Saturday, September 3, 2016

ObamaCare has a 'zombie uninsured' problem

"You wouldn't believe the panic. Streets not fit to be on." The post-apocalyptic television drama "The Walking Dead" premiered with this dark depiction of humanity in the days immediately following a zombie epidemic.

Halloween ends at midnight on Nov. 1 this year, and with it, the online doors open for enrollment on the Patient Protection and Affordable Care Act's (ACA or ObamaCare) Health Insurance Marketplace (or "exchange"). However, for millions of Americans logging onto HealthCare.gov, it will still feel like Halloween with sheer fear at the sight of skyrocketing premiums, limited to no plan options, and their doctors no longer accepting the coverage that remains. Their questions will be plentiful. What happened? What went wrong? What do I do now?

It wasn't supposed to be like this, remember? President Obama promised the ACA would provide "the same kind of choice of private health insurance that members of Congress get for themselves." Then there was, "If you like your healthcare plan, you'll be able to keep your healthcare plan, period." Oh and, of course, "We will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period."

Flash-forward to the present, and it seems another major insurance carrier is dropping from the exchanges every day. Aetna, United, Humana, Harken. After a while, it becomes white noise; just big insurance company names in the news scrolling across our TV screens, phones and tablets, all void of the true impact these seemingly small but ever-piling-up events will ultimately have on so many. The premiums that were promised to decrease have skyrocketed, the plans we were promised we could keep have or will be canceled and the "competition" that was promised to drive the exchanges has ended. We are rapidly approaching a healthcare apocalypse.

Ground zero is Pinal County, Arizona. After Aetna recently announced its withdrawal from the exchanges, Pinal County became the first county in the U.S. to have zero insurers on the public exchange. Pinal County exchange customers are officially out of options, left begging insurers to stay or come back. Ten-thousand people or more will be left without coverage. And this is just the beginning.

Looking back, this crisis was entirely too easy to spot. ObamaCare removed the ability for insurance carriers to rate individuals on their preexisting conditions. While this may be humane, it is wholly unsustainable. The carriers took on a rash of chronically ill patients filing costly claims, counting on taxpayer subsidies to bear the burden. This outcome was in fact predicted. Except, at the time, it was looked at as a conspiracy theory or some sort of healthcare science fiction.

Michelle Katz, a nurse and nationally recognized patient advocate, has seen this happen firsthand. "As a patient advocate, nurse and patient myself, the biggest concern I have about the future of the Affordable Care Act exchanges is what happens with those suffering from chronic illnesses and medications thinking they could afford this 'affordable' insurance back in 2014? Now they are going to be priced out of the market? They're the real victims."

So who are these victims? You may know them, be related to them or, sadly, be one of them: part-time workers, self-employed workers, workers who lost jobs during the Great Recession. Coverage-bare "zombies" with only broken promises are left endlessly online, wandering for that one precious plan that may still provide some semblance of cost absorption for their growing healthcare needs.

These working Americans, often times called contingent workers, make up 30 percent of the American workforce. By 2020, that number is expected to rise to 40 percent. With slim to no options on the exchanges, these workers will be forced back into emergency rooms, or paying out of pocket for emergencies as they arise. The added insult? The increasing individual "penalties" owed next April at tax time for not having coverage.

One of these victims who reached out to Katz is Robin Farmanfarmaian, whose highest-level California plan dropped her main hospital with no notice or warning. "My insurance premium this year spiked over $150. I renewed because I thought I was 'safe' on that plan. Had they told me they were dropping my hospital of six years, I would have changed plans instead of renewing my old plan."

The presidential election has been mostly dormant on this rapidly approaching crisis. Talking points and stale solutions involving more government promise little hope. Unlike reality, science fiction, even the most farfetched, often offers warnings and lessons of survival. To avoid a nation full of hopelessly "walking uninsured," let's hope our leaders see this crisis coming. We need to develop immediate survival solutions for these victims before promising more sweeping new legislation. Because this Halloween, we won't want more tricks.

Rotella is founder and managing shareholder of the Rotella Legal Group.

The views expressed by contributors are their own and not the views of The Hill.


Source: ObamaCare has a 'zombie uninsured' problem

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