Numbers Tell a Story of Obamacare’s Success(Tallahassee Democrat, OPINION, 11/5/14, p. 5A)
One year ago, we embarked on the first nationwide health insurance enrollment under the Affordable Care Act. Approximately 8 million people across the country enrolled in health insurance plans to gain access to comprehensive health coverage. Although Florida refused to expand Medicaid to help Floridians with limited incomes, the state ranked second in the nation after California in the number of enrollees in the Health Insurance Marketplace.
Let’s take a closer look at Florida’s (ACA) Success Story.
Enrollment: Nearly 1 million people gained access to comprehensive health insurance during enrollment ending April 19; 91 percent selected a plan with financial assistance.
Medicaid: Approximately 240,000 Floridians were able to receive coverage through Medicaid and CHIP (Children’s Health Insurance Program).
Young adults: Children may stay on their families’ health insurance policies until age 26. This option is estimated to affect 224,000 young adults in Florida.
Pre-existing conditions: Nearly 8 million nonelderly adults (under 65) and more than 960,000 children in Florida have some type of pre-existing health condition. Under the ACA, insurers no can longer charge women more because of their gender, nor can they deny coverage to those with existing health conditions.
Preventive services: In 2011 and 2012, 71 million Americans with private health insurance gained preventive service coverage with no cost sharing, including 3,762,000 in Florida. Approximately 47 million women, including more than 2.4 million in Florida, will now have guaranteed access to additional preventive services. These screenings are encouraged to reduce emergency hospital room visits and remove financial barriers for those seeking timely, preventive health care services.
Mental health parity: The law expands benefits for mental health and substance abuse to nearly 62 million people nationwide and more than 4.2 million in Florida.
Lifetime limits on health benefits: ACA bans insurers from placing a lifetime dollar limit on health benefits. This is particularly crucial for cancer patients and those suffering from chronic diseases, to avoid interruption in health services. In Florida, 5,587,000 people are affected by this change, including 2,170,000 women and 1,411,000 children.
Medicare also saw significant changes:
Prescription drugs: In 2013, more than 290,000 individuals in Florida saved over $249 million or an average $859 per beneficiary on prescription drugs. Coverage for both brand name and generic drugs will gradually increase over time until the coverage gap is closed.
Preventive screenings: In Florida, more than 2.8 million people with Medicare used one or more free preventive services in 2013.
Medicare premiums: About 4 million Floridians who enroll in traditional Medicare Part B will not see an increase in premiums and deductibles in 2015 (both 2014 and 2015). This is primarily because of the slower growth in health care costs since the passage of the ACA. According to Health and Human Services, Floridians will spend $66.2 million less in premiums on drugs and health care coverage in 2015.
Solvency: Because of tougher screening procedures, stronger penalties and new technology, $19.2 billion in savings have been recovered over the last five years.
A major component of the ACA is to decrease the number of uninsured individuals by expanding Medicaid or offering an alternative approved plan to help Floridians in the coverage gap (those who do not qualify for Medicaid but can’t afford coverage through the Healthcare Marketplace). Because of the U.S. Supreme Court decision in June 2012, this benefit is a state option.
Although the federal government made $51 billion available to Florida, the Legislature did not expand Medicaid or offer a viable alternative to help an estimated 800,000 Floridians. These are individuals and families with incomes at or below the federal poverty level. The cost of uncompensated care and use of hospital emergency rooms for primary care services are examples that should be a major concern for all of us.
Breast Cancer Awareness Month just ended, but take this as a reminder to make appointments with your health care providers to receive timely checkups. Health care plans approved under the Affordable Care Act include screenings for early detection of all kinds of cancers, prevention and management of chronic conditions, as well as lifestyle/ healthy behaviors for all individuals.