The view that is frequently presented here is that Affordable Care is not nearly as “revolutionary” as it was publicized to be because health insurance works one way, and one way only, charging enough to the consumer to cover the potential liability in dollars of an insurance company while protecting revenue for the insurance company.
We all would have been better served by more information and less politics in consideration of the Act during the seemingly endless election season.
Now, with the election behind everyone, except for the talk-shows involved in the endless post-mortem of how bad one candidate or the other was, again, we’re faced with the reality of our healthcare system.
November 20th news stories informed that new rules will support certain insurance plans in raising the deductibles they can include in order to meet cost-sharing goals and limits on how much individuals should be “sharing” in the costs of their health plans. (Search Rule Changes November 2012 Affordable Care Deductibles.)
To keep costs of the health plans down FOR INSURERS, insurers will be permitted to increase the amount of deductible for the plans they offer. Of course, this is a back-door way of having consumers pay more since deductibles are amounts paid out of pocket by consumers BEFORE full insurance under a plan is provided, or in some instances, any insurance coverage.
By increasing permissible deductibles, insurance companies increase their profitability by incorporating the fact that each family or individual would have to spend more on their own healthcare rather than insurance companies contributing at earlier stages of healthcare treatments before deductibles are met.
In addition to upping the deductibles, proposed rules that allowed for drug coverage of a single drug option within specific classes of drugs will be changed to be required to cover the same number of drug options as in “benchmark” plans for each state. This should increase alternative drugs within the same class available to individuals. For instance, organizations such as those advocating for people with cancer approve of this change.
These November 2012 changes start to illustrate that the Affordable Care Act is much less revolutionary than publicized. After all, charging less for a plan with a higher deductible is not exactly novel.
Ultimately, the failure of the Affordable Care Act to have a public option, with the additional Federal government handicap of being barred from the Supreme Court in creating a mandatory expansion of Medicaid eligibility in order for states to receive Medicaid funding, will likely do little to improve healthcare for individuals through improved access to and affordability of health insurance that pays for medical care when individuals are ill.
