Monday, November 2, 2015

Sinking Ship

From Yahoo:
"Prices, politics challenge health law's 3rd sign-up season"
  The government's insurance website is faster and easier to use, but as a third sign-up season gets underway, President Barack Obama's health care law is approaching limits Enrollment on the federal and state exchanges began Sunday. While the law's expanded coverage has reduced the uninsured rate to a historic low of about 9 percent, the gains will be harder in 2016  Supporters may feel they're running to stay in place, rather than taking a victory lap during the president's last full year in office. The reasons have to do with the structure of the complicated law, the effects of a major change introduced by the Supreme Court and political divisions likely to be magnified in an election year. The fate of the Affordable Care Act — known as "Obamacare" to its detractors — is very much in the hands of the next president. A weak sign-up season could embolden opponents who are so far unwilling to relent. The law's two major engines of coverage expansion face challenges simultaneously.  Costs are going up on the private, taxpayer-subsidized coverage sold through and state insurance exchanges, and many of the more than 10 million eligible uninsured Americans are skeptics. They tend to be younger people on tight budgets, with other priorities for spending their money. A sharp increase in fines may sway at least some fence-sitters. In 2016, the penalty will rise to $695 or 2.5 percent of taxable income, whichever is higher. This year, the fine is the greater of $325 or 2 percent of income. On the law's Medicaid expansion, the other big mechanism driving coverage, the limitations are clearer and perhaps more consequential. The 2012 Supreme Court decision that upheld the law's individual coverage requirement also gave states the choice to decline expanding Medicaid. Across the South, Republican-led states have turned down the Medicaid option, leaving millions uninsured. Many are trapped in what's called the "Medicaid gap." They cannot get health insurance through because the law prevents people below the poverty line from using the insurance exchanges. So the private insurance alternative is closed to them, even as their states refuse to expand public coverage.  If five southern states — Texas, Florida, Georgia, Louisiana, and North Carolina — were to expand Medicaid, that could potentially add another 2 million people to the coverage rolls. "It seems like most of the Deep South is saying, 'We are not doing it,'" said Tom Scully, a lobbyist who served as Medicare chief for former President George W. Bush. Reading the signs, the Obama administration has set a modest sign-up target of about 10 million private insurance customers enrolled and paying their premiums by the end of 2016. Most would be consumers renewing from this year, but one-third or more are expected to be new customers previously uninsured. Partly because it can be so hard to hang on to customers, the administration and the states have focused on making their websites more consumer friendly this year. Consumers have until Jan. 31 to sign up for coverage. If they want their coverage to start at the first of the year, they need to apply by Dec. 15.
Consumers can expect to see such changes as:
—automatic reminders to enter Social Security numbers and immigration information, critical details that help the government verify eligibility and prevent cancellations months later.
—call-center help for customers bedeviled by a maddening glitch that can get them locked out of their accounts. This can happen to people who no longer have access to the email accounts originally used to set up their coverage.
—an out-of-pocket expense calculator tailored to different levels of medical use. The feature can help people estimate how their deductibles and copayments will add up to total yearly costs under different health plans.
At the same time, there's plenty of unfinished business. Doctor and prescription look-up tools that were supposed to be showcase improvements this year are still in final testing and could turn out to be less than reliable. "We do think that enrollment gains are going to be significantly lower," said Elizabeth Lukanen of the State Health Access Data Assistance Center at the University of Minnesota. "The ramp-up period for (the law's) full effect might extend a couple of more years."
^ Big surprise - Obamacare has caused a lot more problems for ordinary Americans then it has fixed. I have said it time and again: I completely agree that there should be universal health coverage for every American, but  I disagree with how Obamacare was created and how it is run. It simply adds millions upon millions of people to an already crumbling health care system rather than fixing the system first and then adding people to it. The United States has the best medical training and equipment in the world yet it's basic health care system (ie hospitals, ERs, PCPs, nursing, hospice, etc) tend to fail in patient care. I have used different hospitals, ERs, Urgent Cares, doctors and pharmacies around the country and have come to find a basic lack of compassion and basic care in most places. The patient or their caregiver is expected to do everything themselves from ordering their own food during a set time period to asking why things are being done since no one has bothered to inform them. Obamacare has meant more people being insured but also longer waits in already crowded ERs and doctors' offices, higher costs of private insurance (I know that for a fact) and higher costs for prescriptions. What seemed like a good idea to some (like Obama) on paper has changed health care in the US and not for the better. As with most things Obama has touched since becoming President we can only hope that the next person to fill that post will make the needed changes to the health care system so everyone can be covered and treated like people rather than numbers. ^

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