By Ricardo Alonso-Zaldivar
WASHINGTON: Now is when Americans start figuring out that President Barack Obama’s health-care law goes beyond political talk, and really does affect them and people they know.
With a cranky federal website complicating access to new coverage and some consumers being notified their existing plans are going away, the potential for winners and losers is creating anxiety and confusion about the Affordable Care Act.
“I’ve had questions like, ‘Are they going to put me in jail if I don’t buy insurance? Because nobody will sell it to me,’ ” said Bonnie Burns, a longtime community-level insurance counselor from California. “We have family members who are violently opposed to ‘Obamacare’ and they are on Medicaid — they don’t understand that they’re already covered by taxpayer benefits.”
“And then there is a young man with lupus who would have never been insurable,” Burns continued. “He is on his parents’ plan and he’ll be able to buy his own coverage. They are very relieved.”
A poll just out from the nonpartisan Kaiser Family Foundation documents shifts in the country in the month since insurance sign-ups began.
Fifty-five percent now say they have enough information to understand the law’s impact on their family, up 8 percentage points in just one month. Part of the reason is that advertising about how to get coverage is beginning to register.
“The law is getting more and more real for people,” said Drew Altman, the foundation’s president. “A lot of this will turn on whether there’s a perception that there have been more winners than losers. ... It’s not whether an expert thinks something is a better insurance policy, it’s whether people perceive it that way.”
The Obama administration insists nobody will lose coverage as a result of cancellation notices going out to millions of people. But at least 3.5 million Americans have been issued cancellations; the exact number is unclear. Associated Press checks find that data is unavailable in a half the states.
Mainly they are people who buy directly from an insurer, instead of having workplace coverage. Officials say these consumers aren’t getting “canceled” but “transitioned” or “migrated” to better plans because their current coverage doesn’t meet minimum standards. They won’t have to go uninsured, and some could save a lot if they qualify for the law’s tax credits.
Speaking in Boston’s historic Faneuil Hall last week, Obama said the problem is limited to fewer than 5 percent of Americans “who’ve got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident.”
In a nation of more than 300 million people, however, 5 percent is a big number — about 15 million people.
There’s a chance the number of people getting unwanted terminations may grow. In 2015, the law’s requirement that larger companies provide health insurance will take effect. It’s expected that a small share of firms will drop coverage, deciding that it’s cheaper to pay fines imposed under the law.
Signing up the uncovered
Before the law’s online health-care markets launched Oct. 1, the administration estimated nearly 500,000 people who currently lack health-care coverage would enroll for subsidized private insurance within the first month. Despite high consumer interest, a computer system beset by gremlins has kept most from doing so.
The administration refuses to release enrollment numbers until mid-November, when a crash program of computer fixes may be showing results. The numbers are expected to be disappointingly low; officials acknowledge as much.
A different prong of Obama’s coverage expansion seems to be doing fairly well. It’s an expanded version of Medicaid, embraced so far by 25 states and the District of Columbia. An informal survey of 14 of those states by the Associated Press shows that at least 240,000 people had enrolled in or applied for the expanded safety-net program as of the third week of October.
Americans are still divided over the Affordable Care Act, with negative views outweighing positives. But they also lean against repealing it. The final judgment may be in the hands of people who now have employer-provided health insurance. They’re about half the population, and they’ve noted Obama’s assurances that their coverage won’t be disrupted.
Up to now, the changes for employer plans have been incremental. They tend to expand benefits, not take things away.
For example, young adults can stay on a parent’s coverage until they turn 26. Employers cover women’s birth control as a preventive service, free of charge. Screening tests such as colonoscopies are also free.
But cost-control provisions, mainly a tax on expensive insurance plans that starts in 2018, are converging with the long-standing push by employers to tame health costs. Some companies have raised deductibles and copayments for employees, saying they need to scale back to avoid tangling with the coming tax. Others are giving employees a fixed amount of money to shop in private health insurance markets that resemble those created by the law.
Expect cutbacks to be blamed on the law. Sorting out whether that’s warranted may be difficult.