Six months after the rollout of the federal Affordable Care Act it seems appropriate to question whether the controversial plan, better known as Obamacare, has been good for Americans and, in particular, good for the residents of New York State.
New York was one of 14 states that opted to run its own health care exchange or marketplace. Thanks to a surge in enrollment over the last two weeks, the Obama administration announced on Monday that 5 million people have signed up for health care insurance.
New York did twice as well as any other state with 244,600 signups. That’s 142 percent of its goal. That’s an enormous accomplishment. These individuals and families can now see a doctor or go to a hospital when necessary.
Bottom line that’s what the Affordable Care Act is all about. In the greatest nation in the world it is unthinkable that people should suffer from illness in their homes because they can’t afford health care. It is likewise unconscionable that people should be denied insurance because of a pre-existing condition or dropped from a plan because they become sick with a serious illness.
And, despite the fear mongering of the far right, the sky did not fall in. The major insurance companies did not fold. There remains a fear that smaller businesses will reduce the hours of some employees below 40-hour threshold to get around the requirement that they provide health care. Although there are anecdotes, we have not seen numbers to justify that fear.
It should be noted that Obamacare provides tax incentives and guidance for small businesses looking for an affordable provider.
For many families still reeling from the recession, the Affordable Care Act expanded eligibility for Medicaid, especially for the working poor. For those whose income is below 400 percent of the federal poverty level, that’s $94,000, for a family of four, there are tax credits that assist in the purchase of a plan.
Insurance companies can no longer deny coverage for pre-existing conditions. And the companies can no longer drop anyone from coverage once they become seriously ill. If a company denies someone coverage, that person can take advantage of an external appeals process.
One popular myth is that the federal government will suddenly be subsidizing health care when it hasn’t before. For roughly the half of the population that gets their health insurance through their employer, the government does not tax the value of that health insurance. This is a regressive system in which the higher the tax bracket the employee is in and the more expensive the health insurance offered by the employer the greater the benefit. That’s a federal subsidy for those who need it the least.
Although libertarians and free-market fanatics may disagree, common decency says health care should be available to everyone in a great nation. This is especially true for the working poor who will now be covered by Obamacare. Sadly this is not as true in the 25 states that refused to expand Medicaid even though it won’t cost them anything for the next few years and only 10 percent thereafter.
There are penalties for those who don’t have a health insurance plan and refuse to sign up for Obamacare. Young adults, in particular, may feel invulnerable, but clearly they are not. The penalties in this case are fair.
Although we applaud the rollout of Obamacare and its great success in New York, the application process for many has been maddening. We have heard from some New Yorkers who say they have been trying to get signed-up online for three months or more. When, after waiting on hold for 45 minutes or more they get a representative from the New York Health Care Exchange on the phone, the person who answers explains the exchange is “swamped” and it could take weeks before the caller finds out why the application did not go through.
Even the specially trained “Navigators” at various community organizations have been frustrated by the complexity of the process and the inexplicable delays.
This does not serve Affordable Care Act and the Health Exchange well and feeds its critics. That has to change in the next six months.
