I’m Alive Because of the ACA
With talk of the repeal of the Affordable Care Act (ACA) – a.k.a. Obamacare, we should look critically at how to replace it. There are many elements of the ACA that we need to in order to continue to keep healthcare available to many, and make sure no one dies because of a lack of access to the meds/health services they need. These are some of the essential elements that have helped millions of Americans keep as healthy as they can.
How the ACA has affected my health for the better, and ultimately has saved my life
- Children Until 26
Without this standard, I worked a 39 hour job so my employer wouldn’t have to pay for benefits. My employer at the time was the state of California. In order to make up for that gap I could either elect to purchase non-subsidized healthcare from my employer for $700 a month with a $2,200 paycheck, or I could attend school full-time and stay on my parent’s plan until 25. In addition to working full time, and going to school full-time, I had to attempt getting treatment. The process took months longer than it should have because I didn’t have the time to make doctor’s appointments easily.
Keeping “until 26” allows more people to have insurance when they need it, with no visible additional cost to taxpayers.
- Preexisting Condition
- Labeling Laws
- The Healthcare Marketplace
- Full Time Employment Adjustment
- Subsidy (premium tax credit)/Requirement
- Source of Subsidy.
Most Americans have a preexisting condition, to deny insurance based on that, or to deny care/meds undermines the very reason for healthcare in the first place. Literally it’s saying you’re sick, so we’re not going to treat you. Because health insurance is essentially the common method of payment, it is vastly different than any other form of insurance. In case you weren’t participating in health insurance before the ACA, if you have a preexisting condition, you essentially can’t have a break in coverage. (The proposed replacement presently wants to allow insurers to impose a 30% assessment on individuals who fail to maintain continuous coverage.)
It boils down to the fact that if you had a preexisting condition before you started insurance, they can deny you service. The ACA took effect the year I turned 26. In California, the 26th birthday marks the end. Some states go until end of calendar year. Because I wasn’t certain of the future if the ACA, I kept my insurance for two months between companies, spending nearly 2,000 on health insurance via COBRA, because my new employer used a temp agency to hire from, even though I’ve never communicated with anyone at that temp agency.
If a preexisting condition isn’t barred, the situation I came across is mild. Many will find their asthma, cancer or hepatitis bars them from becoming healthy.
In order to fight the growing obesity epidemic, properly labeling and informing consumers about their food is imperative. But it’s more than that. For those of us with specialized diets, watching these factors and labels becomes a big issue. For me it was my electrolytes. In order to keep going, I had to know what I could and couldn’t eat. Restaurants of a certain size need to provide nutritional content information. They have to use additional large labeling for common content like calories.
The marketplace needs to continue to be able to serve as a place to buy insurance. To a company, moving an employee to full time means paying significantly more, so they’re hesitant to give it to lower level employees. People who are underemployed, disabled and between jobs can get insurance without the exorbitant costs of COBRA.
Currently, full time is considered (on average) at least 30 hours per week, or 130 hours per month. If this changes, people between 30 and 39 hours will find themselves in need of insurance, with little means to otherwise gain access. If I had been 26 when I was working 39 hours per week,I would have extended COBRA, reducing my living wage income by $900 per month (before out of pocket medical expenses.)
The requirement and subsidy are linked, because it would be unreasonable to mandate these costs without some form of tax abatement. Without a scaling (over time) abatement it would have the effect of reducing minimum wage by the value of the price of insurance. In order to ensure that young/low income earners can still insure themselves, the sliding scale must exclude age as it presently does.
Presently, a large source comes from a payroll tax increase, a net investment income tax, and the penalty also partially funds the program. Without the penalty, fewer healthy people would be incentivized to have health insurance, thus raising the overall costs of it for every payer. This is the heart of the problem with the law for most conservative voters.
There are elements in the proposed replacement that are appealing; however, the new proposed replacement is very different from the ACA. It lacks the same allowances for coverage now, and in the future. And, it would eliminate the penalty, a source of funding the credit, whilst creating a 30% coverage gap penalty that goes to insurers; which means it’s not so much eliminating the penalty, as it’s moving the penalty to benefit insurance companies. The rationale behind this is undermined by the idea that insurers would lower their rates based on additional revenue from a source which costs no additional maintenance.
This ACA replacement affects every American, we should be more critical of its reincarnation than we were in its creation – because now we have comparative data.