Monday, September 16, 2013

Some Rare Truth About Obamacare

As a cancer patient, I like the fact that the Affordable Care Act, better known as Obamacare, ensures that I will remain insurable despite my pre-existing condition. But I also recognize there are fundamental flaws with this law, namely that it is just so damn long and confusing and that, yes, it will mean higher insurance rates for some Americans.

As is most often the case, the truth about Obamacare falls smack dab in the middle between the breathless and at times preposterous rhetoric on both the right and the left. Those who know me know that I can be fairly objective on Big Issues related to healthcare. After researching Obamacare, I've come to the easy conclusion that while it is bad for some, and is in many ways a missed opportunity to initiate real change in the way we receive and pay for healthcare in this country, it is good for many Americans. 

But this is such a polarizing issue, it is unlikely anything I say here will open or change any minds. We're living now in a post-facts world in which people no longer rely on or believe in hard data. Facts used to be stubborn, ornery things, but now they are ethereal and elusive. All "facts" can be skewed, apparently. 

Regardless, here's one of them pesky, no-good facts: As a result of Obamacare, many states are seeing insurance rates go down, while some others are seeing them go up. The most comprehensive study I've seen to date is the one released last week from the nonpartisan Kaiser Family Foundation which reports "lower than expected" premiums for Obamacare's new insurance exchanges, which go into effect on Oct. 1. 
Kaiser wrote that "while premiums will vary significantly across the country, they are generally lower than expected." The analysis compares the premiums in the largest cities in each of the 17 states plus DC for individuals and families in different circumstances to illustrate the insurance rates they might pay, with and without the tax credits created under the law to make coverage more affordable. The 17 states plus DC include eleven operating their own marketplaces (also called exchanges) and seven that have defaulted to the federal government.

A wide range of premiums exist, with tax credits varying based on enrollees’ income levels and the second-lowest-cost “silver” plan available in each market. Eligible enrollees may use their tax credits to help pay for the silver plan or any other generally available plan in the marketplace, including the less generous (and less costly) “bronze” plan.

I'm no cheerleader for Obamacare. It is far from ideal. In my view it didn't go nearly far enough to reign in the insurance industry lobby. This is not a radical left-wing plan or some conspiracy to turn our nation into a communist state. In fact, the bill defers way too much to big business. But it is hardly the apocalyptic, Hitlerian disaster many would have you believe. 

It has a lot of things going for it, especially for young people, poor, working Americans who are uninsured, and of course people like me who have serious and uninsurable health conditions. It also stresses preventive medicine, and in that sense it will save this country literally billions in the coming years.

As for the often reported notion that companies are cutting jobs or reducing worker hours because of Obamacare, some are, but a lot of the reporting on this is disingenuous. Despite all the politically motivated talk and selective journalism about this, apparently not that many companies have actually cut employee hours or let people go because of Obamacare, according to a new analysis by the Center for Economic Freedom and Policy Research. 

Companies had been shifting toward part-time workers and cutting benefits for these workers long before Obama. While some companies are genuinely concerned about Obamacare's impact, it appears others are cynically using the law as an excuse to punish workers.

You can of course believe what you want about Obamacare. You can fervently support the 40 extremist House Republicans' efforts to defund it, and defend their willingness to shut down the government and even keep poor folks from getting health insurance in order to win this unwinnable political fight. 

But I think it's better to stick to a conversation about the actual substance of the bill and what it will or will not do for you. That's what matters, not scare tactics or glowing praise that have nothing to do with facts. Please do not rely on media on the left or the right to get your facts about Obamacare. I recognize the legislation has flaws but I believe these flaws could and should be fixed through the amendment process. 

A good friend of mine is understandably outraged that Congres and members of their staff are asking to be exempt from Obamacare. 

"This is the height of incredulity and hypocrisy," he says. "First Congress asks and is given waivers from any of the impact of Obamacare that the regular citizens will face for them and their staffs - because the ones who wrote it do not want any part of it for themselves. Now the same major union chiefs who spent millions and millions to help get this passed realize the raw deal they are gonna get... and they were just today meeting behind closed doors at the White House to they to work out some deal to get their unions waivers from much of the law. That is simply not right."

My friend goes on to say that these politicians are cutting every deal and "granting every waiver possible to continue to ram this down our throats. Why should Congress and their staffs and unions be exempted from the same law they worked for and passed? Hypocrisy on steroids."

It's a fair complaint. Should members of Congress and their staffers be exempted from Obamacare? No. But the idea of elected officials on both sides of the aisle wanting more than what they provide for their constituents is nothing new. This is de rigueur in Washington. It is politics, sadly, as usual. 

Bottom line? Obamacare is political trail mix - not all of its ingredients are bad, and certainly not all of them are good. But I don't expect many people to read this and have an all-new, balanced take on this law. To get your questions answered about Obamacare without any political hype, a good place to start to is that Kaiser study. Good luck.


  1. Jamie, I don't have the time, energy or tools right now to try and figure out the new health-care plan (it's not ACTUALLY called Obama Care, is it?), and I greatly appreciate this article.

    As I suspected, it's not the Anaffordable Communist Act, nor is it the Holy Grail.

    Good work! Thank you!

    As for Congress... don't get me started.

    1. Thanks Richard. The Affordable Care Act has basically been renamed Obamacare. It's a common usage thing. :)

  2. Well done piece Jamie. I am exhausted by the parties involved and wished that people would think through the cloud of self-serving "public servants". Yes there an significant issues and the complexity is astounding. My favorite personal rant is "We're Americans, and if we can spend twice as much, take twice as long and make it more difficult that it needs to be, then by God we'll do it."
    I really like how the Germans do it over here. It is very simple and does a nice job. BTW 1 card, yes only 1 card, that all. Medical, Dental, Life insurance, Mental Health Services, Rehab, Nursing care, Maternity Care, Post Partum care, everything. 1 card. No endless forms, no 12 different forms for a broken arm for 12 different insurance companies. Just a simple quarterly statement.

  3. We're living now in a post-facts world in which people no longer rely on or believe in hard data