Ron McNear, a concerned citizen of Oregon County, said that people should be educated about the Affordable Care Act, which is often called Obama Care. "Our healthcare industry is often called a healthcare system. That is probably the last thing it is, a system. There are big problems regarding costs and services. Something has to change and maybe tonight we will find out what can change and what may not change," said McNear.
McNear introduced, Ryan Barker, Director of Health Policy at The Missouri Foundation of Health, by telling the crowd, "Over the last nine years, Barker has focused on Missouri Medicaid, increasing health equity and strategy to provide quality, affordable healthcare to all Missourians."
MHF Community Meetings
The Missouri Foundation of Health has presented approximately 200 meetings to inform communities about the Affordable Care Act. About 70 people were in attendance at the Thayer meeting, which Barker said was a great-sized group. "We feel it is so important that everyone understands the good and bad in this law, and how it is going to impact you and your family," Barker said.
"Why am I here?" Barker asked, answering that MFH heard a lot of the rumors that were going around and that people were panicking over what they thought was included in the Affordable Care Act, so MFH wanted to inform people of the facts.
"We do not take a position on any piece of legislation. I am not here to convince you that this is the greatest thing in the world, that it will save this country, but I'm not here to convince you it's the end of the world as we know it. Truthfully, it's somewhere in between."
Why change the system?
Barker used statistics to illustrate the current standing of the healthcare coverage. "One third of consumers, physicians and employers gave our current healthcare system an A or B, leaving two-thirds to say that it grades a C, D or F," Barker said. He said that people describe it as fragmented and uncoordinated. The main source of healthcare costs are hospital costs. Barker said, "Physicians say consumer behavior, such as smoking or not eating right, is the main source."
"The main focus is to get healthcare systems to talk to each other and coordinate," said Barker. Another top priority is changing the fact that 50 percent of Americans do not have health insurance. "One out of every six people has no health insurance," Barker said.
What is health reform?
The main elements of ACA are health insurance exchanges, tax credits for individuals, impact on small businesses, employer requirements, private insurance, individual mandate, Medicaid, Medicare, Workforce access to care, quality of care, prevention, and new models of care.
The purpose of the health insurance exchange is to provide affordable healthcare for small employers, an individual or family. Barker compared the exchange to a farmer's market and said that insurance companies with the same set of benefits will be available to people. "The law says it will be consumer friendly and easy to understand. The book of benefits will be revamped to be easy to read and understand," Barker said. The exchange will be available online or in person on Jan. 1, 2014.
"Congress said a state can set up its own exchange or the federal government will come in and set one up for them. The Missouri Senate filibustered the bill that the House voted on unanimously, which would have allowed Missouri to set up its own exchange, and not much has been done since, due to the election season."
Barker said that unless the legislature discusses it further in January, it looks like the federal government will come in and set up an insurance exchange or do a partnership with the state. "The object of the exchange is to lower the cost of insurance by having it available to more people," said Barker. There are four levels of insurance plans. With the Platinum plan, insurance pays 90 percent and the consumer pays 10 percent, Gold plan insurance covers 80 percent and the consumer is responsible for 20 percent, under the Silver plan, insurance pays 70 percent and the consumer pays 30 percent and the Bronze plan pays 60 percent and the consumer pays 40 percent. There is also a Catastrophic plan that will be available to those under 30 years of age that will be the cheapest plan.
The biggest change for insurance companies is that, currently, some only offer certain coverage areas but, if they are a part of the exchange, they will have to operate statewide. "It is estimated that 800,000 Missourians will participate in the exchange," said Barker.
Health reform benefits
A positive change in health insurance will be availability to all. "Insurance companies have to offer insurance to everyone. No one can be denied, and they are required to renew the covered individual," said Barker.
Another change is in the rating rules that insurance companies use. Now, insurance companies can rate you on gender, occupation, health status, age, family size and geography. With the ACA, most rating rules go away. They will not be able to rate on gender, occupation or health status, but they can on age, at a smaller ratio, family size and tobacco use. Currently, women pay 150 percent more than men, rates are increased for people with diabetes, high blood pressure, or other pre-existing conditions and an elderly person pays eight to nine times more than a younger adult.
An additional change allows dependents to stay on parents' insurance policies until the age of 26, a benefit which has already begun. Eighty to 85 percent of premiums that insurance companies collect from consumers and employers must be spent on medical care for everybody. That change went into effect in 2011. Barker added the only way a child can be kicked off their parents' insurance is if they work at a job that provides insurance.
Next week, the discussion of affordable health care will continue, as Ryan Barker discusses religious exemptions and how Medicaid, Medicare and hopsital care will be affected by health reform.