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Betty Arenson:Affordable Care Act in practice

Posted: January 24, 2014 2:00 a.m.
Updated: January 24, 2014 2:00 a.m.
 

Ask yourself the honest question: Did you truly believe The Patient Protection Affordable Care Act, or ACA, was going to work as promised? If the answer is “yes,” then did you earnestly think through the practical workings of the program?

Those are sincere questions. Vigorous promotion of the many promises of the ACA caused prudent people to consider the operating mechanics and how it was all to work in practice. Unfortunately, politics reigned when questions were raised.

The askers were too often dismissed as the enemy and emotions smothered practicality, no matter the validity of their questions.

Putting politics aside, the ACA is a massive venture that is now a law in America, and it affects every citizen.

The primary aspects of promoting and enacting the ACA were: (1) to provide health insurance coverage to the oft-quoted 47 million uninsured Americans; (2) plans would be “affordable” for everyone; (3) responsible people would keep their existing chosen plans and providers; (4) having coverage would assure payments to medical providers for services rendered; (5) overall health care costs would decrease; (6) Americans would save money on premiums and (7) Americans would not be burdened with medical bills driving them into bankruptcy.

There were initial practical questions. How are 47 million people added to the rolls going to decrease costs? How can workers keep their plans if employers cannot offer them anymore?
What is the mechanism for forcing people to buy the mandated insurance to make them monetary participants? Is every single person being mandated into the ACA law — no exceptions and no waivers?

What will occur to keep doctors practicing when many say they will depart? How and where is all of the electronic medical data going to be gathered, viewed and stored? How will those processes mesh with HIPAA (federal law mandating health data privacy)?

Most unfortunately, the public weighed in on a crucial topic with an immense absence of the facts as written within the multi-thousands of pages of the Act and its ensuing regulations.

We were denied information that reflected poorly on the plan because the promised transparency of getting all of the details via C-SPAN 72 hours before the law was passed never happened.

As time passed, more and more irregularities surfaced, which generated more suspicion, animosity and fear.

It’s needless to list the numerous and continuing “Obamacare rollout” failures as the rollout is only part of the picture. Instead, be mindful of some very serious facts.

The law has been arbitrarily changed, multiple times, by sole decree of the president, without proper congressional legislation. Such a precedent should scare every American.

Waivers have been granted for political gain. Among other negative elements, non-participation directly affects funding necessary for the ACA to be effective.

To date, 6.3 million insurance policies that existed a few months ago are now canceled. That number of policies can easily calculate to lost coverage for 12-19 million people.

That’s a new total of up to 68 million uninsured. The sum doesn’t stack up to the reported 2.1 million sign-ups — a deceptive number as many are not actually on the books as paying customers.

People’s permiums are doubling, their deductibles are in some cases tripling, and they’re facing increased out-of-pocket expenses.

Three of my family members work with health insurance and attendant ACA regulations. They would tell you plans are unnecessarily complex. For instance, some plans do not consider all out-of-pocket costs as applicable to paying down the deductible, resulting in more increased costs.

Doctors and facilities still have the legal right to pursue monies owed to them for services rendered — thus bankruptcy remains an issue.

Medicaid (Medi-Cal for California) has notably expanded with new enrollees; intended cost-savings are seemingly backfiring.

Recently, the New York Times reported a journal “Science” article on a finding in Oregon stating: “Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts during their first 18 months with insurance.

“The findings cast doubt on the hope that expanded insurance coverage will help rein in emergency room costs just as more than 2 million people are gaining coverage under the Affordable Care Act.”

As 2014 slides into 2015, more regulations will surface. If you are not presently affected, changes are inevitably in your future.

Be honest with yourself and think clearly. Do you trust your personal or family medical insurance coverage and overall health care to politicians and their un-elected appointees?

How did we get here and who got us here?

Betty Arenson is a Valencia resident.

 

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