Wednesday, December 4, 2013

healthcare and the affordable care act

If you have been following the blog for awhile now, you might have picked up that healthcare is an area of great interest for me. (See the Wisdom Teeth Saga of 2012 for a taste.) I don't think I'm alone in this, either. In many cases, new adults like myself have been used to the college healthcare plan that includes: squeezing all our doctors' appointments into Christmas break; mediocre campus health services; or perpetually self-medicating.

And now things are a little different. We make our own doctors' appointments. I, for one, am eternally grateful that I am now covered by my dad's insurance coverage until I'm 26, and I can say even more confidently that I'm not alone in that! A few of my classmates and friends have been faced unexpectedly with bigger medical issues: traffic accidents, surgeries, food poisoning, and even cancer.

I know that, at least in my circles, a cheer went up when Obama won the presidential election in 2008, and again when the Affordable Care Act (ACA) passed. Affordable healthcare options are a weight off our shoulders, once we've seen our monthly student loan payments, the discouraging job market, plus the cost of a data plan/rent/gas/car insurance (which we need to be able to drive our cars to work).

But this is all theoretical, right? October 1 is now infamous for the launch of Healthcare.gov, which more or less collapsed under the apparently colossal demand. Perhaps that demand in itself testifies to the importance of accessible healthcare options. And now, the December 15 enrollment deadline is rapidly approaching. I thought it was high time I address this topic.

Now, I have gone out of my way to learn about this Obamacare business. I have been collecting intel on it for months. In the summer and early fall, there was a lot of talk about healthcare and insurance marketing to millennials. (My take? Stop messing around and be real with us. We've got an eye for real value. Just tell me: what am I getting out of this? It'd better be good!) Then, after October 1, and after the government shutdown fiasco blew over, it was all about the broken website. There has been a disturbing undercurrent of what I can only see as propaganda, trying to convince young people in particular to defy Big Brother and forgo coverage. And now everybody's in a panic, because we don't really know what's going on, but we know it's important and it probably impacts us in a big way.

So I tried to talk to a bunch of people to get a feel for the personal experiences of the ACA an the changes to the healthcare system. I didn't get to talk to any newly married couples, but I will say that most of us who are under the age of 26 are just sticking with our parents' plans until we can't anymore. My lucky 30-ish friends who already have jobs with benefits are set, and their spouses are also OK. Some of them are batting around the idea of fast-tracking their upcoming marriages to get uninsured spouses covered before 2014. I also have friends who have switched jobs in the past year, with benefits being a major motivating factor. There are a few who don't have insurance at all, don't have a way to get it, and simply can't afford the monthly premiums. That is a real thing, and a problem.



I work for a small company, which hired an insurance consultant to discuss our needs and options with each of us individually. This guy told me about the bronze, silver, gold, and platinum level plans, how much each of them costs, my deductible for each and what's covered under every level. He said the factors that influence the cost are my zip code, my birthdate, and whether or not I smoke. So, my coworkers who live in a different state will have different options. I will tell you that the plans ranged in price from $190 to $330 a month.

I balked at this. To be honest, I just don't have that kind of money left over in my monthly budget. That would eat up my emergency fund - the dollars that would cover healthcare expenses up to my deductible amount, for example. Even splitting that cost with my employer, I would be hard-pressed to keep those payments coming for a sustained period of time.

Now, don't get me wrong; I completely buy into this system. I count it as a victory that people with pre-existing conditions, poor people, and single-parent families now have a shot at being insured, and I would chip in for that in a heartbeat - if I could. For now I am heaving a sigh of relief that my dad's plan will still cover me at no extra cost to him or to his employers. (For the record, this is something I'm not clear about: the healthcare advisor said that under a family plan, each additional member costs extra; but most of the people I talked to said it makes no difference for their family how many people are on the plan. There's a premium and a deductible for a family, no matter how many members are covered by the plan. For this reason, most of my peers are staying on our parents' plans as long as we can.)

It's not a perfect solution, by any means. I have heard time and time again that the success of this new system depends on the buy-in of 20-somethings, and this could be a problem. Because we feel invincible (not me, definitely, but that's the stereotype). Because we are in many cases unemployed, or in the Peace Corps. Because we just can't afford it. Because we don't understand it and how it works, and we don't understand how to look for the information we need.

(FYI, in Delaware, there is a service called Choose Health Delaware created to help people navigate the system. I have no testimonials on whether or not it works, but they're marketing it pretty hard.)


It's not a perfect solution, but it is an answer to a very real problem. The healthcare and public health situation in this country is horribly broken, and we're paying for it as a nation - financially, culturally, emotionally. It has very serious side effects on our economy, and more importantly, on our national psyche.

I have been encouraging my peers to participate in the exchanges, if they can. I have been encouraging them to seek out information. I have been asking questions and trying to understand the strengths and weaknesses of this new system. I believe we need this, as a nation, whether it works or not. Our public health system is sorely lacking in comparison to that of other developed nations, in most areas except one: spending. That should be enough to grab our attention.

I strongly believe that this is a step in the right direction. Our healthcare system is a mammoth monster and it will take time and probably many stumbles for us to overcome it and find a system that works. I quote a friend of mine who is working on a master degree in social work:

"This very imperfect system (The ACA) is a step toward really really important universal coverage. Because the UN and lots of people view universal healthcare as a human right, I think the ACA is an important step forward. I think the Obama admin. (despite handling things like the website horribly) is really trying to offset costs for young people but the insurance reality remains that healthy people subsidize sick people and young people are overall healthy."

All this being said, readers, if you're still with me - I urge you not to give up. Do not be discouraged. Keep thinking critically, as we were raised and educated to do, about the problem that faces our country and the bodies that constitute it, the bodies both healthy and ill. Let's be constructive and creative, and while we do what we must do for the time being, take note of what works and what doesn't, and what we need to be better and stronger and healthier as a nation. It's not impossible. We just don't know how to do it yet.

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Readers, I'm still curious. I know I still have a lot to learn about our healthcare system and the changes that are taking place. What are your thoughts and experiences with all of this? Share them with me in the comments.

And thanks for reading!

posted from Bloggeroid

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