President Barack Obama is catching fire from congressional Republicans over the federal government’s hapless website. They hope it leads to the destruction of Obamacare.
“Rate shock!” “Millions lose their insurance!” “Health-care crisis!”
Reading and watching coverage of the unfolding Obamacare implementation, aka the Affordable Care Act, would like to give you palpitations. Or send you running to the hills screaming, “We’re all gonna die!”
Which is true enough, actually, we are all gonna die. The question is, will we have health care to at least forestall the inevitable? Particularly if we’re poor?
Until now, the answer in Nevada was “frequently not.”
For thousands of Nevadans, the “doctor” was a very expensive, even ruinous, visit to the emergency room of the closest hospital.
The Obama administration has certainly piled the fuel on the fire of health-care hysteria. It’s ballyhooed “launch” on Oct. 1 of the new national health-exchange market was a Titanic-level, catastrophic cow flop that engaged sneers and snickers, frustration and anger among would-be customers.
People in 36 states are depending on that national system to sign up, before March 31, for health insurance, as now required by law, so it’s a serious problem for most of the country.
But, take a deep breath. Nevada is not in one of those 36 states.
Gov. Brian Sandoval, a Republican who initially opposed and even sued to stop the Affordable Care Act, was one of those who cooperated in establishing a state-based exchange for people - including thousands who qualify for subsidized plans - to sign up.
Unlike the still not-functional national system, Nevada’s is apparently working just fine. According to Jon Hager, Silver State Exchange director, there’s very little overlap between the state and federal systems.
“We’re doing pretty good,” he said late last month. The exchange, dubbed Nevada HealthLink on the Internet, has logged 229,000 visitors and about 16,000 applications for insurance customers, many of whom will see cheaper and better insurance than they previously could buy - if they could buy it at all.
(Disclosure: As a freelancer last year with a pre-existing medical condition, I was able to enroll and buy insurance through Obamacare. The plan cost me about $380 a month, and dramatically reduced the cost of life-saving medications I needed, saving me about $200 a month in pharmacy costs. I could not find insurance at any price on the private market because of my medical situation; I am an insulin-dependent diabetic.)
Hager said the Nevada system had a few bugs, mostly because of the volume of would-be users, in its first few days up last month, but now seems to be running smoothly.
Hager echoed what other policy analysts have been saying: The overwhelming majority of people should see little or no change in their health-care plans that they receive from their place of employment.
In last week’s New Yorker, author Ryan Lizza, citing MIT economist and architect of both Mitt Romney’s health-care plan in Massachusetts and the ACA, broke down the numbers. Similar or identical numbers were reported last month in numerous other analyses.
* 80 percent of people, those with health insurance through their place of work, will see little or no change. Some changes will be part of the rules and will benefit the insured, for example, a ban on lifetime caps and a requirement that pre-existing conditions be covered.
* About 14 percent of Americans who now do not have or cannot afford insurance will have access to subsidized coverage through the ACA, many for the first time.
* The headline-grabbing controversies are about the final 6 percent of Americans who buy insurance on the private market. About half of these people will see little change to their policies, although they may find cheaper alternatives in the state exchanges.
* Insurance companies, however, may require customers to buy more expensive policies than they were previously offered. This is because of a deliberate effort to raise the quality of insurance policies, including a cap of $6,000 on out-of-pocket expenses.
The horror stories of “rate shock” apply to this fraction of the total market, but those working on the issue said the headlines often are more alarming than the reality.
Hager said it is tough to compare policies and prices pre- and post-Obamacare.
“It’s a completely new world and it’s very difficult to make comparisons,” he said.
(This is the first of two stories on Obamacare, the Affordable Care Act, in Nevada.) CL