Curmudgeon column confusing; don’t blame the ACA

Jan 16, 2014

Editor:

The Constant Curmudgeon’s column about the Affordable Care Act (ACA) left this reader confused.

Is he an 80-year-old who is a Medicare recipient and thus whose “insurer” could only have been a Medicare Advantage plan, a Medigap plan or a drug plan—none of which would have been offered through the exchanges and whose cancellation would have had nothing to do with the ACA, or is he introducing an unrelated topic when he talks about the elderly on fixed incomes?

Medicare recipients will benefit from the ACA by seeing a narrowing of the “doughnut hole” in the prescription drug plan, Medicare Part D. (That reduces the dollars the individual has to pay out before plan coverage begins.)

Medicare recipients also will find they have expanded coverage of preventive services.

If the Curmudgeon is not a Medicare recipient and participates in the exchanges, he is ignoring important benefits provided to him by the ACA.

He states that neither he nor his wife has excellent health. Prior to the ACA he could be denied participation in a new insurance plan because of pre-existing conditions. Now he cannot.

His new insurance plan will have to provide “essential health benefits” and cannot impose maximum lifetime dollar limits on its coverage. The plans are required to spend 80-85 percent of premium dollars on medical care.

Private health insurance companies make decisions each year about whether or not they will participate in state and federal programs, offer new plans, contract with certain hospitals or physician groups, increase or decrease their fees … It’s too easy to lay the blame for their business decisions on the enactment of the ACA.

The ACA has been made a scapegoat for many of the troubles of our healthcare system. Its enactment was an effort to address a glaring social issue—that in this, the wealthiest country in the world, we have more than 48 million people without healthcare coverage.

Sincerely,

Dorothy Monroe

Edmonds

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