By now you probably know that under Obamacare, every American man, woman and child is required to carry health insurance by January 1, 2014. Along with the universal coverage requirement, there are a whole raft of other changes coming into play, up and down the system.
If you’re lucky enough to have a stable employer with excellent benefits, you may feel like you don’t need to pay much attention. But at some point, no one will be immune from this sweeping overhaul.
Here are five ways that everyone will feel the Affordable Care Act.
1. What you pay will change. How it will change depends on who you are.
One of the goals of the new law is to drive down costs. But the debate is still raging over whether insurance rates will actually go down—or up. Chances are, they’ll do both.
With the way our health insurance system works now, many sick people are tossed aside or charged more by insurers. With many of the “high-risk” folks out of the pool, prices are lower for the young and the healthy (though many of them now opt out of insurance entirely).
The universal coverage mandate means everyone must get into the pool—and that will make some waves. If you’re over 45 and/or you’re unhealthy, you might see your rates go down. But if you’re young and rarely visit the doctor, you might be in a different boat: your costs could rise.
How much your rates change will vary by where you live, your age, your income, your current coverage, and your gender. Expect to see the biggest increases if you are young and male (sorry, guys!). The consolation is that 26 million low- and moderate-income people are expected to qualify for government subsidies.
Put plainly, the young and healthy will subsidize the old and sick. That’s the way insurance pools work, after all. If that sounds shocking, you should know you’re already doing it: it’s how our Medicare system takes care of retirees. So if you’re paying more now, take solace in the face that you’ll likely be at the receiving end someday.
2. You won’t need to hide your past.
Nearly one in five Americans suffer from high blood pressure, and tens of millions more have diabetes, asthma, arthritis, cancer, a history of heart attacks and a host of other conditions that have been used by insurance companies to charge more or deny coverage altogether.
Every insurer has a different list of “pre-existing conditions”—some major, and some that could turn out to be insignificant—so it’s tough to get an accurate count of how many people are in this boat. But a Government Accountability Office review estimated it’s between 20 percent and 66 percent of the population—depending on how many types of chronic conditions are included. For women, the high-end estimate is 72 percent.
Under Obamacare, insurers are banned from rejecting people based on their health history. And they can’t charge more either.
That’s important for everyone. Even if you feel immortal and your health record is as clean as the day you were born, the chances are pretty high that you or someone you love will be diagnosed with a chronic or serious condition at some point. With universal coverage, they won’t be penalized for it.
3. You can go mobile.
Once it’s up and running, the re-vamped health care system will make it easier to move around—from job to job, plan to plan, and doctor to doctor.
Until now, the insurance company penalties for pre-existing conditions have seriously limited people’s ability to become self-employed or move between employers—so-called job lock. Those days are over.
Also under the new law, insurers are prohibited from charging new enrollees higher rates than existing customers for the same plan, and from baiting new customers with teaser rates and then jacking them up. Those reforms mean fewer repercussions for changing insurers.
The health-care overhaul also happens to coincide with the explosive expansion in cloud computing. New rules encourage coordination between healthcare providers—think of it as billing for packages of care rather than itemized billing. This increased integration means that medical records will have to be stored and shared electronically, and be accessible from anywhere.
Besides being a boon to the tech companies who will get new business, this also means your records will be more portable.
4. Even if you do end up paying more up front, you’ll have fewer unpleasant surprises.
Another key part of the Affordable Care Act is that insurers are banned from putting annual limits on coverage. They also can’t peg lifetime coverage to dollar amounts, and there are caps on out-of-pocket spending tied to income.
In addition, all insurance plans must meet certain standards, and they must include a package of care classified as “essential health benefits.” To be certified, all plans must include services in ten broad categories, from maternity and newborn care to mental health issues and emergency care. Some services must be provided without any co-payments or deductibles. These standards apply to both individual and all employer-provided plans.
While individuals can still choose to buy basic insurance with minimal services, there will be no more “junk plans,” or surprises hidden deep in the fine print. In other words, people who thought they had catastrophic coverage won’t find themselves walking out of an emergency room and straight into bankruptcy. That should help drive down the number of people with unpaid bills or crippling medical debt—last count, 75 million.
5. Everyone will be confused, and the system won’t be perfect.
With so many moving parts in such a complex system, there are many things that could go wrong. Some people and companies will find ways to take advantage of the chaos. Many of the changes are experimental, and even though they’ve been studied and debated and planned for, there’s no guarantee that it will all work smoothly.
The only guarantee is that things will be topsy-turvy for some time to come. For the near future, expect conflicting information, media reports of snafus and probably some horror stories. But it can’t be worse than the system we have now.
Find out more about how to shop for plans and what documents you’ll need by visiting Rocket Lawyer’s Affordable Care Act center.
- Health Insurance for All: An Affordable Care Act Timeline (rocketlawyer.com)
- A Good Dose of Health Privacy Law (rocketlawyer.com)