Affordable Care Act Meeting

The Mitchell County Extension office hosted Roberta Riportella, a professor of Community Health at Kansas State University to help to explain and advertise the Affordable Care Act, or Obamacare. She was a health policy specialist at the University of Wisconsin - Madison prior to her job at Kansas State.
Riportella said that there are 3 main reasons that health reform is necessary. Those things are the expensive cost of service, inconsistent quality and inadequate access to healthcare. She showed a chart displaying rankings of Australia, Canada, Germany, Netherlands, New Zealand, the United Kingdom and the US. She pointed out that according to the research that created that chart, the US was last in most of the categories.
Riportella said that in the state of Kansas, 51.8% of the population is insured through their employer. She said that 13.1% of Kansans are uninsured. She said that most of the uninsured have a low or moderate income. She said that the poorest of the poor are on Medicaid. She called Kansas "less generous" than her home state of Wisconsin in terms of dealing with healthcare for those with low income. She said to avoid cost problems with healthcare, be very poor or very rich. She said most of the 13.1% uninsured in Kansas are working families, and that the number is not any higher because of the help of Medicaid and CHIP, which provides for children.
Riportella pointed out that if people are uninsured, they have a 25% greater chance of premature death than if they were insured, and that over 18,000 people die a year because of a lack of insurance. She said that in a community with uninsured people, the quality of care for the insured drops. She said that the insurance status of your neighbor affects everyone, and that everyone should care about that.
At one point during the meeting, Riportella said that her life would be made easier if the Affordable Care Act was simpler and less huge, but that she would continue trying to learn and teach the Act, and that she has not read it all the way through.
She said that the goals of the act are threefold. The first is to make coverage available and affordable. The next is to improve the quality of cost-effective care, and the third is to end abuses by insurance companies. Riportella said that under the law, it is illegal for insurance companies to deny children for preexisting conditions, to set a lifetime cap for the amount of care received when sick and other restrictions. She said that insurance companies have to meet 80% medical expenses, 20% profit restriction to make sure that they are not just taking client money for profits.
"Also, don't worry about Medicare, this bill makes it stronger," Riportella said.
Riportella also wanted to discount what she called rumors about the Affordable Care Act. She said that it doesn't create government-controlled or socialized healthcare. She said if people are worried about that, they should be worried about something closer to Medicare. She also said that it doesn't create what some people call "death panels."
Riportella then moved on to the implementation of the law. She said that the bill passed on March 23, 2010, and the Supreme Court ruled that the mandate would be upheld in June of 2012. They also shot down the state's requirement for expansion. She said that major implementation of the law will go into effect on January 1, 2014. She said some provisions are already in effect, and there will certainly be some changes to the law before and after the implementation date.
She said that most individuals will be mandated to have insurance under the Supreme Court ruling, but that some are exempt. She also said that individuals with employer or private insurance don't have to change their policies, but that this Act just builds and expands on the employer-based insurance system.
She said that the law requires large employers to insure, and that there will be a fine if they do not comply. She said that it is estimated that 4% of companies will take the fine over paying for insurance in the new plan.
Riportella then said that there will also be a marketplace, or exchange, set up to select insurance policies. Through the marketplace, Riportella said, nobody can be turned down for insurance. She said that Kansas has currently opted for the Federally-facilitated marketplace.
Riportella then talked about the Medicaid expansion to the state. She pointed out that Governor Brownback has not issued his opinion on the issue, and is part of one of 4 republican-leaning states yet to issue their decision on the expansion. According to Riportella, the proponents of the expansion say that the more insured there are, the better the quality of care becomes. Also, that it will offset payment cuts to providers, benefit the economy, and that it is too good a deal to pass up. She said that opponents of the measure say that it is unaffordable, and that Medicaid is broken and it needs to be fixed.
She said that as these programs progress, there will be toll-free hotlines, agents, brokers and navigators for the marketplace.
Riportella then opened it where several questions were asked. Among them, Jim Nelson of Jewell County asked if the penalty for employers that do not follow the mandate create a sort of police state under this law. Riportella said the Supreme Court found it to be constitutional, and that she didn't write the bill, so she cannot directly defend it, or take the blame for its contents.
Mitchell County Commissioner Tom Claussen asked what the law considers a full-time employee, and Riportella replied that the law describes it as anyone who works 30 or more hours in a week. She said that a downside of this rule, is that some employers are only hiring people for hours just below 30 a week to avoid qualifying for the insurance mandates.
Riportella thanked the crowd for attending and told them to direct any further questions to healthcare.gov.

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