Millions of Americans have been watching, waiting, for the sky to fall on the Commonwealth of Massachusetts. Republicans predicted it would. In 2006 the state passed a health insurance bill that looked a bit like the federal bill Congress passed last year. Republicans predicted economic catastrophe when the bill, dubbed Romneycare, went into effect. So all of us sky-watchers should look upward at Massachusetts.
Chicken Little was wrong: the economic sky did not tumble. In fact, the state looks in better health, insurance-wise, than before the state legislature acted (www.healthaffairs.org).
In 2006, 86.6% of the states non-elderly residents were insured higher than in many parts of the nation. By 2010, 94.2 percent were insured. The reason: Romneycare. Without it, Massachusetts would have seen its census of uninsured rise, as layoffs drove more people off their employers rolls (and bankruptcies eliminated some other employers rolls entirely). Coincidentally, emergency room visits, as well as inpatient hospital stays, declined.
As for costs, they rose, but theyve risen throughout the country. Romneycare, moreover, did not seek to curtail costs. In the Monty Python world of Republican primaries, Gov. Romney is running away from what in a more rational time he would claim as a victory. Of course, Massachusetts is not the nation. Will the Affordable Care Act, dubbed Obamacare, topple the economic sky? I think not.
As in Massachusetts, the census of the insured will rise. Citizens will still worry about jobs, the environment, foreign wars. But people who are ill, needing care, wont be hysterical that they cannot pay.
Obamacare will nix some of the toxic insurance products. Consider a few: No more exclusions for pre-existing conditions. From the vantage of insurers, these exclusions are wonderful; they reduce the insurers risk from the outset. The insurer is not rejecting the applicant, just rejecting any bills for treating the applicants illnesses that existed prior to enrollment (for example, cancer, diabetes, asthma, arthritis widespread maladies). Investors, focused on profits, have welcomed the exclusions. Only the patients have suffered.
Huge profits will also go into the ash-heap. Patients do best when most of the money collected in premiums goes to patient-care, not to administrative salaries and dividends. Already the Affordable Care Act has put brakes on insurers.
Policies will no longer drop young adults at age 21. Those recent college graduates searching for a job with insurance (a challenge) can stay on their parents policies until age 26. This is a minor codicil in the law, but one that will help thousands of families. As for immunizations and preventive services, in the small-print of traditional policies those low-budget items often require high co-pays, or fall under deductible limits.
Under the Affordable Care Act, policies will have to cover these services. The small-print caps and lifetime ceilings will also go. People who need major surgery or rehabilitation wont hear, midway, that they have exhausted their benefits, hit their ceiling.
The sky wont fall. Years from now, well wonder why we feared it would.
Joan Retsinas is a sociologist in Providence, R.I. Email firstname.lastname@example.org.
From The Progressive Populist, March 15, 2012
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