This is the first of a series that will appear each Wednesday — editor.
The goal of this ongoing series is to take the myth out of the upcoming federal health care law that will go into effect on Jan. 1, 2014. The new law is more than 900 pages long and even the most educated people are still having trouble understanding what the new plan actual does or doesn’t do. This series will give people the facts so they can make educated decisions. In the next few weeks, we will look at terms like state insurance exchanges, Medicaid expansion, essential health benefits and levels of coverage, federal poverty level and government assistance as well as penalty taxes. We will put it all into a language that every person can understand. This week we will discuss the background of the new health care law and how will it applies to our readers.
The Patient Protection & Affordable Care Act is the official name of the new health care law. The media and a number of people in Congress had been using the name Obamacare or the ACA during the election. In this series, I will use ACA to discuss the program since the media and the federal government will start using these three letters to talk about national health care moving forward. The ACA was created to address the number of Americans within the United States who are uninsured. When the ACA was approved, its goal was to cover some 30 million Americans without insurance and provide them with a basic set of health benefits they are not getting now, such as maternity and preventive care. Also, another welcomed addition, the ACA will stop the practice of increasing rates for people with “pre-existing conditions.” While these are just a few benefits of the ACA, they do afect the greatest number of people. The question of how the government plans to pay for this coverage will be addressed since there are a number of factors on how it will happen. We will cover those issues later in the series.
Currently, many of the people who are counted in the 30 million fall into two main groups — unemployed and uninsurable. According to the Division of Employment Security of NC, if you are unemployed and made over $802.81 a week, you are collecting the state maximum of $535 a week. The problem, for a family of four who need health coverage, it can range from $375 to $1,400 a month. That can be one week of pay or almost three weeks depending on the health plan you need. There is not much room for car payments, food or paying the mortgage or rent. Since people need a roof over their heads, a car to get to work and food for their family, the need for health insurance is low on the list.
The other group is the uninsurable or high risk. Do you have a medical condition like high blood pressure, diabetes, cancer, or heart problems? If you do, either the insurance companies won’t take you or the rates are so high, you can’t afford it. Some rates can be as high as $2,000 a month. Under the ACA, there will be no penalizing people who have medical problems. Everyone will be treated the same. So two people who are 35 years of age and one is in good health and the other has medical problems, they will pay the same rate.
The problem is the government hasn’t given exact numbers on what the plans will cost. It has been a moving target for a while as the states work with the federal government and the insurance companies to create these new programs. Hopefully by the end of this series, North Carolina will have a working model which we can look at.
Next article, we will look at the cost of some of these plans that North Carolina is creating and how people may now qualify for Medicaid under the new rules.
Darek Hunt, a Lumberton resident, has his master’s degree in Public Policy and Administration and is a doctoral student in Health Sciences. He specializes in health care administration and health policy.