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Think Obamacare Doesn’t Affect You? Think Again

Even If You Don’t Get A Subsidy,  Obamacare Affects You

Open enrollment season is coming to an end. People all of the country are tucking away their insurance cards as dreams of government subsidies dance through their heads. And as the Obama administration touts the success of the program, many Americans who get more traditional coverage through their employer are turning an apathetic ear.

Those Americans who have insurance through an employer are under the impression the Affordable Care Act (also known as Obamacare) doesn’t affect them because they are not getting a subsidy. As a result they have tuned out the debate over health care coverage.

If you are one of those people that think that the Obamacare law doesn’t affect you, this post will give you a few reason to think again.

Stifling Patient Choice

Lost in all the noise about mandated health insurance coverage is the fact the Affordable Care Act completely changed the way Hospital systems and physicians are reimbursed.

At the Hospital level, the reimbursement system changed to a focus on individual outcomes rather than the number of patients and the time in which they are treated. Now insurances are looking for whether or not hospitals are evaluating patients for all possible health issues that could cause a readmission. That includes anticipating medical needs the patient might have after discharge form the hospital.

In general, if a patient is readmitted within 30 days the hospital system receives a penalty imposed on future reimbursement. The system includes the hospital and all of the doctors that work within it.

This change in focus has resulted in massive changes in healthcare systems. Because Hospitals are forced to anticipate future healthcare needs of patients, they have been expanding into other services like home care, hospice and even nursing homes.

By doing this hospitals hope to avoid readmission by controlling where patients are referred after discharge. This can stifle patient choice if patients lack knowledge about the services to which they are being referred.

Read Related Story: Hi-jacked Healthcare and How I Regained Control

Restricted Hospital Admissions

In order to be Re-admitted to the Hospital you have to be admitted in the first place. That is why now more than ever Hospitals are careful about who they actually admit to the hospital. Many people don’t know that when a patient goes to the emergency room they are not actually admitted to the Hospital. Emergency falls into a type of outpatient care where admission to the hospital is not necessary.

Because of the focus on outcomes, Hospitals are now increasingly careful which patients they actually admit for inpatient care. If there isn’t a clear positive outcome, hospitals may resist admitting a patient in order to avoid a re-admission later on.

The difference between admission and outpatient treatment is a key distinction for insurance companies. Some tests and treatments aren’t covered if given on an outpatient basis. Hospital admission is also trigger for insurance coverage of other services like Sub-Acute Rehab. If a visit to the ER turns into an overnight stay, don’t assume you have been admitted, ask the attending physician.

We Are All Stakeholders

Even if you don’t receive a direct subsidy for your healthcare coverage, Affordable Care Act regulations have most definitely effected your company’s health care insurance policies. Whether it be an increase in premium or change in enrollment procedures this law effects everyone.

It is silly to think that universal healthcare coverage will be repealed, no matter who wins the white house in 2016. That is why it is important to be aware of the changes in our healthcare system and they effect the average American. If the country is going to get universal healthcare coverage right, we need the input from every American.

Presidential Candidates Should Look Beyond Obama Care Repeal

Like it or hate it, the Affordable Care Act (aka Obama Care) was the most significant legislation to be passed into law since the Patriot Act.  The sweeping reform of the healthcare system had the country in an uproar after along passing along party lines in a democrat controlled congress.  Now the uproar has been reduced to a murmur as more and more American’s seek to get coverage from the insurance marketplace.

That is of course unless you listen to the Republican Candidates who vow to “repeal and replace” a law that is set cost the federal government $2.76 Trillion over 20 years including over $270 billion in administrative costs.  

The GOP prefers an open market that will allow competition to lower cost for consumers and increase accessibility for consumers.

But the changes in how consumers buy insurance is nothing compared to the changes in the healthcare system at large since the ACA’s passage. The insurance reimbursement to Hospital systems and the physicians has changed drastically.  Quality Care Thresholds have also changed making reimbursement based on outcomes and not volume of patients treated.  Mountains of policy and regulations changes have occurred as a result.

It is the mountain of new rules that makes the notion of totally repealing Obama Care a false premise. It can only be tweaked but never rolled back completely.

This may be disconcerting for the one issue voters out their who hope a vote for a Tea Party Candidate can get them the type of healthcare reform they prefer.

So if the law can’t be repealed, how can we effect change?

The Affordable Care Act is so complex federal agencies are still working on the regulations that will enforce the spirit of the law.  Decisions on how healthcare organizations are funded, the availability of expensive treatments and quality of care indicators are all being discussed as you read this post.

The ACA gives government agencies more power over our healthcare decision then any other point in our American history. Now is the time for consumers to stay vigilant and voice concerns over the new policies and program being put into place.

The 2016 Presidential Candidates need to back away from sound bites full of empty rhetoric and educate the voters on how they can effect change moving forward. Adhering strictly to the talking points won’t accomplish this.

If the Republican field is truly serious about protecting the healthcare consumer from government overreach they should appoint a healthcare advisor to each of their campaigns to take a hard look the new regulations are having on real people. Otherwise any talk about improving the healthcare system is a waste of our time.

Obama Care Battle Continues After Federal Ruling

Just when you thought all the fuss about Obama Care was over.  Wednesday’s ruling  by Federal Court Judge Rosemary Collyer put the Obama Care fight back on the table and thrusting it into the political spotlight after years of battle.

At the core of the judges decision is funding for the monstrous trillion-dollar healthcare program which was allocated by executive order instead of the regular appropriations process.

“The House of Representatives as an institution would suffer a concrete, particularized injury if the Executive were able to draw funds from the Treasury without a valid appropriation,” Judge Collyer said in her 43-page decision.

Because congress was passed over in the appropriations they did not have the opportunity to excercise their constitutional duties.  Now according to the Judge they can sue for the right to fund (or defund) the program, a lawsuit that will likely land Obama Care on the steps of the supreme court once again.

“The president’s unilateral change to Obamacare was unprecedented and outside the powers granted to his office under our Constitution,” Mr. Boehner said in a statement after the ruling. “I am grateful to the court for ruling that this historic overreach can be challenged by the coequal branch of government with the sole power to create or change the law.”

What does the Republican lawsuit mean for consumers.  Not much considering Republicans are not likely to strip millions of American’s of health coverage during an elections cycle.  However if congressional republicans are success in the suit against the executive branch you may see some changes to the health insurance market place.

If you are hoping that the Collyer’s decision will be the beginning of the end of Obama Care keep hoping.  Reams of paper have already been used to write the regulations guiding the implementation of the wide-reaching health care law.  Consumers may see some tweaks but don’t expect the program to completely roll back.  But don’t expect that to stop the candidates from talking about it as Obama Care will become a hot campaign issue once again thanks to the ruling.

Listen to the Fischer Report during Conversations In Care on Wednesday’s at 8 pm.