trust me, I hear those words over the dinner table more times than I’d like to recall, as my husband’s in the “industry,” but it’s even time for me to start paying attention again. Can you sense my excitement?) While many of the changes have already started taking place, a lot of the big ones start taking effect in January 2014. That may seem far off still, but open enrollment, the period when you can sign up for a new plan, starts October 1st — that’s right around the corner.
Just for the record, Obamacare, The Affordable Care Act, and health care reform all refer to the same thing, though it is officially called the Patient Protection and Affordable Care Act (PPACA). (I may or may not be sharing that tidbit of information right up front because I was way too stubborn to ask my insurance-know-it-all husband if they were all the same.)
The Affordable Care Act should expand insurance coverage to around 32 million of the 55 million current uninsured. The two main ways of broadening coverage are by expanding the Medicaid program, and providing new subsidized insurance programs through state-based health “exchanges” (or plans). Individuals who have a lower income but make too much to receive Medicaid will be given assistance in paying for private insurance through the new exchanges. The whole program will cost the federal government $960 billion over 10 years; $438 billion of those dollars will come from new taxes. In addition to providing insurance access to more people, the PPACA aims to improve quality of care, better care coordination, and improved technology. The White House explains that some of the goals of the Affordable Care Act are to prevent insurance companies from dropping you if you get sick, opting to not cover you if you have a pre-existing condition, charging you too much because you’re sick, or limiting your lifetime benefits. The new health care laws should also prevent coverage loss due to change in jobs or being laid off. As an advocate of preventative health care, I’m a fan of the next law change: health insurance companies will be required to cover preventative care without co-pays. That includes (but isn’t limited to) wellness visits, immunizations, mammograms, and colonoscopies.
Better coverage, cheaper costs … All of this sounds great, so what’s the big fuss? A surprising number of people are concerned what the new law will mean for their health care. A Fox News poll found 68% of people were worried about the new healthcare system, with 43% being “very concerned”. Less than 40% of voters approve of the job President Obama is doing when it comes to reforming health care, which on an approval rating scale puts it somewhere between terrorism (better approval rating) and the economy (worse approval rating).
But the biggest problem (in my eyes) is that only 1 in 4 people understand the impact the new health care laws will have on them, and one third report they don’t understand the new healthcare changes at all, or at the most, not much. I didn’t think the changes would affect me much at first because I’m lucky to have a policy where some of these things are already standard — One of my favorite things about my health insurance is that I don’t have a co-pay for preventative health care, like yearly physicals, well-baby check ups, or routine OBGYN appointments. Not having to fork over money with each visit makes it a lot easier to swallow actually going to the doctor. But there are still some major changes with Obamacare.
One group (and I’m included in this group) that may fall into the category of not knowing how healthcare reform may affect them? Moms! Under the PPACA, employees are required to provide a non-bathroom private space and break time for breastfeeding moms to pump during the workday for a year after childbirth. In addition, breast pumps are covered under insurance, as well as pregnancy and newborn care — the latter of which fall under covered “preventative services” in the new state-based health exchanges. I wish I could have gotten a breast pump covered by insurance so I wouldn’t have been stuck with a not-so-good pump that barely pumped anything. If you’ve ever been at the mercy of a bad pump, you know what torture this can be.
Insurance companies will also no longer be allowed to charge women more for the same conditions as men. I find it ridiculous this even happened before — I was discriminated against and didn’t even know it. The ACA also helps moms and families by requiring health insurance companies to cover kids up to age 19 regardless of pre-existing health conditions. Kids can also stay on their parents insurance until they’re 26, instead of just 18 or 19. Being able to stay on my parents’ insurance after college would have made a huge difference, as I could have avoided the supremely dumb decision to forego health insurance until my husband and I had jobs. It just seemed so expensive at the time. (Oh hey, mom? Pretend you didn’t read that.) Of course now that I have a kid I completely understand the value of health insurance, and I’m particularly grateful of the new rule on covering pre-existing conditions — my son was recently “not-diagnosed” with asthma so it wouldn’t affect his insurance status later in life.
Even before this healthcare revamp was proposed I found health insurance to be a rather confusing and overwhelming beast. Now it seems even more abstract and hard to swallow because not only are there changes, but many of them come with a heavy side of opinion. It can be tough to dig through the politics to come up with a clear picture of what’s coming (and what’s already happening).
All opinions and personal thoughts aside, here’s a (hopefully) understandable version of what you need to know come October (or what you may need to know to understand what’s already different).
If you want to know specifically about taxes or little tidbits you might not know, jump towards the end of the slideshow.