Posted: 04/18/14 00:24
by Dave Mindeman
The ACA hit 8 million sign-ups.
Actually it is over that figure, but the 8 million is a good announcement figure. Except you won't hear much about it from conservative media. Fox News front page had a single small link which actually appeared in the Fox Business section, not the main page.
The main page, of course, had to blair the headline....
REID: Bundy Supporters Are Terrorists
The Minnesota conservative blog aggregate is Look True North. Not one single post about the ACA milestone - even to criticize it.
Everything about the ACA is starting to fall into place-- as it was designed to do. The numbers surpassed projections. The 18-34 group makes up about 28% of the total - a little low, but it has been steadily climbing and will probably be a bigger share in the 2015 sign up period.
Polls indicate that the number of uninsured is dropping -- much more in the states that accepted the Medicaid expansion. Numbers are beginning to show that over 5 million people are being DENIED the opportunity to sign up in the "red" states that refused the expansion.
The number of paid premiums is in the 85 to 90% range.
Even the persistent critique about "keeping your plan if you like it" has a snag to it. Obamacare has 10 certain requirements that make an insurance plan offer true complete insurance. I think it is worth noting what those 10 items are:
1. Ambulatory Health Services. This is basically outpatient care and most insurance coverages had this.
2. Prescription Drug Coverage. Most insurance plans would offer this ONLY with an additional cost. With the ACA, some form of this must be offered in the original plan.
3. Emergency Room Visits. Most plans had this but the ACA did away with coverage denial because it lacked "pre-authorization". Some plans would still write that into their policies - now they cannot.
4. Mental Health Services. Few insurance plans would write this into their policies. They must have it with the ACA although they can charge up to $40 as a copay.
5. Hospitalization. Plans usually covered this but with all sorts of different variables. The ACA requires coverage - although up to 20% copayment may be needed within deductible limits.
6. Rehabilitative and Habilitative Services. A lot of insurance plans would cover rehab - but the ACA requires habilitative service which are therapies to help overcome long-term disabilities, such as those that accompany a disease like multiple sclerosis. Insurance plans tried to opt out of a long term commitment.
7. Preventive and Wellness Services. The ACA instructs insurers to provide all of the 50 preventive services recommended by the U.S. Preventive Services Task Force at no extra cost. Prior to the ACA, insurance would only cover things they knew could save THEM money in the long run. Others would ignore all of it and take their chances if the contract was short term. Many believe that this part of the ACA will be the biggest cost saver in the law.
8. Laboratory Services. Although most lab test were always covered, the ACA makes it a standard. Insurance companies can't pick and choose which test can be in their plan.
9. Pediatric Care. The ACA adds some preventative dental and vision coverage as mandatory.
10. Maternity and Newborn Care. Yeah - men don't need this, but their significant others might in family coverage. Some of this care, like prenatal nutrition and care and some parts of childbirth were left out of regular insurance coverage. Up to 2/3's of plans did not meet the new ACA requirements in this area.
When you look at these standard coverages in the new law, you can see how many of the "junk" plans would have to be scrapped and new policies issued. Yes, a lot of people lost the plan they "liked"....they were just fortunate enough not to need it.
A lot of the insurance horror stories and coverage nightmares that have become part of media coverage over the years will be ending.
Reliable, affordable health care is here to stay. The conservatives will continue to complain about whatever they can...they have to, it has become their only political plan for this election cycle. But the ACA is working and has gone beyond the threshold of viability.
We can now move on to improve the law where needed and health care can be a bipartisan priority.
At least I can dream.....