In the United States, health professionals and politicians are eagerly anticipating the opening of online insurance marketplaces on the 1st of October. With the arrival of these exchanges, wherein consumers and small businesses can compare and purchase insurance, it is expected that the nation will finally know whether or not the Affordable Care Act is affordable, feasible and useful. In the run-up to this all-important opening of the health insurance exchanges, both supporters and opponents of the state exchanges (and by extension of Obamacare as a whole) have found plenty to discuss.
A good amount of recent Obamacare news has centered around the potential problems that insurance exchanges may face, however it’s not all bad news. In partnership with women’s magazine Cosmopolitan, Kaiser Health News reported this week on the ways in which young women may benefit from the forthcoming effects of the ACA. Firstly, there’s the fact that young adults both men and women have already enjoyed the advantage of remaining on their parents’ insurance plans until the age of 26; a policy that was put into place in 2010 and resulted in insurance coverage for over 3 million youth.
The Cosmopolitan/Kaiser Health News story also pointed out the Obamacare benefits that have affected women in particular. The ACA mandated that starting in 2012, insurers had to provide a wider range of preventative care services, including all contraceptives approved by the FDA – birth control pills, intra-uterine devices, hormone implants and so on. This preventative insurance coverage is also a benefit to women who might be in need of HIV or diabetes screening, or other family planning services. Obamacare also eliminated the possibility that an insurance company might charge a woman more than a man of the same age, and guaranteed access to maternity coverage, to breastfeeding supplies and counseling, and even to a “reasonable break time” in order to pump breast milk more comfortably at work.
However, despite these positive aspects of the ACA outlined by Cosmopolitan, Kaiser Health News and others news outlets, the media attention on Obamacare has primarily focused upon what might go wrong. Another Kaiser story, published this week in collaboration with NBC News, asked the question of whether or not the Affordable Care Act could actually be affordable for all Americans. One woman interviewed in the story explained her concerns about being legally forced to hold health insurance starting January 2014. The woman, Michelle La Voie, is a single mother with two children and an income of less than $40,000 dollars per year. Therefore, even with financial support from subsidies, purchasing health insurance would mean spending nearly $200 per month, a sum that La Voie says is much too high for her family’s budget. Moreover, even if the family did have a health care need, the co-pays and deductibles could mean thousands more in health care costs; therefore negating the likelihood of going to the hospital, even with a health insurance policy.
Indeed, many Americans like La Voie wonder whether it’s not better to pay the fine for failing to hold insurance, rather than purchasing a policy: the fine for being uninsured in 2014 will be $95 or 1 percent of household income, whichever figure is larger. If La Voie purchased an insurance policy with premiums of $200 per month, she would be spending around 6 percent of her income on health insurance.
And the concerns about Obamacare do not end with questions over the affordability of mandated insurance. According to a number of news reports over this past month, the technical aspects of online exchanges may also prove difficult to manage. Oregon, for example, announced during the summer that its state marketplace would be opening later than expected due to bugs in the marketplace program software. Although state residents can apply for exchange membership beginning October 1, they will not be able to shop the marketplace for insurance policies until two to four weeks after that.
Perhaps even more worrying to consumers around the nation is that Washington DC is another state district that, like Oregon, is delaying full exchange capabilities due to software glitches. Normally, an insurance exchange website should be able to calculate the subsidies to which each shopper is due, based on that person’s income, place of residence and other eligibility details. However, Washington DC has announced that its online exchange is not currently able to perform these calculations and give exchange customers an accurate idea of how much they have to pay for a policy, and how much will be covered by outside subsidies. Spokespeople have indicated that although district residents can begin shopping for insurance on the marketplace starting October 1, prices cannot be accurately determined until November.
These and other issues have furthered criticism from detractors of Obamacare. Still, for those who support the ACA, there is plenty of evidence that the health care law will work as intended and bring better, cheaper health care to the nation. Benefits already in place, such as mandatory preventative health services, more comprehensive care for young people and better prescription coverage for the elderly have already increased access to care and reduced costs for many. Other figures suggest further advantages to come – a wider availability of disease screening, greater financial help for lower-income insurance users, and lower premiums for everyone.
In an article published this week, the Washington Post makes the excellent point that, in the end, the success or failure of Obamacare will be determined by individual Americans; by a person who finds an affordable insurance plan and enjoy preventative care for the first time, saving hospitals and taxpayers money in the process; or, by a person who falls just above the poverty line and must face either breaking the mandatory insurance law, or paying for insurance that she can’t afford to use.