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Tulsa World: Dr. Katherine Scheirman: Affordable Care Act is a success



Many politicians, including Rep. Glen Mulready (“Like your health insurance? Tough,” July 16), are peddling myths about the Affordable Care Act that sound scary, but never turn out to be true. Remember being told that “no one will sign up?” More than 8 million people signed up for private health insurance coverage through the marketplace.

So let’s look at some facts instead.

Citing a new study, Forbes said that “new Hepatitis C therapies such as Sovaldi and a flood of new health-care consumers, thanks to an improved economy and the Affordable Care Act, will help push health spending up 6.8 percent in 2015. But researchers at PwC’s Health Research Institute say employer strategies to shift costs to workers through consumer-directed health plans, savvier health-care shoppers generally and the increasing shift away from fee-for-service medicine ought to keep health inflation from jumping by double-digit percentages common in the late 1990s through much of the early 2000s.”

So health-care spending is going up because more people are getting care, but costs are rising more slowly than before, which sounds like a win for everyone.

As for premiums rising in 2015, consulting firm Avalere Health has found insurers plan to submit only modest (average 8 percent) rate increases.

For consumers who sign up through the federal marketplace, nearly 90 percent receive tax credits to help them afford coverage. Nearly seven in 10 enrollees are paying $100 or less per month and nearly half are paying $50 or less per month. The average premium after tax credits is $82 per month.

In spite of the limits on insurance company profits, no insurers have dropped out of the program. In fact, many more will participate, because many new customers means a lot more profit. UnitedHealth Group, which initially limited its plans to four states due to concerns about the health status of the newly insured, will expand into as many as two dozen states next year. More competition should lead to lower rates.

Prior to “Obamacare,” small businesses paid much more than large firms for the same coverage, and their premiums could shoot up rapidly if even one employee developed an expensive illness. Now, the Small Business Health Options Program Marketplace lets small business owners leverage buying power with others, getting comprehensive information about benefits, quality, and price — leveling the playing field.

Businesses with fewer than 25 employees that offer coverage through SHOP and meet eligibility requirements may claim a small business health-care tax credit worth up to 50 percent to help offset the costs of premiums.

The number of Americans without insurance has dropped sharply. According to a new study of “Obamacare’s” newly insured, 78 percent are satisfied to very satisfied with their coverage, including 74 percent of those who identify themselves as Republicans. Sixty percent of the newly covered already have started to use their new insurance, and most enrollees said they could get an appointment within two weeks.

The Affordable Care Act is a success, giving people the freedom to change jobs or start a business, without fear of losing health insurance, delivering financial security in a time of economic uncertainty while slowing the rise in health-care costs.

It could be even more successful in Oklahoma if Gov. Mary Fallin would stop blocking low-wage Oklahomans from access to health care, which is already funded with our taxes — millions of federal dollars that our hospitals and economy need, that we already paid for, and that now go to other states.

Dr. Katherine Scheirman, MD, is state director of Doctors for America. She lives in Edmond.


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