LOS ANGELES--Now that President Obama has won re-election, those with pre-existing conditions like myself won’t have to worry about losing our Pre-Existing Condition Insurance Plan, young adults won’t have to worry about being kicked off their parents’ health insurance, and parents with chronically sick children won’t have to lose any more sleep worrying about what will become of their babies.
All of the above likely would have happened had Mitt Romney been elected and succeeded. We do not now now have to worry about our health insurance companies cutting us off for whatever reason or capping our health care coverage with lifetime limits—limits that could fall well short of the cost of needed but expensive treatments.
Seniors won’t have to go uninsured because they can’t afford to make up the difference on health insurance premiums because the Medicare voucher proposal by Romney and his vice presidential partner Paul Ryan wouldn’t cover it all.
And since most older people—especially pre-retirees not yet eligible for Medicare -- have pre-existing conditions, they wouldn’t have to fear being dropped by their insurance companies, which could have gone back to doing whatever they want with the termination of the Affordable Care Act (ACA). They won’t have to ration their medications or go without.
Seniors can now stay healthier longer by being able to take advantage of the free wellness exams and preventative care, thanks to Obamacare.
California’s Model Health Insurance Exchange
In California, legislation has already passed that reinforces the ACA. Thirty health insurance companies are getting ready to compete with one another for more customers through California’s new health care exchange, called Covered California.
The exchange – an online “mall” providing the public comparative shopping for qualified health plans – aims to offer more competition for uninsured people. They will receive federally subsidized coverage on a sliding scale up to four times the federal poverty level (FPL). Those subsidies, along with the individual mandate requiring everyone to have insurance in order to get everyone in the cost pool—will mean lower premiums for everybody.
Laws have already passed that make it easier for Californians to be properly informed about their options for health care coverage during a life change (divorce, change in employment).
The expansion of Medicaid (called “Medi-Cal” in California) will be a relief to thousands. No longer will they have to have certain medical conditions or life situations—be a single mother in poverty, for instance—to qualify. ACA includes anyone in this program whose income falls at or below 133 percent of the FPL. In California that will help nearly 1.5 million people by 2014.
Individuals with an annual income of $14,856 this year or up to $30,657 for a family of four will finally be able to afford health insurance.
A family of four earning as much as $92,000 (400 percent of the FPL) annually will qualify for a price break. And low-income adults without children will be able to sign up for Medi-Cal simply based on their income for the first time.
California has eight months to implement everything it needs to in order to take full advantage of the federal government’s assistance. Statewide, nine out of 10 people under age 64 are expected to be insured when everything is fully implemented.
6 Million in California
On January 1, 2014, 6 million Californians who have been unable to get health insurance either because they work for a small company, are self-employed or have pre-existing conditions, will finally be eligible to get insured through Covered California. And 2 million will qualify for subsidies when the health insurance exchange opens in September.
Coverage starts in January, when ACA goes fully into effect.
Elders will no longer have to pay up to 10 times more than younger people for their premiums, but only three times more due to higher costs of care for seniors. Women will no longer be charged more than men. Patients who don’t speak English will have to be given an interpreter in their language.
In addition, insurers won’t be able to charge small business owners more for employees who are sick. Newly expanded Medicaid programs mean more kids will get immunizations. Emergency rooms will finally get a reprieve from an overcrowding of uninsured patients.
Small business owners also will be able to take advantage of tax credits of from 35-50 percent for purchasing health insurance for their employees. If a business is small enough, its employees will be able to buy their insurance on the state exchange.
The change is profound. Under ACA California will go from a system that bases its policy rates on how sick a person is to how much he or she can afford.
California is off to a healthy start because—unlike states where political leaders actively opposed ACA--it has been preparing for this day. In fact, it’s being emulated as a national model. But it still has a long way to go.
Government and Personal Responsibility
I hope Gov. Jerry Brown moves quickly to enroll those lower-income Californians in the Medicaid program and begin insurance company reforms so the state can reap the most benefits from the federal ACA funding. Obamacare will pay 100 percent of the costs for newly eligible Medicaid enrollees for the first three years, and 90 percent after that.
Although the experts are fast at work putting policies and systems in place, the rest of us can do our part by taking better care of ourselves so we don’t get sick. Eat well and exercise. Don’t smoke or abuse alcohol or drugs. Make sure you keep current on the free annual exams, screenings and birth control that are part of the ACA.
In addition to attending to our own health, we need to stay informed and help educate others about the new reforms. People are still misinformed about the ACA. The media can help by doing its job: Report the facts.
After everybody comes to understand all that is in ACA, I would like to see California maintain its lead by adapting a single-payer health care system, something adopted throughout the world and that has been put forth by Democrats for decades, but continually shot down by Republicans.
People are not numbers on paper or political pawns. Health care is a right, not a product to be consumed – a product that only the lucky and affluent can afford.
Spike Dolomite Ward is an artist and leader in nonprofit arts education. She lives in the San Fernando Valley. Her recent experience of developing stage 3 breast cancer while temporarily uninsured has made her a health care reform advocate. Visit her websites www.highdeductibles.blogspot.com and www.spikedolomite.com.
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