This past weekend marked the third anniversary of passage of the Affordable Care Act, also known as “Obamacare.” This is the ACA’s big year; this Fall Americans will be allowed to start enrolling in health insurance plans. Starting on January 1, 2014, virtually all Americans will be required to have health insurance – either from the government, their employer, or through a health exchange. Yet, even at this late date, many Americans are still unsure of its impact.
Nearly half of Americans recently told pollsters that they have heard nothing at all about whether their state will run its own exchange – New York will run its own exchange. Over three-quarters say they don’t know if their state plans to expand Medicaid to cover lower income individuals. New York has decided to expand its Medicaid program.
Many still have bad information about what the law does: Nearly 60 percent incorrectly believe that the ACA includes a public option. Nearly half believe the law provides financial assistance for illegal immigrants to buy insurance. And 40 percent — including 35 percent of seniors — still believe that the government will have “death panels” make decisions about end-of-life care.
While there still is confusion about the law, it already has done much to reform the nation’s health insurance system. Starting in 2010, dependent children up to age 26 can still be covered under the parents’ insurance. As a result, over 6.5 million people ages 19 through 25 have been able to stay on or join their parents’ plans, with more than 3 million previously uninsured young adults getting health insurance.
The law also requires private health insurers to provide free preventive care, without co-pays or deductibles. Over 70 million Americans have received at least one free preventive service, like a mammogram or a flu shot, and an additional 34 million Medicare beneficiaries got free preventive services last year.
Private insurers are now required to cover children with pre-existing conditions, which means that an estimated 17 million such children have been protected against being uninsured.
The law also bars insurers from canceling policies on sick people; previously, 10,000 people a year had their policies canceled.
The law also provides for prescription drug discounts to Medicare beneficiaries. More than 6 million older or disabled people have already saved more than $6 billion on prescription drugs since 2010 and will save even more as a gap in coverage, known as the doughnut hole, is filled in by 2020. And the law ended lifetime dollar limits on services covered by private plans, a matter of great importance to people with very high medical costs. Annual limits on what plans will pay are being phased out.
There are still big problems looming: When the law first passed, the Obama Administration didn’t expect 33 states to refuse to build their own health insurance exchanges. When it asked Congress for an additional $1 billion for implementation, Republicans refused.
The ACA won’t work if people don’t sign up for coverage. But they won’t sign up if they don’t know how to enroll, how it may help them or what they are signing up for.
Luckily in New York, the state is developing its own health exchange. The main question here is whether the Cuomo Administration’s plans will aggressively market its exchange to the one million plus uninsured expected to sign up for coverage and then be able to handle the inevitable administrative difficulties to run this massive new program.
But for those without health insurance, who fear that a serious illness could bankrupt them and their families, help is on the way. And despite its flaws or difficulties in implementation, it’s about time.
Blair Horner is the Vice President for Advocacy for the American Cancer Society, Eastern Division. His commentary does not necessarily reflect the views of the American Cancer Society.
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