by Lin McNulty
Nearly 50 people gathered on Friday night, September 13, at the Eastsound Fire Hall to hear a presentation on the new Affordable Care Act, and how they, as individuals, might be affected.
The Eagle Forum is a local, conservative group promoting Education, Liberty, and Limited Government as they attempt to elevate and educate the community. It was stressed this was not a protest meeting, but an effort to explain what the Affordable Care Act (ACA) is all about. Although ACA is more popularly known as Obamacare, speakers were purposefully careful not to use that term.
Dr. Roger Stark, a retired cardiac surgeon and current health care policy analyst at the Washington Policy Center in Seattle, began the presentation and set the tone of the evening by declaring he “doesn’t like political jokes, as it seems that too often they get elected.”
He provided detailed background on what he considers to be a “Frankenstein monster type of legislation.” Late in 2008 and early 2009, as the country was in throes of recession, this 2,700 page bill was passed without support from Republican members of Congress. He noted that the Medicare/Medicaid bill, which passed in 1965, was only 137 pages and had support from both political parties.
The legislation requires three key mandates:
- The Individual Mandate (effective 2014) requires that anyone 18 or over, (“in order to be a citizen,” in Dr. Stark’s words) must own health insurance or pay a penalty. That penalty will initially be $95/year, increasing to $700/year or 2.5 percent of gross income.
- The Employer Mandate (effective 2015) requires employers to provide health-care coverage or pay a penalty of $2,000/year/employee. Some 30 percent of smaller businesses are expected to cut health insurance, Stark said, opting instead to pay the penalty.
- The Insurance Mandate places all people in a community into the same risk pool, combining the risk of those who are healthy along with those who have health issues. Insurance companies must sell you health insurance no matter how old, or how sick, you may be.
State insurance exchanges have been set up, effective October 1, 2013, for full implementation of the mandates on January 1, 2014. It is still possible to contract with a private insurance company, bypassing the state exchanges. Individuals may, however, want to explore both options to find the best deal.
Where does the money come from to fund the program? Medicare will cut provider reimbursement in the amount of $500 Billion. There will also be increased taxes on those making over $200,000 per year, along with an additional capital gains tax of 3.8 percent.
Where does Dr. Stark and the Washington Policy Center see this all going?
They have used the the health care program adopted by Massachusetts in 2006 (RomneyCare) as their guideline for projections. The number of individuals not covered by health care declined from 10 percent, down to 2 percent upon implementation of the the health care plan. Demand, however, skyrocketed. With no increase in doctors or hospitals, Massachusetts now has the longest wait times in the country for health care services.
“If not repealed,” says Dr. Stark, the Affordable Care Act program “will be crushed and dismantled piece by piece.”
Daniel Himebaugh, staff attorney in Pacific Legal Foundation’s (PLF) Pacific Northwest Center, has contributed to efforts to challenge the Patient Protection and Affordable Care Act. He outlined several currently pending court cases that challenge many portions of the ACA.
One of the most controversial provisions of the Patient Protection and Affordable Care Act is the establishment of an Independent Payment Advisory Board (IPAB), which has the explicit task of achieving specified savings in Medicare without affecting coverage or quality. While some applaud the new advisory board as a mechanism for controlling health care costs outside the influence of political processes and pressures, others have criticized the scope of its authority and the lack of flexibility in its mandate. Because of these serious concerns, the American Medical Association opposes the IPAB and supports its repeal.
What do our local doctors and medical groups think about the ACA?
Was anyone present or invited to the gathering to present a contrasting view?
Dr. Stark did report, as we recall, that from the money funded for the program, subsidies will be available to pay the penalties for the Individual Mandate. His mention of it was tucked into other statistics and we were not given details.
We left the meeting following Dr. Stark’s presentation as we thought this would be a discussion about the ACA, its pros and cons simplified for those interested. Instead, we were “treated” to a very one-sided, conservative opinion! We’re still planning to check out the statement about the current state of the Massachusetts health care plan, as well as some of the other voiced statistics.