There are winners and losers in Obamacare, and they have nothing to do with lofty values, ethical considerations or even, in many cases health. It’s money, pure and simple. So, as October 1 begins, consider whether Obamacare for you will be a trick or treat.
If you get insurance from your employer, you’re likely tricked. Instead of older models where companies negotiate the best deals for their employees using the tradeoff of lots of members for better insurance options, the PPACA actually brings the misery of the go-it-alone mentality into corporate America.
The shift is that employers and insurers are the new bonded team in the triangular relationship of insurer-employer-employee. Companies have teamed up with insurers and the provisions of the PPACA to squeeze their employees whether it’s through increased cost sharing in the form of copayments and deductibles, or the trickier approaches of overcharging for dependent coverage that employees can purchase for their family members, or the tricky approach of dropping spousal coverage options if a spouse has coverage available elsewhere.
If you think that medical costs will go down, you’ve been tricked. Consider recent articles about US citizens traveling out of the country for medical care (NY Times this summer, for instance) as a means of affording medical treatment. Hardly reflective of Obamacare as a “solution” in any way for rising medical costs.
If you think your healthy lifestyle justifies your finger-pointing at “unhealthier” Americans as the reason for health cost increases, you’ve been tricked. Health costs are rising because they CAN, there is no limit on what you can be charged for medical treatment, and insurance companies are chasing those costs and working out their own ways to avoid paying. You will pay less while you’re healthy, you know, when you don’t NEED health insurance to pay for necessary medical care ONLY.
If you’re unemployed and poor, you’ve been tricked. You are outside of Obamacare, especially in states that have opted out of expanded Medicaid coverage. Our poorest citizens will remain uninsured, though not liable for the tax on being uninsured, but paying increased health costs with no safety net.
If you have no employer insurance and fall within income guidelines for Obamacare, and therefore participate in the exchange, you’ve got a treat, access to credits and rebates based on your adjusted gross income even if your other assets amount to millions of dollars, such as a home, since these are not considered in the calculation.
If you hedge your bets and you stay well and buy the cheapest insurance, then you’ve got a treat, checkups in many cases for free, cheap premiums, perhaps even paid for if you participate in an exchange, and no significant out of pocket costs for actual medical treatment.
If you hedge your bets but you become sick, this could be the year of the trick. Health plans will likely provide you with fewer in-network choices and you’ll have to use those in-network choices in order to benefit from rules regarding the OOP, the out-of-pocket maximum. In-network choices will start racking up higher cash contributions from you.
If you’re young, you’ve been tricked, your premiums are going up.
If you're young and you gamble that you won't need health insurance this year, and you don't need health insurance this year, and you pay the tax for not purchasing healthcare, you'll likely get a treat since the penalty is far less than premiums. (Nobody will advise this, since you could get sick.)
If you smoke you’ve been tricked, your premiums are going up.
If you want to keep your teeth and you buy into the "free" premium scenario published by the Federal government, you've been tricked, dental insurance is separate.
If you are fat, you’ve got a treat, your premiums are not going up, but, costs for your treatments, your contributions in cash to your care, will likely rise since there are no limits on what can be charged for medical treatment.
If you’re an employer looking to offer HSAs (health savings accounts) as a cheap alternative to other insurance products, the PPACA actually gives you a treat, more and more people are likely to use these plans as a less expensive alternative. These plans don’t work well for everyday consumers who will find themselves tricked if they choose the plans, but they’re a great way to hide money for the rich, so they’ll get a treat.
If you’re on medications that are provided through a company separate from your health insurance, you’ve been tricked. The amounts you spend are not only likely to go up, but they won’t contribute to your out-of-pocket maximum for the 2014 year.
If you believe that you'll get cheaper health insurance that covers more than other health insurance you've had, you've been tricked. This will be evident when you read through your policy.
Ultimately, the PPACA is a significant testament to money and has less to do with addressing our healthcare “crisis” than it does with uncovering flawed ideologies on both sides of our government.
So, if you listen to the President, or to the Republicans, take it all with a grain of salt, both sides are guilty of what the President scolded Republicans for this week in his Weekly Address, a willingness to “…hurt people for the sole purpose of advancing their ideological agenda."
