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Wendell Potter

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The Affordable Care Act? What the Heck Is That?

Posted: 09/29/11 11:45 AM ET

The Kaiser Family Foundation just released the findings of its annual survey of businesses to determine how much the cost of employer-sponsored health coverage has gone up. There were some unexpected findings.

One was that the average cost of annual premiums for family coverage is now more than $15,000. The 9 percent increase in the cost of health insurance over last year caught many people by surprise, because it represented a bigger hike in premiums than in recent years.

What seems clear is that insurers decided last year to charge their customers considerably more than necessary this year to be able to meet Wall Street's profit expectations; insurance companies are also concerned that such increases will be more difficult once health care reform is fully implemented in 2014.

Here's another surprise. Kaiser found that 50 percent of small employers are aware that they are now eligible for a tax credit from the federal government--thanks to the Affordable Care Act--if they provide subsidized coverage to their employees. I can hardly believe the awareness of the tax credit is that high.

As I have traveled across the country in recent weeks, speaking to a wide range of audiences, one thing has become abundantly clear: the provisions of the Affordable Care Act already in effect are anything but abundantly clear to people.

That's because opponents of health care reform have won the public relations battle in defining the Affordable Care Act.

While the most recent Kaiser survey did not seek the views of the general population nor ask employers what they think or know about the Affordable Care Act, other polls show that advocates of the new law have been losing ground in the battle for public support.

This week I have been speaking at Florida churches -- a Catholic church in Winter Park, outside Orlando, Monday night, and a Unitarian Universalist church in Clearwater Tuesday night. The hosts wanted an overview of what's in the new law and what's not--to provide factual, unbiased information and also to dispel many of the myths that have gained traction, starting before the law was even enacted.

What the hosts told me--and what I learned from talking to people who attended the forums--is that the Obama Administration and the national groups that backed the legislation have essentially been missing in action when it comes to explaining the benefits of the law.

Kaiser's finding that 50 percent of small businesses were familiar with the tax credit would certainly come as a shock to Dr. Patrick Cannon, advocacy director for Florida CHAIN (Community Health Action Information Network). He has been traveling the state trying to reach small business owners and educate them about the tax credit.

He has found almost no one even knows about it. This undoubtedly helps explain why the number of small businesses offering coverage to their employees dropped significantly in the most recent Kaiser survey.

Cannon believes that one of the reasons is that reform advocates missed an important opportunity to brand the Affordable Care Act in positive terms--starting with the most basic term of all, the name of the law itself.

As Cannon pointed out, opponents of the law use a single term to describe the law: ObamaCare. The term has so seeped its way into the vernacular that even some of the law's advocates have started using that pejorative label. The groups that support the law, he notes, use a wide range of terms to describe it.

Cannon is embarking on an effort among supporters to be consistent in calling it the Affordable Care Act.

Because opponents have been able to define the law on their own terms (or term), advocates are finding it increasingly difficult to have civil conversations with people about it--including with independents.

Liz Buckley, executive director of Focus Orlando, told me that, "If you even try to have conversations with people about it, people think you're just trying to reelect Obama. They just shut down the conversation."

Why the administration has been so inept or disengaged is baffling. It's true that people will be skeptical of information about the law that comes straight from the White House, but the folks behind the Obama campaign in 2008 seemed to know how to get third parties motivated and active on behalf of the candidate.

Where are those folks now? If the White House is serious about making sure the law goes forward--and making sure the Obama legacy is a positive one--they better get in gear and turn public awareness and attitudes around. Otherwise, pretty soon, it may be too late.

 
 
 

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HUFFPOST SUPER USER
thecreeksedge
12:55 PM on 09/30/2011
The third section of the Act addresses Increasing Access to Affordable Care. These provisions became effective in 2010.

The Pre-Existing Condition Insurance Plan provides options to individuals who have been uninsured for at least six months because of a pre-existing condition.

Young adults are allowed to stay on their parents’ plan until they turn 26 years old if they do not get coverage at work.

A $5 billion program provides financial help for employment-based plans to continue for people who retire between the ages of 55 and 65, as well as their spouses and dependents.

Incentives to expand the number of primary care doctors, nurses and physician assistants.

States are eligible for grants to implement measures that require insurance companies to justify premium increases.

States are able to receive federal matching funds to cover some additional low-income individuals and families under Medicaid.

Increased payment to rural health care providers to help them continue to serve their communities.

Funding to support the construction of and expand services at community health centers.

The site http://www.healthcare.gov/law/timeline/full.html provides a year by year explanation of provisions of The Affordable Health Care Act. Anyone who is really interested in having an informed opinion on this important issue ought to at least look at this site or some similar resource.

Of course, many people don't want the facts to get in the way of their strongly held beliefs.
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HUFFPOST COMMUNITY MODERATOR
tacevad
American SS Card Carrying Socialist
11:16 AM on 09/30/2011
Health Insurance ≠ Health Care
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HUFFPOST SUPER USER
thecreeksedge
11:11 AM on 09/30/2011
FOLLOW UP.

Provisions of The Affordable Health Care Act aimed at Improving Quality and Reducing Cost that became effective in 2010 included:

Up to 4 million small businesses became eligible for tax credits worth up to 35% of the employer’s contribution to the employees’ health insurance.

4 Million Seniors Who Hit the Medicare Prescription Drug “Donut Hole†will receive a one-time, tax free $250 rebate check.

All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.

A new $15 billion Prevention and Public Health Fund will invest in proven prevention and public health programs that can help keep Americans healthy – from smoking cessation to combating obesity.

Cracking Down on Health Care Fraud. Current efforts to fight fraud have returned more than $2.5 billion to the Medicare Trust Fund in fiscal year 2009 alone.

Again, it's difficult to see how these provisions represent an unwarranted intrusion of government into the American health care non-system. It is, however, easy to see how an Act with so many provisions is difficult to explain in simple terms that most people can understand.

Next, 2010 provisions aimed at Increasing Access to Affordable Care.
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e-cat
limit the litters, neuter your critters
04:20 PM on 09/30/2011
One little thing to know about the *preventative* colonoscopy healthcare costs......

I was told to have my colonoscopy after August 1st, 2011 as it would be a no-copay/ preventative service, meaning I would pay nothing as my new policy kicked in for the year, and it would fall under the new guidlines of the Health Care Act.

So I had mine scheduled from my yearly exam back in January, and Kaiser took till May to confirm a date for the first *explanatory* visit that would occur in June. From there, I was scheduled to have the actual colonoscopy in September. Hooray..... I would pay nothing. Fat chance. There is a provider that says if they find nothing, you pay nothing. If they find something, you pay up to your deductable, they cover the rest.

They found one non-threatenting polyp, and the cost to me was $1084.00.... because now they could code it as a diagnotic visit, and not a preventative visit. Not only that, but the initial visit to set up the procedure still cost me a $50.00 co-pay.

The cheapest insurance Kaiser offers costs me $323.00 a month, with a $3000.00 deductable.

I'm not against the new Health Care Act..... just wanted to clear up a little matter you mentioned, and thank you for presenting the other facts.
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HUFFPOST SUPER USER
thecreeksedge
09:16 AM on 09/30/2011
An understandable year by year explanation of the Affordable Healthcare Act is available at http://www.healthcare.gov/law/timeline/full.html.

There are obviously too many provisions to list them in this comment. However, it is difficult to see how provisions like these are so hated.

The following consumer protection provisions became effective in 2010:

An easy-to-use website where consumers can compare health insurance coverage options and pick the coverage that works for them

Rules to prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition

Prohibiting insurance companies from rescinding coverage for an error, or other technical mistake, on a customer’s application

Eliminating lifetime limits on insurance coverage

Regulating annual limits on insurance coverage

Provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process

States that apply receive federal grants to help set up or expand independent offices to help consumers navigate the private health insurance system

Future posts will list other provisions of the law.
02:35 AM on 09/30/2011
It's too late to convince. Come 2013, our new one-party government will repeal this Act. Actually, they'll do more than repeal it....
1. U.S. Constitution will be amended to block all government involvement in medical/health care
2. Medical coverage will be totally private and unregulated
3. AND EVEN AFTER THIS... record number of employers will STILL cancel medical benefits (except for executive staff)
Think doctors will accept roasted chickens for payment when "you're on your own"?
Yeah right. Let's hope flights to India and China are cheap because you'll soon be heading their for doctor appointments.
This user has chosen to opt out of the Badges program
01:50 AM on 09/30/2011
Job-based medical insurance costs U.S. jobs:

http://www.nytimes.com/2005/07/25/opinion/25krugman.html
Toyota, Moving Northward - New York Times

"...But education is only one reason Toyota chose Ontario. Canada's other big selling point is its national health insurance system, which saves auto manufactur­ers large sums in benefit payments compared with their costs in the United States.

You might be tempted to say that Canadian taxpayers are, in effect, subsidizin­g Toyota's move by paying for health coverage. But that's not right, even aside from the fact that Canada's health care system has far lower costs per person than the American system, with its huge administra­tive expenses. In fact, U.S. taxpayers, not Canadians, will be hurt by the northward movement of auto jobs.

To see why, bear in mind that in the long run decisions like Toyota's probably won't affect the overall number of jobs in either the United States or Canada. But the result of internatio­nal competitio­n will be to give Canada more jobs in industries like autos, which pay health benefits to their U.S. workers, and fewer jobs in industries that don't provide those benefits. In the U.S. the effect will be just the reverse: fewer jobs with benefits, more jobs without.

So what's the impact on taxpayers? In Canada, there's no impact at all: since all Canadians get government­-provided health insurance in any case, the additional auto jobs won't increase government spending..­."
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HUFFPOST SUPER USER
chlai88
Change is the only constant
01:39 AM on 09/30/2011
Indeed the PR is losing to the Obamacare camp. This is bad news as this marks the first baby steps to reform the current health care monstrosity and its success is crucial to make more progress. But I see really no way to win back the conversation now that the economy overshadows everything. Unless the Obama admin can play up in simple terms the beneficial impacts the law have on our deficit as well as our pockets. It's not gonna be easy.
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rudyg43
OneBadRadCatDad
11:31 PM on 09/29/2011
The Terrifying Errant Activist party is directly responsible for holding the American economy hostage in a "Scorched Earth" policy to guarantee president Obama troubles nationwide. The Treasonous Erring Anarchist party were willing to take down the US debt even at their own expense! The TEA party led and infused Republican/GOP party are fighting the Sarbanes Oxley act of 2002 and the Frank Dodd Act because these two acts provide guidelines and restrictions put into place resulting from the recession of 2007 and 2008! There were major corporate and accounting scandals like Enron and Worldcom which cost investors billions. The Frank Dodd Act provided a sweeping overhaul of America's financial regulatory system to consolidate agencies, regulate financial markets, implement consumer protection, provide financial crisis tools for the FDIC and improving accounting processes and tightening credit rating regulations. America stands at a cross roads in the next election Are we going to be held hostage by this radical fringe element, or are we going to take our country back?
HUFFPOST SUPER USER
CompassionateDemocrat
Corporations can't vote
10:17 PM on 09/29/2011
It would help if this article then told us what is in the Affordable Care Act instead of telling us exactly what we already know which is nothing.
12:45 AM on 09/30/2011
If you want a summary of the act, google it, there are plenty of them out there. If you don't know it is because you have chosen not to know.
Pauline Jaing
Artist, worker, mother
09:51 PM on 09/29/2011
Affordable for who? Not me, that is for certain sure.

There are two forms of modern health care financing/payment suited to an industrialized, COMMODITY PRODUCTION economy, either totally private, or totally socialized. totally private means probably 40% of the population will have no health care at all.

This muddle in between has been tried since Clinton (whom I now DETEST) and its a total failure.

We need to SWEEP all these people in Washington out.
HUFFPOST SUPER USER
dcflush
The nickname is about poker, not politics
02:10 PM on 09/30/2011
Umm, seriously deficient and uninformed comment Pauline Jaing.

First, I'm not sure what 'muddle in between' you are referring to. Clinton made almost no changes to US health care policy with regard to private/public.

Second, there absolutely are positive examples of a mix of private/public funding of health care. North Korea is a perfect example, but there are others.

Third, the full effects of the law aren't in effect yet. This means that the 'affordable' part of it hasn't been implemented. There will be tax credits to businesses who provide insurance. And there will be financial help to people depending on their income range. There are also regulations that will prevent insurance companies from making large increases in rates.

I would prefer single-payer. But the mandates and exchanges and regulations that will go into effect in 2014 is far better than what we currently have in place.
HUFFPOST SUPER USER
dcflush
The nickname is about poker, not politics
02:10 PM on 09/30/2011
Oops, I meant South Korea, NOT North Korea.
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HUFFPOST SUPER USER
sean alphonse
09:38 PM on 09/29/2011
The inverse eponymous "Affordable" Care Act was still born when it was signed into law. Why? Neither the president nor the Democratic congress had the guts to tackle the key issue of American health care: Cost. Those of us that have worked in Western Europe know that Americans pay three times as much as Europeans for medicines, tests, devices, surgeries and hospitals. Americans pay a huge disproportionate share of pharmaceutical's R&D. Those companies, many of which are based in Switzerland, love Americans. Without a public option or single payer there was no way to negotiate for lower national rates for Americans, as a group. This is what Germany, Holland, France and Belgium do. Instead, Americans still are forced to belong to a regional monopoly that supposedly will charge you fair rates because of the government regulators. I hope you don't believe that. The Right claims to like capitalism. So lets have it: Free competition across state lines for all medical costs, including importation from Canada. But we can't have that because the fat cat Big Pharma and Medical Insurance and For-Profit hospitals have the congress and the president firmly tied to their unlimited campaign contributions. This is crony capitalism. Support Dylan Ratigan and public elections.
HUFFPOST SUPER USER
dcflush
The nickname is about poker, not politics
02:15 PM on 09/30/2011
First, I don't disagree with the first half of your comment.

However, the Affordable Care Act is and will be a huge positive compared to the current system when it is fully implemented.

Look, I would far prefer single-payer or even government option. But both of those were non-starters. They were impossible to achieve and had President Obama gone for either, we would have nothing (exactly like Hillary in 1995).
HUFFPOST PUNDIT
JShankel
I want my country forward
09:28 PM on 09/29/2011
Why is this surprising?  Democrats NEVER defend their policies because they never know when they're going to have to throw them under the bus.  Which is why they end up having to throw everything under the bus.

How long before we hear Democrats saying that only "professional leftists" think that insurance companies should cover pre-existing conditions?
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HUFFPOST PUNDIT
Jannsmoor
09:26 PM on 09/29/2011
America is faced with a problem that keeping or repealing the Affordable Care Act does not solve - we need to control the growth of health care costs. Insurance companies have utterly failed in this regard. They have found they make more profits by simply pushing added costs onto the insured - higher premiums, higher deductibles, less coverage. I realize the ACA moves a small way in that direction, but we need to get serious about this, the sooner the better.
09:00 PM on 09/29/2011
Obama assumes incorrectly that people are rational and know their self-interest.
09:30 PM on 09/29/2011
Would it be in my self interest to try and have other people foot the bill for me?

Yes, financially but I'm against it.
01:11 AM on 09/30/2011
Point?
03:57 AM on 09/30/2011
Ummmmmm, isn't that how all insurance works? You put your money in and if you are lucky enough not to crash your car, burn your house down, or become tragically ill, YOUR "hard earned money" foots the bill for other people's problems.

Based on your libertarian philosophy, I assume you do not have any type of insurance policies, instead opting to create your own savings accounts to pay for any disasters that may befall you or your family. Because I'm sure not only would you not want to foot other people's disaster bills, but you certainly wouldn't want them footing yours.

Right?
kellygreen
"Ideology is the Science of Idiots" John Adams
01:31 PM on 09/30/2011
Or at least that rational self-interest would trump racial, ethnic and class resentment.

Which----obviously---it doesn't for many people.
Zip Zinzel
If a Nation expects to be both Ignorant & Free . .
08:51 PM on 09/29/2011
AFFORDABLE CARE ACT IS UNPOPULAR
. . . due to a relentless Right-Wing Propaganda campaign
AND
no truthful counter messaging
------------------------------------------

The Right-Wing Propaganda Campaign is built almost entirely
on misinformation & false arguments; as well as blatent lies ie. Death Panels

TYPICAL FALSE ARGUMENT:
Under ObamaCare Healthcare costs will go up.

TRUE, MORE POWERFUL ARGUMENT:
Healthcare costs will go up under any imaginable scenario-
Healthcare cost will go up LESS under the ACA, than without it.
=============================

The fact of the Affordable Care Act's unpopularity only confirms the adage:
---------------------------------------------------
If you repeat a lie often enough,
sooner or later, it will become accepted as true
. . . by at least some portion of the population