Hello, everyone, and welcome. Today we’ll be talking about WebMD’s exclusive interview with President Obama about the Affordable Care Act, just released today. Valarie Basheda, Director of News and Editorial Content here at WebMD, is joining us to get feedback from health reform experts. Our experts can also answer your questions about the interview or the topics we’ll be discussing.
And as a reminder: WebMD is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your doctor or other qualified health provider because of something you have read on WebMD.
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Valarie, are you ready for a lively discussion?
Yes! We’re looking forward to a great discussion. This was a unique opportunity for WebMD readers to get their concerns in front of the president. Here’s what happened: earlier this week, WebMD sat down with President Obama to talk to him about the Affordable Care Act. We asked readers to send us questions to take to the president, and we received nearly 5,000 submissions.
WebMD’s health care reform expert, Lisa Zamosky spoke with the president for nearly 25 minutes about your concerns. Today, we’ll talk about your questions and the president’s answers.
We'll get started in just a couple more minutes. If you do have a health insurance question, just click “Make a comment” in the blue bar below. Please know that while we will try to respond to as many people as possible, due to the high volume of questions, we may not be able to respond personally to every question submitted during the live event.
Hi, I'm looking forward to responding to your questions today.
Bill and Sarah, let’s start by talking about your key takaways from the interview. What was most interesting or surprising to you?
I was impressed with his knowledge and understanding of the issue. The ACA is a complex law and has a lot of moving parts. He seemed to know them well and defended the law, but at the same time was realistic in its limitations.
The President was clearly frustrated with the reaction to the law at the state levels. People are clearly having a different experience with the law based on their state
Let’s turn for a moment to costs. About 40% of the questions we received were about this topic. Many readers said that the plans are just not affordable to them. Sarah and Bill, how do their concerns compare with what you are hearing?
I think costs are the number one concern from people trying to buy insurance. Not only the cost of premiums, but the deductibles, copayments and co-insurance that's required to use their insurance. This is going to continue being an issue going forward.
We're already getting a lot of reader questions today on that topic.
The law attempts to address the affordability of health insurance through a the subsidies available in the marketplaces, the ability to shop for coverage, the pooling of risk and the expansion of Medicaid. The law reduces the cost of coverage for many people, but does not eliminate those costs. In 2014 there is quite a bit of variation based on where you live in the costs of plans you will face.
Dale, If you’ve gone to healthcare.gov and found out if you qualify for a tax subsidy, but still can’t afford the premium you may qualify for a hardship exemption from the tax penalty. If you cannot find insurance that is less than 9.5% of your income, you will not be required to pay the penalty.
Here's what the president said about costs: “Well, the first thing is making sure everybody has the right information, because there's been so much politics swirling around this, that I think a lot of folks still aren't sure what exactly is available. My most important recommendation is for people to go to the website --healthcare.gov --and look for themselves at what plans are being provided. And the website helps you calculate whether or not you qualify for a tax credit. If you do qualify for a tax credit, then I think a lot of people may end up being pleasantly surprised because, for a large portion of those folks, health insurance may end up costing $100 or less. It may end up costing less than your cable bill or your cell phone bill.”
It’s true that there is a lot of misinformation out there and healthcare.gov is the best place to go for reliable information on what health insurance will cost. The President didn’t have time to get into a lot of detail on how the tax credits work. The tax credits are based on a rule that insurance should only cost a certain percentage of your income, and that percentage increases as your income increases. So, for example a single person with an income of $23,000 would pay no more than 6.3% of income or $121 a month for a comprehensive insurance policy. If the second lowest cost policy for that person costs $200/month, that person would get a $79/month subsidy in order to bring the cost down to $121/month.
What we are hearing from some readers, however, is that even with the tax subsidy, they still cannot afford insurance especially the people at the upper ends of the subsidy qualifications – those making $35,000-$40,000 who have to pay 9.5% of their income towards their insurance premium. For them, insurance can still cost about $300/month even with the tax subsidy.
Empressdvr, most health plans today have a deductible even if you stay in network. They may have a separate, higher deductible if you go out of network. Plans are trying to share their risk by requiring you to pay a portion of your medical costs, in part, hoping to reduce the use of unnecessary care.
Janet, Health care costs have risen more slowly over the past few years than they have previously, but they are still rising faster than inflation. Health insurance premiums will increase with health care costs every year. What the law does do however is prevent your premium costs increasing each year based on your health care needs. So next year the premium increase you face will be the same as every one else in your area faces.
The president also addressed a reader question asking if the law is making his employer-based insurance more expensive.
Here's what the president said: “A lot of people have looked at this. And there's nothing in the Affordable Care Act that would impact an employer-sponsored plan,other than making sure that the employer-sponsored plan is actually providing a certain basic level of coverage. Now, I don't know the particulars of his employer's plan.But what people forget is that the average premium was going up 15% a year beforethe Affordable Care Act.Health care costs overall are actually going up more slowly over the last three years than any time in the last 50. And that's true in the private insurance sector. It's also true for Medicare and Medicaid. So, what we actually know is, is that premiums are going up more slowly, not more quickly, than they were before this law was passed.”
The President is correct that the growth in employer sponsored insurance predates the passage of the ACA. According to data from the Kaiser Family Foundation, the average family premium for employer insurance increased 80% from 2003 to 2013. The percent of the premium employees paid increased 89% during that same period. Premiums for a family premium have increased an average of 6% a year, each year during that period.
We also heard from readers wondering what would happen if enough people took the penalty rather than buy insurance.
Here's what the president said: “Well, at this point, enough people are signing up that the Affordable Care Act is going to work. The insurance companies will continue to offer these plans. We already have four million people, over four million people signed up. It will be a larger number than that by the end of March 31st,the deadline to get insurance this year.”
He said enough people have signed up to make the law work. What do you think, Bill and Sarah?
In the first few years, a number of people probably will take the penalty rather than buy insurance, but over time the number buying insurance will likely grow as the penalty becomes larger. Enrollment is not as high as the President would have hoped, but given the troubles with the website, I think enrollment is realistic. If insurers did not feel like the law would work, they wouldn't participate.
In order to have a sustainable insurance market you need a sufficient number of people to sign up and continue to purchase health insurance coverage.As the President says enough people have signed up for coverage in 2014 the Marketplace to make the market work. But its important to realize that the law pools all individual insurance together. Many people have coverage in that market they didn't buy through the Marketplace and they count as well.
We heard from many readers asking why Congress was exempt from the ACA plans.
Darren, members of congress and their staff are required to buy their insurance through the marketplace. The only difference is that they will be able to keep their employers share of the premium contribution. Right now marketplaces are not open to other large employers.
The waivers for business and unions are for specific technical requirements. The exemptions phase out over time. They will eventually all be under the same requirement. The waivers were to ease the implementation of the law.
We also heard many readers who are still having trouble trying to buy a plan through the Marketplace.
The president said the website is working and that it may take longer for some people because their situation may be more complicated.
“But if you ever actually try to buy health insurance with an agent by yourself, it’s a complicated process and it actually takes a lot longer than signing up on healthcare.gov. So we haven't been able to eliminate any inconvenience. It’s still a big transaction for families to sign up for health insurance. But the website itself, actually, at this point, is working quite well, and people have until the end of March 31st to sign up.”
Maureen, the open enrollment period for the Marketplace ends at the end of this month, but people who have certain qualifying events can sign up at the time they are newly qualified. When your COBRA runs out that is a qualifying event. So you should be able to sign up again on that date. You may have to use the phone number on Healthcare.gov and talk to someone at that time
I think there is a lot of confusion on the ACA - and it is confusing! I would recommend people contact a Navigator if they are having trouble understanding their options. You can find a Navigator in your area by going to localhelp.healthcare.gov/