Friday, December 20, 2013

Affordable Care Act - More Questions Than Answers


I spent a good part of the morning researching how the Affordable Care Act is being implemented in Connecticut. I am on Medicare, so it doesn't effect me, but Leon is self employed and has private health insurance; we think he can keep his coverage beyond January 1st, but we're not rally sure. It is confusing.

Not as simple as it is being made out to be - at least not for some people.

Of main concern is the fact that in Connecticut we have adopted "extended Medicaid" - an expansion of  Medicaid to include anyone whose income is below $15, 500. For people who are making minimum wage or are self-employed, $15,000 can be a wage that allows for the accumulation of some assets - a retirement fund, savings, a car, even a home. Now it is a wage that may effectively force these individuals and their families into poverty.

Given state statutes that are on the books, I believe that Medicaid can attach such assets, put a lien on a house and obtain payback for expenditures on behalf of that individual after the persons death - leaving nothing for a spouse or family, let alone an unmarried "partner"- unless, and this is very unclear, unless these provisions are not enforced under "extended Medicaid" - but nowhere on the state's websites is this made clear or even addressed.

And I searched every which way I could for several hours. And I spent over an hour calling state agencies and state legislators. Nothing. I actually knew more than most of the people I spoke with, not surprising, really.

I've also learned that many individuals with HIV may possibly lose state assistance that pays for private medical insurance premiums under Ryan White if their income is less than $15,000 because they too will now be forced into Medicaid.

So for the nouveau pauvres on the Medicaid roles there is no information about how being on Medicaid will affect retirement savings, a home or other assets.

It could be that such individuals may lose everything they've worked for and at death, their estate, if any, will be used to pay back the state for lifetime of health care premiums and costs with nothing left for survivors, even taking marriage equality into account.

I could be wrong about all of this, and I hope I am, but no one here has been able to clarify these issues. I've actually called several state agencies and received contradictory information.

So, I think the working class being forced into Medicaid is despicable. Some philosopher once said that every solution creates new problems. So it is for the Affordable Care Act.

I blame the Congress for making minced meat out of Obama's original proposal - Universal Health Care with a single payer system.  Obama's biggest mistake - letting them call their Frankenstein monster Obamacare and using that as a term of endearment himself.

P.S. If anyone who knows anything about this issue can clarify it for me - please leave a comment.

1 comment:

  1. Obamacare is indeed mincemeat - I'm sure it's full of all sorts of stupid provisions and exclusions.

    Thing is, it was the best we could get at this moment in history - just the first, halting step in a long, long road to universal coverage and single-payer healthcare.

    Which is the only sensible thing to do in a modern industrialized country - trouble is, by the time all that comes to pass, you and I will be beyond all need of it.

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