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Birthday “Kudos” to the P.P.A.C.A.!

March 26, 2015

The Patient Protection and Affordable Care Act celebrates its fifth anniversary this month. Its quasi-full implementation was completed in most states with the establishment of insurance marketplaces and the expansion of the states’ Medicaid programs.
All gloomy predictions of disaster by those opposing the Patient Protection and Affordable Care Act, and STILL wage war on it, have no sound foundation to continue their ideological opposition. The continued frivolous legal battles waged against the ACA has cost states vast sums of money better spent on supporting their own state health concerns. Hopefully, the U. S. Supreme Court decision, now under consideration on insurance premium assistance to low-income families (re: states that did not establish an Insurance Marketplace), will put brakes on this waste of taxpayer money.
In the first year of the Affordable Care Act operations via the Marketplace, almost
10 Million people were no longer uninsured. In this last open enrollment, which ended February 15, 2015, just under 11.7 Million Americans, using state or federal marketplace plans, either enrolled or were automatically re-enrolled. Locally, without state governmental assistance, 69,221 Oklahomans were able to use the federal marketplace during the 2013-2014 open enrollment period. If the U.S. Supreme Court upholds the lawsuit brought on by those states which did not establish a marketplace ( including
Oklahoma), 79% of those Oklahomans currently using the federal marketplace will no longer be able to afford insurance.
Because of the very stringent qualification limitations placed on Oklahoma’s Sooner Care Program (Medicaid), because of Gov. Fallin’s and our legislature‘s, refusal to expand Medicaid, only 13,526 individuals gained Medicaid or Child Health Insurance Program (CHIP) coverage during the ACA’s first full-year of implementation of the Marketplace. This indicates that Oklahoma’s Sooner Care Program is maxed out, leaving 123,000 Oklahomans without medical coverage.
If fully implemented by Oklahoma, the ACA would have provided adequate care for mental health and substance use, benefiting an additional 774,018 Oklahomans.
Upon initial implementation, 49,000 Oklahomans under the age of 26 gained health insurance through their parent’s health insurance policy.
Approximately 1,578,794 Oklahomans under the age of 65 have some degree of pre-existing health conditions, including in this figure 218,356 children. Neither group can now be denied health coverage. Along with ending discriminatory health insurance policies, health insurance companies can no longer charge women a higher premium rate because of their gender.
The Affordable Care Act has also had a positive effect for care of those citizens over 65 years of age. Not only has it strengthened Medicare, offered a wide variety of preventive services at no cost, but now provides discounts for prescription drug coverage to those in the Medicare Part D “donut hole.”
When enrolling in Medicare upon reaching the age of 65, you are automatically covered for your Part B physical screening during your first 12 months enrollment. Every 12 months thereafter, you are eligible for a preventive services screening. For the full list of covered preventive services, either discuss it with your physician during your initial “wellness visit” or go online to Medicare.gov, or call 1-800-633-4227. TTY users can use 1-877-486-2048.
In spite of the “foot dragging” of Oklahoma’s elected administration 1,197,000 Oklahomans (including 450,000 women and 317,000 children) no longer need to worry about lifetime limits on coverage due to chronic diseases or catastrophic illness. Those who had affordable private health insurance also join new enrollees in all of the aforementioned preventive health services. What this means is that 849,000 Oklahomans (including 330,000) women are included in the preventive services that private insurance companies are now required to provide.
The Affordable Care Act strengthens Medicare. The Medicare Trust Fund for hospital insurance coverage is now projected to be solvent until 2030, four years longer then the projection in the 2013 report. Less than a decade ago, they projected the trust fund to run out of money by 2017.
As with most socially beneficial programs, the Patient Protection and Affordable Care Act has some minor flaws and, like most government programs put into operation for the first time, may need to be ADJUSTED – but NOT REPEALED!

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