Why The Repealing of 'Obamacare' Is So Dangerous to Our Economy

Gerrie Schipske, RNP/JD

Since its passage in 2011, I have deducted points on term papers when the students in my healthcare law class refer to the Patient Protection and Affordable Care Act as “Obamacare” for two very sound reasons: 1) Students studying the law need to use the correct citation and name of a law when discussing a statute, and 2) from the beginning, “Obamacare” was a term used to deride and denigrate the most important piece of healthcare legislation since the 1965 Social Security Amendments which established Medicare and Medicaid. Such negative and pejorative reference prevents one from understanding how complex and important these laws are to our economy and personal health.
So what’s so awful about the Affordable Care Act? Apparently nothing if you use that term and not refer to it as “Obamacare” when explaining what it is and does. However, when you ask the same people what they think of “Obamacare” they “hate it.”
So let’s go over the facts and the fiction about ACA:
1) It is doubtful that the law will be really repealed. For show, politicians will posture how they voted to “repeal Obamacare” but it will most likely be renamed and tinkered with so they can claim victory. Here’s why: because it is the biggest gift to the insurance industry since the invention of managed care. It mandates that everyone must have healthcare insurance coverage – a mandate by the way that was upheld by the US Supreme Court as constitutional. Do you really think politicians are going to let the insurance industry lose this gold mine?
2) In return for mandating everyone have healthcare coverage, insurance companies agreed to some very significant changes that greatly impacted the health and financial stability of American families by ending discrimination against women, older people, and children and adults in less than perfect health: a) insurance companies can no longer deny coverage for pre-existing conditions; b) insurance companies cannot place a “lifetime” limit on benefits; c) insurance offerings have to include basic preventive care that cannot be charged to the patient – things like pap smears, mammograms, immunizations, birth control, and screening for a number of child and adult illnesses and diseases; and d) children under the age of 26 can remain on their parents’ healthcare policy. These are the provisions that voters like. Just try taking these back without a major political backlash once voters realize what is being done.
3) Premiums for coverage under the ACA are not set by the government. They are set by the insurance companies. Premiums have increased because the insurance companies want to make more profit.
4) Payments to physicians and hospitals under the ACA are not set by the government (unless care is given to Medicare or Medicaid patients). Payments are determined by the insurance companies.
5) Under the ACA, the government does not determine who you can pick as your doctor. The insurance companies contract with physicians who must agree to accept lower payments for care. If they won’t accept the lower pay, the insurance company drops them from network and you no longer can see that physician. The government has nothing to do with this.
6) The ACA has many other features that few, even those in congress, know about. The law: prevents insurance companies from spending more on marketing and administration than on paying for your healthcare; it helps fund education programs to fill the shortage of healthcare professionals in this country; it focuses on quality improvement as the basis for paying providers for care; and it expands efforts to crack down on fraud and abuse in the healthcare industry.
So what is the replacement being offered? Well, they are still writing it. Keep in mind that political opponents to the ACA have their own healthcare insurance plans. They won’t feel anything if the current system is killed.
One “replacement” proposal floating around is to promote the use of health savings accounts. These are tax free accounts which a person sets up by designating money from their pay into an account that can only be used to pay for deductibles and co-pays charged by their healthcare insurance. What is laughable is that you need to have a pretty good paying job to set one of these up.
By the way if you don’t use the HSA, you lose it. Furthermore, if your employer is no longer obligated to provide healthcare coverage for you (which they are under ACA), an HSA is meaningless because you won’t be able to afford coverage.
It is unfortunate that there are those who are willing to do or to say anything to end “Obamacare” out of political spite without concern about the impact on millions of Americans who will once again not have healthcare coverage and will be faced with financial ruin over the high cost of care.
Gerrie Schipske, RNP/JD, is an executive faculty member, CSULB Department of Healthcare Administration and Beachcomber contributor on Long Beach history.



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