March 23, 2013

Affordable Care Act: Racing against deadlines, detractors

Republican opposition and looming deadlines are two big hurdles facing the future of health care.

By RICARDO ALONSO-ZALDIVAR The Associated Press

(Continued from page 1)

Maria Webster
click image to enlarge

Maria Webster joins others protesting against Texas Gov. Rick Perry’s stance on health care outside the state capitol in Austin, Texas, in January. Despite the state having the highest percentage of uninsured, Perry is not promoting federal insurance exchanges.

The Associated Press

A LOOK AT THE HIGHLIGHTS OF THE AFFORDABLE CARE ACT

The new health care law was devised in Washington, but it's in the states where everyone will find out if it works.

The Patient Protection and Affordable Care Act is the biggest safety-net legislation since Medicare and Medicaid in 1965.

Enrollment starts Oct. 1, 2013.

It will move the U.S. closer to other industrialized nations that provide health care for all. About 30 million uninsured Americans are eventually to gain coverage, at an estimated cost of $1.3 trillion from 2013-2023. Insurers won't be able to deny people with health problems.

The law mandates that most individuals have health insurance, provides subsidies to help pay premiums and penalizes people who can afford coverage but don't do so. It imposes penalties on businesses with 50 or more fulltime workers that don't offer coverage.

Health insurance exchanges set up in each state will offer subsidized private health plans to middle-class households. Medicaid, the government's health insurance for the poor, will be expanded to cover low-income individuals making up to about $15,400. States can opt out of the Medicaid expansion.

-- The Associated Press

"It is a much bigger lift here," said Anne Dunkelberg, associate director of the Austin-based Center for Public Policy Priorities, which advocates for low-income people. "The sooner the federal exchange can get engaged and working with all the folks here who want to promote enrollment, the better."

The Congressional Budget Office predicts a slow start overall, with only 7 million gaining coverage through the exchanges next year, rising to 24 million in 2016.

At a recent insurance industry meeting, federal officials directing the rollout rattled off a dizzying list of deadlines. Public outreach will begin in earnest this summer and early fall, said Gary Cohen, head of the Center for Consumer Information and Insurance Oversight.

The government sees three main groups of potential customers for the new insurance markets, he said.

There's the "active sick and worried," people who are uninsured or have pre-existing medical conditions. Under the law, insurers will no longer be able to turn the sick away.

There's the healthy and young. "They feel invincible, they don't feel a need for health insurance," said Cohen.

Finally, there's the passive and unengaged. "For these people, a significant education effort needs to happen," he said.

To keep premiums affordable, the government will need to sign up lots of people from the last two groups to balance those in poor health, who will have a strong motivation to join.

The official heading consumer outreach for the rollout, Julie Bataille, acknowledges the challenge but says she's confident. "This is a really an enormous opportunity for us to change the conversation around health care and help individuals understand the benefits they can get," she said.

 

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