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Informing Patients About Care Via the American Medical Association

Posted on Sep 30, 2013 by Ailee Slater ()  | Tags: American Medical Association, AMA, ACA, Obamacare, Affordable Care Act, the Independent Payment Advisory Board, IPAB, individual mandate, Medicare

A major concern of legislators and health care workers in the United States is that many citizens don’t understand the Affordable Care Act. In August, the Kaiser Family Foundation reported that 31 percent of people polled didn’t know whether or not Obamacare had been signed into law (it was, in March 2010), and at the beginning of this month, former president Bill Clinton published a live webcast attempting to explain some key aspects of the ACA. But this week, the American Medical Association launched a new website designed to help not consumers, but rather their doctors, understand Obamacare. 

The American Medical Association (AMA) is hoping that if doctors are better informed about Obamacare, they can then be better equipped to pass on that information to patients, many of whom still have questions about that ACA. In the American Medical Association’s Frequently Asked Questions About Obtaining Coverage, a number of Obamacare policies are addressed. The document explains that health insurance marketplaces in each state will open this October and operate online; that online marketplaces might help patients find more affordable insurance; and that online insurance exchanges will also help customers to find out if they are eligible for financial assistance or any other insurance discounts. 

The AMA’s FAQ document also provides information about the individual mandate; an issue that patients are likely to bring up with their physician. The individual mandate of the ACA states that every U.S. citizen is required to hold health insurance by January 1, 2014. Any person not holding insurance (whether purchased independently or provided through an employer) will have to pay a penalty. The FAQ sheet explains that for the 2014 year, a person not holding insurance will be required to pay a fine of either $95 or 1 percent annual income, whichever is greater. However, the FAQ document also reminds patients that most people already hold the minimum level of coverage required, and that if insurance does need to be purchased, the online marketplaces are there to help. 

Along with fact sheets for physicians, the AMA has also published a number of informational fliers which can be given to patients directly or posted around clinics and exam rooms. The posters include directions on how to sign up for a state health insurance marketplace, and a simple graphic on how the new online exchanges will work. Another AMA brochure offers patients a list of actions they can take now to prepare for the upcoming opening of health insurance exchanges. The AMA recommends that new health insurance customers make a list of questions (for example, “does this plan cover health care while I’m abroad?”) before shopping for a plan. Similarly, the AMA reminds patients that before finding a plan through an online exchange, it’s important to understand a few fundamentals of insurance – copayments, deductibles, out-of-pocket limits and more. Setting a budget and looking at annual household income are other important steps before purchasing insurance. 

The American Medical Association calls itself a “Champion of Coverage,” meaning that the group is committed to getting people informed about the ACA and signed up with an online insurance marketplace before the end of the year. However, the American Medical Association is notable in its disagreement with the federal government over one Obamacare policy: the Independent Payment Advisory Board. 

Created with the passage of the ACA in 2010, the Independent Payment Advisory Board will be a 15-person panel hired to help Congress make decisions on Medicare and controlling Medicare expenses. The Payment Board was created due to fears that Medicare spending might grow too quickly, and that an independent entity was necessary to keep the federal insurance program under control. Many Republicans, Democrats and public groups such as the American Medical Association, however, have denounced the Board. Many Congresspeople have said that the Payment Board takes away too much authority from legislators; especially considering that Congress is legally obligations to enforce the Payment Board’s recommendations. Some lawmakers have called the Payment Board “health care rationing,” saying that it will lead to worse medical services for the disabled and seniors that depend on Medicare. 

The American Medical Association has very clearly stated its opposition to the Independent Payment Advisory Board, and has called for its repeal. In a February 2012 letter to Congress, the AMA explained that because Medicare is already lacking in stability (due to program payment formulas waiting to be updated), adding the Payment Board would cause more confusion and potentially dangerous cuts to service. In the same letter, the AMA also warned that the because Payment Board can’t be held accountable for its actions, proper consideration wouldn’t be given to the effects of health care cuts on the millions of Medicare patients. 

Despite calls for its repeal, the Independent Payment Advisory Board remains. And although the American Medical Association is fully opposed to this aspect of Obamacare, the groups is still promoting the Affordable Care Act and working hard to get patients signed up to health insurance exchanges. Considering how much partisan squabbling has occurred as a result of the ACA and related legislation, it’s heartening to see that a public entity such as the AMA can both approve of Obamacare as a whole, while also using legislative efforts to hone in on changing the parts the Association opposes.

 

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