I trust the Kaiser Family Foundation’s polling on healthcare issues. Kaiser’s polling is objective, methodologically sound and accurate. That is why it is disturbing to see the current results of the uninsured on the Affordable Care Act. LET’S CLOSE with a reminder of what an uninsured person in Allen County can stand to gain. An uninsured single non-smoking man, age 32, in Allen County earning $18,000 per year can get “Silver” coverage from Blue Care Network or Coventry for about $64 to $101 a month. If he selects the least expensive policy he will have an annual deductible of $750, a doctor visit would cost $20 and a generic prescription $15. If he doesn’t get insurance he would be subject to a tax penalty of $180 in 2014. Thrive Allen County offers the assistance of trained and vetted Navigators to help residents of Allen County enroll in the health insurance Marketplace. Call 365-8128 for an appointment or drop in at Thrive Wednesday evenings 5-8 p.m. for assistance.
As of January 2014, those without health insurance viewed the ACA as 24 percent positive, 47 percent negative, and 28 percent undecided. This reflects a deep and significant disconnect between the very group with the most to gain from the ACA and their views on the law. I believe the ACA is the best opportunity the uninsured have to obtain quality healthcare right here in their own community, with our own doctors, hospital, health center and local health care providers. This why it is so important to understand why the uninsured view it so unfavorably and to do everything possible correct this misunderstanding and encourage use.
Another recent Kaiser poll lends some insights in what the uninsured understand about the ACA. This poll shows only 54 percent of the uninsured know they cannot be turned down for insurance because of pre-existing medical conditions. Only 58 percent know the law allows states to expand Medicaid and what that means. Only 63 percent are aware financial help is available to pay for insurance. But the one thing the uninsured “know” (81 percent) is that Obamacare will fine them if the don’t obtain insurance, even though no penalty would apply to many of the uninsured and free coverage would be available for many if Medicaid were expanded in Kansas.
So why do the uninsured have such negative views of the ACA and what can be done to encourage them to enroll?
1. Bad. Bad. Bad. Rollout. The healthcare.gov website was critical to a successful rollout of the Marketplace program. The site should have been functioning and user-friendly right from the beginning. It was the middle of December before the site was even minimally functional.
2. Massive campaign of misinformation. There continues to be deliberate and malicious talk about the program on talk radio and cable news outlets. Most famously, bold face lies about “death panels,” needlessly scaring and ginning-up opposition by seniors. Just this week, the same outlets have deliberately misrepresented the CBO report on the ACA as “costing 2.5 million jobs” even though the report and testimony of the authors was clear that no jobs have been “lost” nor did any unemployment result. The report was discussing “Job Lock,” where employees no longer have to stay with a job just for the sake of its insurance coverage. These people now are free to leave a job because they can buy insurance on the open market.
3. No Medicaid expansion. The failure of many states to accept Medicaid expansion produces perverse, unjust and failure to help the most disadvantaged Americans. People with lowest incomes (138 percent of the Federal Poverty Level or FPL) were to receive free health insurance from Medicaid under the ACA. This would be based solely on income and not require disability, pregnancy or young children as now is the case. But when the Supreme Court ruled the ACA constitutional, it also gave states the right to “opt out” of the Medicaid expansion. Kansas is now among 21 states not taking this option. Even worse, no provision was made in the law for people with income under 100 percent of FPL to get any subsidy on the Marketplace. A substantial number of people who seek insurance on the Marketplace now must be told they are too poor to get help.
4. New coverage did not begin until Jan. 1. One reason for the law’s unpopularity among the uninsured is that it simply has not had the chance to “deliver the goods.” The flawed rollout kept people away from enrolling and generated negative views. Most people’s benefits will begin in February, March and April, or in subsequent open enrollment periods.
5. The ACA requires new behavior with unclear costs and benefits. This is perhaps the most powerful reason for unfavorable views among the uninsured, especially among low-income residents. As the Kaiser poll indicates, far more of the uninsured are aware of a possible penalty than are aware of the actual benefits. When you already have demands that more than use up all of your money for basic demands like rent, utilities and gas for the car, any additional demand cannot be greeted with approval. This is especially the case when the benefits are unknown and misinformation tells you there are no benefits and that somehow your healthcare will get worse than what you have without insurance today.
These are the facts. It’s up to you to determine if that’s a good deal.
— John Robertson
Healthcare myths overwhelm
