Changes In Health Insurance from the Affordable Care Act

The Supreme Court upheld almost all of the Affordable Care Act, yesterday.  This law is a push towards innovation and quality outcomes in health care.  It is a move towards greater cost efficiency and effectiveness.  It makes sense.

If you already have health insurance, you keep your health insurance.  Frankly, those of us who are employers purchasing health insurance for employees have seen annual double digit cost increases in health insurance premiums year after year, even as we reluctantly scaled back coverage, increased deductibles and co-pays for our employees.  Politics aside, this law brings much needed change, and makes health insurance more secure and more affordable for those of us already paying for it.

The Supreme Court also upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance.  This is important for two key reasons:

First, when people who have chosen not to purchase health insurance show up at the hospital emergency room for health care, the rest of us end up paying for their care in the form of more costly health insurance premiums. They not only are not paying for the services they are receiving, they are going to the most expensive place you can go to get their  medical or other needs met. It's a double whammy for the rest of us who are footing the bill in our more expensive health insurance premiums.

Second, if you require insurance companies to cover people with pre-existing conditions, but don't require people who can afford it to buy their own health insurance, a percentage of people will wait until they are sick or have a health problem before they buy the care they need.  This just drives up everyone else's health insurance premium costs.  Insurance companies depend upon you paying your premiums when you are healthy in order to be able to cover the catastrophic costs you unexpectly incur when you do need major medical services.

Insurance companies can no longer impose lifetime limits on the amount of care you receive.  They can no longer discriminate against children with preexisting conditions.  They can no longer drop your coverage if you get sick.  They can no longer dramatically increase your premiums without reason.

We have already seen and experienced some of the good changes in the Affordable Care Act:  young adults under the age of 26 are able to stay on their parent's health care plans - a provision that has already helped many of our kids.  Seniors, like our parents, who often have multiple prescription medications to help with their health, receive a discount on their prescription costs.

For people who do not yet have health insurance, starting in 2014 there will be a menu of affordable health insurance plans to choose from.  Each state, like Michigan, will design their own menu of alternatives, and if we can come up with even better ways of covering more people at the same quality and cost, the law allows that.  Once these health insurance "exchanges" are set up, insurance companies will no longer be able to discriminate against people with pre-existing conditions, charge women a higher cost because they are women, or bill people into bankrupcy.

Simply put, this is a good step in the right direction.