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This article is part of a continuing series on the Affordable Care Act.
2013 has been a perilous year for the Patient Protection and Affordable Care Act.
The ACA has faced Supreme Court challenges, numerous Senate votes and a disjointed roll-out. With more legislation and additional discussion to take place when Congress reconvenes after the holiday break, now is an opportune moment to catch-up with the turmoil and progress of the healthcare law.
The Good
The Healthcare.gov exchange site saw numerous improvements over the Thanksgiving Holiday.
“As we’ve said, with any web project there is not a magic moment but a process of continual improvement over time and we will continue to work to make enhancements in the days, weeks and months ahead,” said Julie Bataille, director of communications for the Centers for Medicare & Medicaid Services in a statement.
Bataille said, via her blog, that more than 400 glitches and issues have been addressed in the past month, resulting in a website “uptime”—time it is functionally available—of approximately 90 percent, almost double the 42 percent uptime the site reported in early November.
Probably the least contentious article of the ACA is the clause which allows individuals under the age of 26 to remain on their guardian’s healthcare. This has allowed thousands of youth to keep health insurance. After 2014, the law allows for several months’ grace period before those who have aged-out of the program must obtain individual health insurance.
Seniors have also greatly benefited from the ACA. This year the federal Department of Health and Human Services (HHS)—the governmental division which administers the ACA—reported that 6.6 million Medicare participants saved more than $7 billion on prescription drug costs, averaging around $1,061 per beneficiary.
Insurance plans offered to those who are not on Medicaid or Medicare must subscribe to the “Essential Health Benefits.” These benefits include requirements for emergency care, psychological health, prescription drug assistance, as well as preventative services such as substance abuse services and smoking cessation.
Women’s health could improve in 2014 when the law requires insurers to fully cover yearly mammograms for women 40 and over.
The Bad
Though the Healthcare.gov site has dramatically improved, the Spanish-language site, CuidadoDeSalud.gov, continues to suffer from the bugs that previously ailed the English equivalent.
The site was little more than a placeholder until recently and users are still only able to browse health plans in English. Attempts to register in Spanish lead to pages that encourage users to request a paper application, call the Healthcare Hotline or find a local “navigator” to help register.
After the Supreme Court decision—June 28, 2012—which upheld the constitutionality of the bill but created a system where states could opt-out of Medicaid Expansion, Texas Governor Rick Perry joined dozens of others in declining to expand the costly social service.
Anne Dunkle of the Center for Public Policy Priorities, a Texas non-partisan advocacy group, said the situation “creates a terribly unfair coverage gap.”
According to the Texas Medicaid website only those living below the $11,500 Federal Poverty Line are eligible for premium assistance. Pursuant to their rules, “working-age” adults without children cannot qualify. Those who do qualify must complete their enrollment by the federal deadline of Dec. 7.
On a larger scale, the Kaiser Family Foundation—a California-based non-profit Healthcare think-tank—has analyzed healthcare spending trends and has made projections that the ACA may have negative impact on long-term healthcare spending. The organization was quick to add the note that much of the reduction in growth was due to the national recession and an overall slowing of the Gross Domestic Product.
The Ugly
Proponents of the ACA have been campaigning to encourage “young people” to buy into the system. In what the Christian Science Monitor called a “moral imperative,” college-aged students are a core part of supporting the system that will no longer allow insurance companies to decline coverage for individuals with preexisting conditions.
A series of advertising campaigns have begun to circulate. The target audience is obvious with taglines mentioning that most people under 30 years of age can purchase a plan for less than $50 a month. A new radio spot featuring Pete Wentz, of pop-punk band Fall Out Boy, pushes listeners to visit the Healthcare.gov site.
Research into the claim of a $50 premium has shown that in order to received rebates and discounts, individuals under 30 must make at least $20,000 a year. The average work-study allocation, as reported by UTEP, Sam Houston State University and Texas A&M, lingers in the $2,000 to $6,000 mark depending on placement and past job experience.
S. David Ramirez may be reached at [email protected].
