The Affordable Care Act: What Americans Are Saying

The Patient Protection and Affordable Care Act launched on Tuesday, and with it came a great deal of frustration and excitement as servers stalled from demand and Americans, who previously could not purchase health insurance, were able to obtain a policy for the first time in their lives.

While it’s easy to understand the excitement of a diabetic patient being able to afford a premium that won’t cripple his budget, it’s still early in the game, and this great experiment in reforming the health care system could easily go south. In fact, for some families it already has.

What Citizens Are Saying

One family in Kentucky, for example, reported premiums that nearly tripled from their current plan. Amy and Andy Mangione and their two sons saw premiums rise from $333 to $965. “I’m the one that does the budget,” Amy explained. “Eventually I’ve got that coming down the pike that I gotta figure out what we’re gonna cut, what we’re gonna do, to afford a $1,000 a month premium.”

However, for diabetics like author David Farland, who recently underwent a traumatic episode in which an accident almost claimed the life of his son and left the family with staggering medical bills (around $1 million), yesterday was a blessing. “Spent part of today looking for health insurance. Finally, after ten years, I have the right to buy it again! Thank you, President Obama!” Farland said.

What Doctors Are Saying

You’ve probably read dueling comments over the last two days on your Facebook wall. Some people feel it will cripple the family budget. Others are elated at being able to walk in to a doctor’s office for preventive care with at least some peace of mind.

In the short term, the new system will work for some and not work for others. But according to Dr. Jason Marker of Wyatt, Indiana, it will certainly come with additional overhead. Marker expects an influx of patients, who are newly insured, and is looking to hire additional staff to keep pace with the needs of his community.

“With that will come additional overhead, but hopefully I will be able to balance that against volume changes in patient care,” Marker said. “There are risks, for sure, that it could be not a winning financial solution, but until you do it, you won’t know for sure.”

Marker is also concerned about doctor shortages in the face of the new law. “We know definitively that health insurance coverage and access to a physician are what improve healthcare outcomes,” he explained. “We’re about to get changes in coverage, but we don’t have a ready way to say, ‘Here’s another million family doctors.’ So there’s a pipeline problem where it will be another five to ten years where we are able to get the volume of doctors to take all these patients.”

Dr. Sue Decotiis, a New York City internist specializing in weight loss and hormonal treatments, foresees a rise in the use of nurse practitioners and “physician extenders” for dispensing preventive care.

“Unfortunately a lot of physicians that don’t believe they’ll be able to branch out into fee-for-service care are getting more physician extenders such as physician assistants, nurse practitioners,” Decotiis explained. “People will have less contact with MDs, and the thing is these physician extenders have to be really well trained … you can get good ones and ones that are not as strong.”

Our Take

Like it or not, ACA is the law of the land, and it’s not going anywhere. Early in the game, all you can do is either keep your existing plan or place yourself in the best position so the law works for you.

If you have plans to sign up for ACA, make sure that you’re looking at the quality of care — as in, what are my deductibles, what co-pay percentage will I be responsible for, what is the max out-of-pocket — and not just the size of the monthly premium.

A $50 per month insurance plan won’t do you very much good if you have a medical event that you’re obligated to pay for at 30 or 40 percent.

Some states will have open-enrollment centers where you can speak to a knowledgeable representative. Describe to them the level of care you’re looking for, and choose the best level of care possible, before making a decision. It may be more expensive than other provisions offered, but you’ll be glad you have it should a major event occur.

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