Obamacare: What does it mean for you? (Part II of III)

July 24, 2012

Mark L. Friedman, MD, FACEP, FACP

The answer to this question is complex, not completely clear, and to a large degree depends on your particular circumstances. The following are my predictions based on what I know: If you are a member of the 40 million uninsured, the Affordable Care Act, or ACA, means you will be eligible for low-cost -- or even free -- health insurance (based on your income). It also means you may be required to pay for this insurance, although it remains unclear how or even if the federal government can and will enforce this provision.

Demonstrators both for and against the Affordable Care Act. 


Depending on what kind of insurance you buy (cost will be a factor), you may obtain a first-rate policy that entitles you to the best health benefits obtainable -- typically those provided to members of Congress. The low-cost plans will essentially provide the same coverage as a Medicaid plan. You will have the choice, and also bear the cost, of whatever level of benefits / coverage you prefer "“ not terribly different from your choice today.

The major change is that you will be required to buy it or potentially face a penalty. Also, everyone will be eligible for (presumably) low-cost Medicaid type plans.

If you are already on Medicare or Medicaid, nothing will change for you right away. As time goes on, changes will undoubtedly occur, as we shall discuss.

If you currently obtain insurance through an employer who elects to continue providing health insurance as a benefit, nothing may change initially as well. The government predicts premiums will go down, but having never seen this in my lifetime, I doubt this will transpire.

More importantly, a significant number of employers will use this new law as an opportunity to get out of the business of providing health insurance. This benefit is a huge cost to employers both in terms of premiums and of the time and energy required to obtain and administer it. Employers will abandon health insurance as a benefit in large numbers. This will then have the effect of throwing millions of people into the individual insurance pool to deal with the new state-based insurance exchanges, which are currently forming. At the same time, insurance agents will be put out of the health insurance business as health insurers accelerate the trend to refuse to pay commissions. Agents may become available for a fee, paid by individuals.

The bottom line in all this for individuals: Healthcare will become increasingly complex, expensive, and difficult to access.

Next: Obamacare "“ What does it mean for America?

Originally published Jul 24, 2012 6:52:09 PM.