Healthcare Reform: A Make or Break for Our Economy

By Ashley Grimes – Licensed Attorney

Health Care Reform is here and many are scrambling to find out exactly what the changes are.

The Affordable Care Act was passed by Congress and later signed into law by the President on

March 23, 2010. The Act was challenged in the Supreme Court and the final decision upheld the

new law. The decision was rendered on June 28, 2012 and can be accessed by clicking on the

link below.

Supreme Court’s 2012 Decision on the Affordable Care Act

The certified full text version of the Affordable Care Act is 2,409 pages and extremely difficult

to read through in its entirety. Rumors spread quickly about legislation and often have the effect

of distorting what the actual law is. I’m here to give you the run down on the new healthcare

reform and how it may impact individuals.

There are pros and cons to the healthcare law and those will depend on what class you fall into as

far as your health and other aspects are concerned. Those with pre-existing conditions and many

others will benefit greatly from the Act. However, those who have great health and were

previously offered comprehensive and inexpensive plans through their employer may see an

increase in premium cost. Health Care Reform effects upon an individual depend on much more

than just health and age. Income, age, health, family size and other factors will determine one’s

satisfaction with the changes in reform.

If you are someone like me who has recently graduated from graduate school, has a family of

four, and an income of $48,000 per year, you may not be thrilled with the results. The current

health insurance coverage that I pay for provides coinsurance of 80% with no individual or

family deductible requirement. Now, after the healthcare reform has occurred, my insurance

requires a $1,500 individual deductible and $3,000 family deductible to be met before coverage

kicks in. Furthermore, the coinsurance is now 70% rather than 80%. Our health insurance

coverage has gotten much worse and the price has risen. So, for my family, the healthcare reform

is costing more.

However, for those who have pre-existing conditions such as cancer, healthcare reform is a life

saver. Insurance companies can no longer deny an individual coverage just because that

individual has cancer or some other condition. Now I will tell you…I lost a dear relative, who

served on the fire department, to cancer just last year. For her, this reform could have

significantly helped her family financially to deal with the expenses of treatment. No one can

predict whether or not they will get cancer or any other condition and I have to pause to ask

myself…is it worth my paying more for worse health insurance so that another person who may

be struggling with cancer can get healthcare? Were I to think about my relative…I would have to

say yes. However, there is another side that still looks at the massive healthcare reform and has

to come to grips….if the government spent so much money on this shouldn’t it be better? Obama

promised to provide the same coverage that government employees had and yet, as a previous

government employee, I would have to say that the options for healthcare arriving from

healthcare reform don’t even come close to the coverage I experienced when I worked for the

government.

As a government employee, I didn’t have any coinsurance, everything was covered 100%, and I

only had to pay set deductibles for things like hospital admission, doctors visits, etc.

Furthermore, my monthly premium was very cheap. So…did Obama keep to his word in

providing similar coverage to that which government employees were previously privy to? I

would have to say no. When all is said and done…I believe that the healthcare reform is great for

those who could not previously obtain coverage due to prior illness or pre-existing conditions.

However, I think that given all the effort, time, and money that the government has put into the

healthcare reform, the end result isn’t even close to what it should be. I believe many individuals

could have come up with a much better system on their own which speaks poorly of the

governmental intelligence on this reform project. Finally, I will add that I lived in Europe for 8

months when I studied there during undergrad. I experienced their universal healthcare system

and it is a system that outmatches our reform by leaps and bounds. It is almost embarrassing that

the current administration has at any point in time called the current health care reform

“Universal Healthcare” as it is known in Europe. The current healthcare reform is anything but

“Universal Healthcare” as it is known in Canada and Europe.

I write this article as a previous advocate for the current administration and an advocate for

Healthcare Reform. Unfortunately, my view altered greatly after reading through the available

marketplace coverage and receiving news of the hike in price and lower coverage threshold

provided by my employer healthcare plans. In my opinion, the new Healthcare Reform will

ultimately hurt the economy as it forces individuals to pay for insurance that doesn’t seem to

provide enough coverage. Please look into the actual act yourself for more information. The

actual law can be found here: Certified Full-Text Version: Affordable Care Act (PDF – 4.27

MB). Knowledge is power.

Now that you know a bit about the changes taking place, here are some helpful links.

Those who are eligible to purchase healthcare through a health insurance marketplace may

qualify for a tax credit. Please click here for the tax credit calculator.

Those who do not purchase health insurance may be penalized through a tax penalty. Please click

here for the tax penalty calculator.

There are currently 5 healthcare plan types: catastrophic, bronze, silver, gold, and platinum. To

see example premiums for your state, please click on this link. Enter the requested information

about family size and location to obtain a sample of possible coverage prices.

If your employer offers coverage, you may not qualify for coverage through the marketplace.

You will need to submit an application and your employer’s coverage will be evaluated along

with your income level to determine whether or not the monthly premium you would pay

through your employer would require you to pay too high of a percentage of your annual income.

If so, you may still qualify for coverage through the marketplace and reduced cost through tax

credits. The tax credits are applied immediately to the monthly premium you will pay for health

insurance if you qualify. I hope this information has been helpful in updating you on how

healthcare reform may affect you.

Written by A. Grimes – Juris Doctor of Law