On October 1, 2013 the federal government rolled out the biggest overhaul of the health insurance industry, the Affordable Care Act, otherwise known as Obamacare. The intention of the law is noble and important. In the state of New York, the Medicaid eligibility increased from 100% of federal poverty guidelines to 138%. This essentially means a single adult can be eligible for Medicaid if they make under $15,800 a year, as opposed to $10,000 last year. Many would argue that, especially in New York City, making less than $20,000 or $30,000 might put you in poverty, but for the 17,000 people that are now eligible for Medicaid it is an extremely important part of the law.
In addition private health care options are now available (for those who make under $45,000) due to government subsidies. The plans range from about $200 per month to over $1,000 per month, before applying government subsidies. There are also important restrictions put on all insurance plans that are now part of Obamacare: you cannot be denied insurance based on pre-existing conditions, and there cannot be a cap on lifetime expenses. Both of these changes are significant. The pre-existing conditions clause is incredibly important for those living with HIV, cancer, or other chronic health conditions that may have left you open to insurance discrimination in the past. The clause on capping lifetime expenses prevents insurance companies from refusing “lifetime-limited” payments and not paying your health care expenses.
Few would argue that our current health care system is working. Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007. This makes a health care crisis the most-likely cause of bankruptcy in our country. It is also important to note that certain racial groups face large disparities in health. Blacks have higher rates of heart disease, diabetes, obesity, and HIV/AIDS than whites. In addition, 18% of blacks under the age of 65 do not have health insurance.
It is important, however, to acknowledge that while the bill does attempt to address these issues, it also leaves people behind. Many individuals still cannot afford this coverage. Subsidies are helpful, but not if you are making under $50,000 and still have to pay upwards of $300 per month to for this coverage. It also forces people to pay a tax when they do not have health insurance further putting low income individuals in a no-win situation.
Many groups are affected by this law in unique ways. One of those groups are youth and young adults who President Obama is counting heavily on to pay into this system. Obamacare ensures that young people can stay on their parents insurance until the age of 26, which is good news for young people who are either unemployed or employed without health insurance benefits. Also in New York state the Child Health Plus insurance option will also remain in place. This is an option for children who do not qualify for Medicaid but whose families are low income. A child is eligible for free coverage if the family makes under $37,668 (for a family of four).
One group of youth who may be particularly disenfranchised by Obamacare are homeless youth. These children may have been kicked out of their homes or ran away to escape an abusive situation. If these youth’s parents have claimed them on their tax return and the parents go to register for health care under Obamacare, the youth will be blocked from getting their own health insurance.
Obviously there are pros and cons to Obamacare and the roll out has been anything but smooth. That said, it is a serious attempt to make health insurance more accessible for millions of Americans. Subsidies have been put in place to help poorer Americans to access this important care. Only time will tell if the Obamacare system proves effective but it is one step in the direction of getting every American the health care they all deserve.