A user’s guide: 20 things to know about the Affordable Care Act

By Carol Ostrom

The Seattle Times (MCT)

Published: Wednesday, Sept. 25 2013 12:00 a.m. MDT

Once most people are in the pool, though, expect some slow ratcheting down of costs as businesses, insurers and health systems find ways to reward care that works and discourage care that doesn’t. According to a recent Institute of Medicine analysis, fully a third of the $2.6 trillion spent in 2010 on health care went for care that didn’t make patients healthier.

15. Expect more pressure from every direction to adopt healthful habits and choices. It may come as an incentive — lower premiums or gift cards — or not. Once we’re all in the same boat, it’s hard to argue that one person’s actions don’t affect others.

16. Businesses aren’t required to insure workers this year. The federal government in July delayed the mandate for business coverage for a year. But in 2015, employers of more than the equivalent of 50 full-time workers will have to insure or pay a penalty.

17. Undocumented immigrants won’t get any subsidies. Immigrants here illegally will continue to try to patch together care in community clinics and emergency rooms. But legal immigrants can buy insurance on the exchanges and qualify for subsidies, if their income qualifies them for help.

Legal immigrants here for five years or more can qualify for Medicaid with the same income limits as others.

18. Watch as hospitals pull out all the stops to sign up patients for insurance. The only really open door in health care is the emergency room. So how cool would it be if the hospital could make sure everyone who comes there is signed up?

UW Medicine hospitals will be doing just that, with enrollment kiosk stations at various areas, personnel trained to help patients enroll, and newsletters to reach out to potential patients.

Look for distinctive buttons or lanyards to identify people who can provide information.

19. Soon, there will be information everywhere. There will be assisters and seminars and advertisements and info packets about the exchange and the ACA everywhere you turn. Even so, not all questions will have answers yet. Think of it as a good first date: Promising, but there are still some mysteries.

20. Despite what you may have heard, Obamacare doesn’t change the world as we know it. There will still be hospitals, and doctors and insurance companies. Employers will still offer insurance to workers. Brain surgeons will still make a lot of money.

The ACA isn’t communism or socialism, and the “free” market will still be alive and kicking — perhaps more vigorously than it’s done in the past. In fact, some predict we’ll find that more choices, more “shopping” and more decisions aren’t really what we all want, after all.


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