By Dave Smith, Contributor to US Daily Review
It has been approximately 18 months since President Obama signed the Patient Protection and Affordable Care Act into law. Commonly known as “Obamacare”, the act made sweeping changes to federal government regulation of health care, insurance, taxes, and personal behavior. Among other provisions, the legislation expanded Medicaid, increased taxes, created new federal agencies, placed restrictions on insurance providers, established provisions for state “exchanges” for insurance, and imposed an unprecedented “individual mandate” – a requirement that each individual purchase insurance coverage approved by the government.
While the impact of Obamacare on the economy and medicine has been the subject of much study and discussion by think-tanks, researchers, and pundits, I decided to focus on the impacts of the new law on one person: me.
Currently, my employer does provide health insurance benefits. I am covered by a high-deductible plan (sometimes called “catastrophic” coverage) along with a health savings account (HSA). In addition to paying part of my premium, my company places a lump sum in my HSA at the beginning of each year. I can add to the HSA tax-free through automatic deduction from my paychecks each month; the balance accumulates interest and can be carried over from year to year. The government maintains a list of acceptable medical expenditures for which money from the HSA can be used (for example, I can’t use my HSA to get a massage or a manicure).
The flexibility of the HSA means that I am free to shop around for various health and medical supplies or services, with the incentive of being able to keep the money I don’t spend and earn interest on it indefinitely. Whether I keep my doctor or decide on a less expensive option is up to me, not a pencil-pushing bureaucrat in the government or an insurance company. I don’t have to look for an “in network” doctor, but I am protected against a catastrophic emergency bankrupting me. In short, the system makes purchasing health care products and services more like every other market. The HSA even supplies a debit card for easy transactions.
Unfortunately, one of the provisions of Obamacare has already impacted the use of my HSA: previously, over-the-counter medications were acceptable for purchase using HSA funds. I have seasonal allergies and periodic problems with acid reflux, so I used my HSA debit card to buy Allegra-D and Prilosec over the counter – two not-inexpensive drugs. I also used the funds for aspirin, Pepto-Bismol, antibiotic cream, etc. With a stroke of the President’s pen, this is no longer legal. I either have to pay for this medicine with after-tax dollars, or else purchase the more expensive prescription drugs. Either way, I’m paying more to combat my heartburn and sniffles.
Another aspect of Obamacare includes mandates that all insurance plans must cover maternity coverage as well as counseling for drug and alcohol problems and depression. Thus, even though I am a single man, I must pay for coverage I would use only if I became pregnant. There’s more added expense. Also, my company already has an “Employee Assistance Program” that provides help with problems like addiction or depression. This means I will be forced to pay for a service I was already getting for free from my company: I’m losing a benefit. Other mandates require coverage for annual physicals and certain preventative care coverage – also items currently provided for me by my employer. Birth control pills must be provided without a co-pay. There are other requirements as well, with the list likely to lengthen as various groups lobby the government to include their own pet services in the government-approved plans. Taken one-by-one, each of these coverage options is likely to appeal to individual consumers; however, why should everyone be forced to purchase coverage they neither want nor need?
A third aspect of the health care law is a concept known as “community rating”. This provision essentially means that younger, healthier customers can’t negotiate better rates on health insurance than customers who might be older or sicker. Applied to auto insurance, this concept would prevent auto insurance companies from providing “safe driver” discounts or charging more for teenage drivers. Eat right, exercise, and keep yourself in good health? Too bad, says the government: no discount for you (or, in this case, me).
There are many more mandates, prohibitions, and requirements in the law – politicians can pack a lot into 906 pages. The new taxes and regulations are certain to have a major impact on health care delivery and the entire economy. Just these three things, however, are already impacting my own health care costs negatively, and the intrusion is going to increase as more aspects of Obamacare are phased in.
In discussing his proposals, President Obama said that “if you have health care, my plan will lower your premiums.” He obviously wasn’t talking to me.
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