Politics Magazine

Part Of Obamacare No One's Talking About

Posted on the 05 November 2013 by Jobsanger
Part Of Obamacare No One's Talking About (This chart showing the different insurance plans under Obamacare is from HealthPocket.)
The chart above shows the different plans insurance companies will be offering under the Affordable Care Act (Obamacare). Some insurance companies will offer all four plans, and others will offer only a couple -- but consumers will be able to purchase any of the plans through their state insurance exchange (or federal exchange for those states who have refused to create a state exchange).
The Bronze plan is the cheapest, covering only the basic requirements of  Obamacare and requiring the consumer to pay 40% of medical bills. The silver plan will cover a bit more, and requires the consumer to pay only 30%. The Gold and Platinum plans are the "cadillac" plans, covering a lot and requiring the consumer to pay less. But all of the plans have a couple of things in common -- all cap consumer costs for medical care at $6350 for an individual and at $12,700 for a family, and all of them are required to have the following coverage:
  • Ambulatory patient services (such as doctor visits and other care you receive as a “walk-in” as opposed to services a person receives as an “inpatient” at a hospital or other care facility)
  • Emergency services - These include care received in an Emergency Room
  • Hospitalization - These include medically-necessary surgeries and other inpatient procedures
  • Maternity care and newborn care
  • Mental health services & substance use disorder services – These services include counseling as well as behavioral health treatment for alcohol abuse and drug abuse
  • Drug coverage – This applies to prescription medication and not over-the-counter drugs
  • Rehabilitative and habilitative services and devices - Rehabilitation covers services such as relearning to speak after an aneurysm while habilitative services involve learning a new skill such as managing diabetes through various behaviors
  • Laboratory tests and services (for example, X-Rays)
  • Preventive and wellness services as well as the management of chronic diseases
  • Pediatric medical services (including both oral care and vision care)

  • But there is something that no one is talking about. It is that through the subsidies provided to those making within 250% of the poverty level, as many as 7 million Americans would be able to purchase a Bronze plan for free (and 1 million would probably be able to get a Silver plan for free). About 6 million of those people are those who currently have no insurance plan at all -- and the other 1 million are people who are currently buying their own insurance (and sacrificing to pay for it out of their own paychecks). And we're not talking about Medicaid here, but people who must buy private insurance because they make too much to qualify for Medicaid.
    Why isn't anyone talking about this? It's obvious why the Republicans are not discussing it. They want everyone to believe that Obamacare will hurt all Americans. The fact that these 7 million Americans would qualify for free private insurance under Obamacare (not to mention that many millions of others will continue to get their insurance provided by their employer, and millions more will qualify for Medicaid) destroys the fictitious argument (lie) they are trying to sell.
    The insurance companies aren't talking about it because they want to sell the more expensive plans to as many as possible (the plans they make the most money on). And the federal government is not talking about it because they want consumers to make up their own minds about what level of plan they need (or can afford). And they are right, since some may be willing to spend a few dollars of their own to buy a better plan.
    That's all understandable, but with the vicious lies the Republicans are telling, this is an aspect of Obamacare that needs to be wider known. The ability to get a Bronze plan (or maybe even a Silver plan) for free will be a real boon for these 7 million Americans -- all of who either can't afford insurance or are struggling to pay for insurance on their meager wages.
    The truth is, even though Republicans don't like it and won't admit it, that Obamacare will either benefit or not affect most Americans. Only a tiny percentage will have to pay a little more for insurance, and they are the ones making enough to afford it. Obamacare is not perfect (a single-payer system would be better), but it is a significant improvement over what the status quo was -- and most Americans will understand that when it has been fully implemented for a while.

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