Readers Debate the Affordable Care Act’s Anticipated Impact
By - Is the Affordable Care Act (ACA) a beautiful success, a gut-wrenching failure, or a complexly vague combination of both? Simply put, opinions are mixed.
Some across the healthcare industry confirm various ACA successes – more uninsured adults acquiring insurance coverage, a resultantly healthier aging population, a decrease in the amount of uninsured individuals, noted benefits for minority populations, and the like. Others contrastingly point to highlights from the ACA flip side – billions of dollars in bureaucratic waste, soaring private insurance overhead, and steep administrative costs.
In light of such debate, Xtelligent Media readers were recently asked the following question: “Where do you think Medicare – the second-largest social insurance program with nearly 54 million beneficiaries & total expenditures topping $610B – is heading next in terms of projected spending trends?” Below is a summary of readers’ detailed responses, insights, and opinions stemming from the posed inquiry.
One reader, a Pediatric Cardiologist, confirms enthusiastic support for the ACA:
Without a doubt, the ACA [has] been the single most important positive change in [healthcare]. Not since the passage of Medicare and Medicaid in the Johnson administration has there been such a quantum change in our ability to deliver comprehensive care. In Nevada alone, the uninsured rate for children has fallen from ~12% to 2%. We have had no substantial increase in our own employee health insurance rates and we have provided health insurance coverage for our employees for more than 3 decades well before ACA.
Our program is an enthusiastic supporter of the ACA and our patients and our practice would be devastated by [a] repeal (which I very much doubt will ever happen as now no more likely than a repeal of Medicare and Medicaid) Are changes needed? Of course no federal law like this is perfect but it is [what] could be passed despite the amazingly uninformed opposition at the time of passage and the continued uninformed opposition, which simply does not wish to recognize the overall positive [effects]. So many will continue to voice their opposition and I am CERTAIN I will change no minds but for us and more importantly our patients the benefits have been much more than we anticipated.
Another reader, an Educational Director and Senior Issues Advisor, confirms the difficulties and limitations faced by the economically disadvantaged:
Here in Missouri, we have Missouri Health Net. Used to be Medicaid, Now Wellcare. Wellcare is a private company that contracts with the state, to care for our poor. If you leave the major cities, finding a doctor to accept Missouri Health Net is difficult at best. They have been under review from Medicare since 2011. Now, to be fair, we (Missouri) have some very poor counties. Between the Lead Belt and New Madrid, [we] have some of the poorest counties in the county. That does not excuse the pure lack of medical care available to these people. We recommend minimum standards for schooling, prisoner care, environmental standards, yet, when it comes to healthcare, we, what is considered to be the wealthiest nation, treat our poor, and let's be fair, those who chose not to cover themselves or their families, in such a primitive way.
A third reader, a Marketing Representative, explains what Affordable Care Act advocates still need to consider:
[Since] the ACA was signed, premiums have already more than doubled in our plans and cost sharing has risen sharply in order to make up for the new taxes and reimbursement cuts in the ACA, and it is my understanding only about 1/3 of the cuts have been implemented? MA insurers don't really get to pick benefits and premiums and offer plans the way [they] would like to, they have to fit into the [formulas] that CMS uses and as reimbursements get cut, cost sharing and/or premiums have to be raised in order to offset those losses.
Carriers merging together will help consolidate resources and make plans more efficient, but the ACA cuts will overtake any advantages gained by the mergers/consolidation. … [When] ACA supporters say the Doughnut Hole will be closed in 2020 you realize that seniors will still have a 25% coinsurance at that point. When supporters say closed, it is not like I would envision the word closed means “shut, gone, can't see it anymore.” [Supporters] mean that the cost sharing in the gap will be down to the level it is in the initial coverage of the model benefit (25%) that you have after you meet the deductible? Yes, even the 65% or 45% seniors pay now is better than 100%, but the coverage gap will never be gone completely!
As the notion of affordability within the Affordable Care Act continues to remain under investigation, scrutiny, and deliberation, the conversation certainly does not end here. As new ACA developments unfold, opinions will, and should, continue to evolve.
