It is also one of the most misleading analyses I’ve ever read because it picks and chooses which facts to include and which to ignore. He doesn't
give you the full picture.
First of all, let’s take a look at the example he uses of a 35-year old with a MAGI of $27,925. Where, exactly, did he come up with a monthly
premium of $187.33 for the Silver level plan? The exchanges have not been finalized as of yet – they are intended to create competition between the
providers offering coverage (there is no public option) – so where did this monthly premium come from for a plan that will not go into effect until
2014? Heck, most states haven't even set up their exchanges and have chosen to rely on the federal government to do it for them.
Secondly, the author fails to mention that this same person with a MAGI of $27,925 will also qualify for other offsets – yes, the plans are set up
to provide a premium assistance tax credit based on the FPL, but they also include cost-sharing assistance which will limit a person's maximum
out-of-pocket costs, and for some it will also reduce other cost-sharing requirements (i.e., deductibles, coinsurance, co-payments).
Thirdly, he fails to mention that although these deductibles are high, they qualify as High Deductible Health Plans (HDHPs) which qualify as Health
Savings Account (HSAs) plans. Depending on where you live, these types of plans are already the norm (I live in the Northeastern part of the US and
my own plan for the last three years has included a $2,500 deductible and 60/40 coinsurance). This means that the same individual paying this
supposed “$183+” in single monthly premiums on a post-tax basis, will be able to set aside into his/her HSA and save paying taxes on $2,050
(double for family) because HSA contributions are made on a pre-tax basis. So not only will the $2,050 (applicable to the Silver plan) be deducted
and set aside on a tax-free basis, but this individual’s net annual income on which he/she pays federal and state income taxes will be reduced from
$27,925 to $25,872.
The thing that really gets to me is that all of these critics stop short of realizing the true fallacy of ACA. It’s not about the insurance
companies making more money and we can argue about this from today until tomorrow but it’s been shown that even though insurance companies will have
more premium-paying individuals, the essential health benefits that they must provide under even the lowest Bronze plan will, by far, cost them more
than any additional premium they may collect (and this is not taking into consideration the medical loss ratio (MLR)provisions of the law which state
that out of every $1.00 in premiums collected, $0.80-$0.85 must be used to pay claims or the difference is returned to the consumer). The true
fallacy of ACA is in that it does ABSOLUTELY NOTHING
to stop the cost of medical inflation. In other words, medical costs can keep going up
and up exponentially.
According to the
Agency for Healthcare Research & Quality
, the average mean cost to visit an emergency room during 2009 was
$1,265. Over the last ten years, medical inflation has averaged 3.84% a year which means that by 2014 the same $1,295 in 2009 will equate to $1,530 in
. Think about that – since the cost of medical care is increasing
at unregulated rates, the ACA makes absolutely no difference to the healthcare industry because regardless of whomever is responsible for whatever
portion of payment (i.e. insurance company versus individual consumer), the healthcare providers will end up being reimbursed the same amount.
In conclusion, we can and assuredly will continue arguing about ACA, but unless you yourself have read the original regulations, the myriad of
revisions released since then plus the interim and final rules, all of which amass to thousands and thousands of pages, you can’t really speak from
a fully-informed position as to whether or not ACA helps or harms us. I believe that the intent of the law was altruistic. It fell short in many
ways, but it will also enhance the level of benefits available to millions of people (no more pre-existing condition limitations, no more maximum
limits, no rescission of coverage, etc.).
Where its true failure lies, however, is in the fact that it did nothing to address the ever increasing cost of healthcare in this country and until a
law is passed which tackles this issue, we will all continue to suffer.
edit on 2/12/2013 by timidgal because: (no reason given)