The Supreme Court, Affordable Care Act & You

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“My view is that health care reform should be guided by a simple principle: Fix what’s broken and build on what works. And that’s what we intend to do.”

— President Barack Obama in 2009 at The Annual Conference of The American Medical Association


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The Supreme Court vs. Obamacare

Everyone is abuzz about the Supreme Court’s impending decision on Obama’s Affordable Care Act. There are of course guesses as to what will be approved and overturned in respect to the hot topic we’ve come to call “Obamacare,” but as Americans and patients, it is important to consider all of the aspects of the mandate and what each section means for you.

What’s All the Fuss About?

If the Supreme Court overturns Obama’s mandate, it could mean disastrous foreshadowing for him in the upcoming election, especially considering his attempt at Health Care Reform has been a staple of his term.  Reporters have stated that this Supreme Court decision will stand as a historical mark for America either way.

Before considering the pros and cons of accepting or overturning the Affordable Care Act, let’s first take a look at the act’s initial goals.

       Better access to quality care for all Americans

       Control runaway, rising health care costs

       Put Americans back in charge of their own health care and coverage

So You Want the Good News First?

The ways in which the Affordable Care Act works to achieve these goals is by keeping insurance companies from limiting needed care and eliminating the barrier between patients and their physicians.  The policies addressed by the ACA include:

1.     Reviews of Insurance Premium Costs

Wahoo: Providing more transparency into the health care system

2.     Keeping Young Adults Covered

Wahoo: Children under the age of 26 are allowed to be on their family’s policy

3.     No Pre-Existing Condition Exclusions

Wahoo:  Insurance companies cannot deny coverage to children based on their state of health, meaning those who really need insurance can get it

4.     No Arbitrary Recessions of Coverage

Wahoo: Insurance companies cannot just take away coverage except in the case of fraudulent activity

5.     No Lifetime Limits on Coverage or Annual Dollar Limits

Wahoo: Being diagnosed with a catastrophic ailment does not mean that a patient will go bankrupt, as the insurance company will still continue to cover large expenses in cases of diseases like cancer.

6.     Protecting Your Physician Options

Wahoo: Your insurance will not limit you to a certain network of physicians; you should be able to see the same doctor you always have seen

This all sounds well and good when you look at these positives, but what about the holes and unanswered questions? There are flaws in this masterpiece, and putting it in words even a teenage girl could understand:

“ [She’s] a full-on Monet. It’s like a painting, see? From far away, it’s OK, but up close, it’s a big old mess.”

– Cher Horowitz, Clueless

Good From Afar, but Far From Good: The Potential Problems

       More than 87 Million Americans could lose access to their current healthcare plan, as 4/5 of employers might opt out of employer-provided insurance in favor of paying less expensive penalty fees.

       Fewer than 700,000 physicians could continue to treat the rising patient population, resulting in longer wait times and a decline in quality of care.

       CMS (centers for Medicare and Medicaid Services) anticipates new fees and taxes to cover the newly insured, will be passed down to consumers masked as higher prescription costs, higher insurance premiums and more expensive services for those who can afford to pay face-value.

       Out-of-pocket spending limits for families could be as high as $11,900 in addition to more expensive premiums

       The government provided insurance could easily be unaccepted by high quality healthcare providers, so while the government boasts better access to physician options, they are not truly the ones in control of who accepts all patients.

Affordable Care Act, Mission: Improbable

Everyone has their own speculations of what the Supreme Court will decide to do, but hopefully by this Thursday we will experience history in the making.  A poll of 56 former Supreme Court clerks leaned towards the likelihood that the mandate will be overturned, but that is not to say that all of the aspects of Obamacare and his administration’s work will vanish.  Some of the country’s largest insurance providers such as UnitedHealth and Aetna, have already promised to adopt the more popular provisions under the ACA whether the mandate is approved or not. These provisions encompass; preventative care, dependent coverage, no lifetime limits and no rescinding coverage in the case of disability or catastrophic illness.

It is clear that transparency (pun intended) in all aspects of care is needed and could very well be the solution to America’s healthcare problem.  We’ve seen healthcare providers and price shopping websites start to adopt this trend towards transparency, but it is largely in the patients’ hands to make sure that they are educated on their resources.

Our Best Guess

So what do WE think will happen? There are too many flaws to be accepted “as-is” and there are still a number compromises that need to be made.  Fortunately it seems that both sides are pro transparency and pro quality care. Now, if we could just figure out a way to make everyone happy!


Resources:

Washington Post: http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/25/the-supreme-court-will-rule-thursday/

Vanity Fair: http://www.vanityfair.com/online/daily/2012/06/Supreme-Courts-Health-Care-Overturn-or-Health-Care-Upholding-Due-Soon

The Health Care Blog: http://thehealthcareblog.com/

ProCon.Org: http://healthcarereform.procon.org/view.resource.php?resourceID=003725

Wall Street Journal: http://online.wsj.com/article/SB10001424052702303768104577460011857583738.html