Health Reform Year Two: Tens of Millions Served

As we mark the second anniversary of the passage of the Patient Protection and Affordable Care Act (ACA) now is a good time to have what in medical parlance is called a “time out” and reflect on how far we have come and where we need to go.

Some states are challenging the legality of vital provisions such as Medicaid expansion and the mandate for all Americans to carry health insurance.  Candidates vying for President Obama’s job vow a complete repeal of the ACA.  Not surprisingly, polls show a confused public wondering what the health law means for them and the health plan they have now.  Despite this, the obfuscations cannot hide the reality that tens of millions of people have already been served by the initial phases of ACA.

* 54 million people with private health plans had at least one new free preventive service in 2011.
* 32.5 million Medicare seniors received at least one free preventive benefit in 2011.
* 2.5 million young adults under 26 years of age now have health insurance through their parents.
* As of this year, health insurance companies must spend 80-85% of your health insurance premiums toward health care rather than administrative costs.  It is estimated that 9 million people will even get a rebate check.

Here is a report on the impact on Californians specifically.

Lets not stop there. Here is get a glimpse of where this train is headed -because the really good stuff is just around the corner.

After January 1, 2014, when the ACA is in full effect, 3 to 4 million in CA, and 32 million nationally will get health insurance either through Medicaid expansion or by purchasing affordable health insurance through the newly formed state health insurance exchanges.  New health insurance reforms will allow you to keep your health insurance even if you have a chronic condition, high cost medical needs, or have a pre-existing condition.  Your premiums can’t be raised based on your health problems or gender.  We can put that under the “nearly everyone served” category.

Other reforms will help decrease cost, improve quality, and move us to a system that rewards quality care and patient outcomes rather than volume of care.

Next week, the United States Supreme court is scheduled to hear oral arguments by states such as Florida who view the mandate to carry health insurance as unconstitutional.   However, often lost in the sound bites is the hard truth that the popular insurance protections and the mandate to have health coverage are two sides of the same coin.  Everyone, both healthy and sick, must participate in order to spread the cost of care.  That way health insurance will be there for you when you get sick.

I will be first to admit that the ACA is not perfect and there are communities I care for who are still left out.  However, I (and my uninsured patients) will take this “good” plan than wait for a miracle when the “perfect” health plan passes in the distant future.  For some, even 2014 cannot come soon enough.

Still not sure what health reform means for you?  Check here.