EDITOR: Opinions of Obamacare, and whether it’s a glass half empty or half full, depend largely on one’s political viewpoint and sources of your information. Opponents of the law, including many in the medical industrial complex with lots to lose if health reform cuts costs, often cite articles hinting that it’s a failure, while proponents cite articles highlighting successes and progress. The mainstream media, in efforts to generate buzz and attention, seem to stoke the fires of controversy by avoiding the hard task of investigative journalism and simply publishing inflammatory stories fed to them by either political party without checking the facts. Then again, the official government numbers, which you can believe or not based on your politics, present a moving target. So, I’m more interested in the trends and the long-term implications and publish today’s byline article with some editorial comments added.
A Checkup on the Health of the Affordable Care Act Thus Far
By Paisley Hansen
What will be the ultimate impact–for good or bad–of the Affordable Care Act on Americans? Although it’s still too early to tell, a January 13 article by the Associated Press posted on AOL sheds some light on the health status of Obamacare thus far [2.2M through December, 2013].
According to the article, of the more than 2 million Americans who had signed up for government-subsidized private insurance through the end of December, older and costlier adults make up the majority. Thus far, young adults ages 18-34, who were anticipated to make a strong showing, comprise only 24 percent of total Obamacare enrollment. In contrast, adults ages 55-64 account for 33 percent of total enrollment. This is not good news, as this younger and healthier population is critical for offsetting the medical costs of the older enrollees, thereby keeping the lid on premiums. [Note that adult children can stay on their parents’ policies until age 26, so this may not be as surprising as it first looks.]
Another disturbing trend, according to Richard Foster, a former statistics chief for the Health and Human Services department who is quoted in the AP article, is that “The uninsured folks for whom the law was intended don’t seem to have signed up in nearly as high numbers. There is still a huge unknown aspect to this.” Commenting on this disparity, Larry Levitt, an insurance expert for the Kaiser Family Foundation was quoted as saying that “it’s nothing of the sort that would trigger instability in the system.”
Although premiums and taxpayer costs per enrollee are expected to rise next year, Levitt gave assurance that the increased costs would not be enough to cause a “death spiral” in the system due to rising premiums, which could discourage healthy individuals from enrolling. Still, Levitt cautioned, “it underscores a need to heighten outreach efforts to young people.” In view of the fact that the federal health care website was down for most of October, administration officials told the Associated Press that they are confident that more young people will come on board as time goes by.
Commenting in the article on the importance of health insurance for young people, Stacy Sylvain, a 19-year-old Miami college student said that, “Many people have a preconceived notion that young people are healthy and don’t need to go to the doctor.” Sylvain had suffered a minor head injury when she fell during an indoor soccer class in 2012. “Not having to worry about being uninsured and the what-ifs has made an incredible impact on my life.”
With a goal of signing up some 3.3 million people by December 31st, officials stated that as of that date, only around 2.2 million had enrolled. Clearly there’s some catching up to do in order to reach the goal of 7 million enrollments by March 31st.
In a related article posted by Reuters on Jan. 4th, the impact of Obamacare on health care providers was discussed. For example, Central Ohio Primary Care, a practice comprised of 250 physicians, stated that it is holding off on filing claims for patients who purchased health plans through the Healthcare.gov exchange. Noting that the delay “surely is not desirable long term,” Dr. David Wulf, the CEO of the Ohio based practice explained that, “The delay will allow insurers more time to confirm membership information and avert any erroneous claim denials.” [My RN wife’s hospital was doing the same thing here in Austin.]
According to Reuters, insurance carriers are hearing from high numbers of new customers in an effort to make sure that they are in fact covered. One carrier, Philadelphia-based Independence Blue Cross, reported receiving an eight-fold increase in calls on New Year’s Day from customers looking to confirm coverage. [Healthcare.gov actually recommended that they do that.]
Also covered in the Reuters article is the issue of newly insured people needing to find physicians. ZocDoc.com, a website for locating qualified health professionals, reports that those with Obamacare insurance, “searched more frequently for primary care physicians, accounting for half of all searches.” [That should be expected from anyone on a new insurance policy, even when they switch jobs and have new employer-provided coverage.]
As for hospitals, Reuters reports that, due to Obamacare, hospitals expect to see an increase in more paying patients and a reduction of uncompensated claims for the care they provide. [This is a good thing.]
So far, according to Reuters, Pharmacists are not seeing any large surges in demand. Markeisha Marshall, a Walgreen Co. spokeswoman, states in the article that, “At this time, activity is fairly typical of what we experience each year when insurance changes take effect. Nonetheless, we anticipate a surge of activity next week.”
What will be the ultimate impact of Obamacare on the quality, affordability and availability of healthcare in America? As physicians often do when caring for sick patients, we’ll have to just watch and wait.
EDITOR: This more recent MSNBC article presents updated numbers from February, just one month later, that may disappoint the doomsayers. It says another 1.2M people signed up in January, boosting total enrollment 53% in one month to 3.3M. Adding the 6.3M people that were funneled into Medicaid (25 states opted out), Obamacare has connected 9.6M Americans since enrollment started in October. And if you then include the 3M-plus young adults still covered on their parents’ plans, the number of people benefiting now tops 12.6 million. It’s not surprising that the accompanying graph “looks less like a crashing train than a fleet of jets taking flight” — or a glass half full.