If you are among the thousands of North Carolinians who pay for their own health insurance policies chances are you received – or soon will – notification that your current plan is no longer in compliance with the new Affordable Care Act and your policy is either cancelled or your premiums increased as much as 400 percent.
The anger is palpable, as people want to know who to blame and what they can do.
Perhaps you’ve seen the current TV ad with the woman lambasting Obamacare, saying the government is incapable of making healthcare choices for you and me. If we were to start at square one in completely reforming America’s healthcare system we would surely design a different plan, and as idyllic as it might sound to say we want government out of healthcare, that horse left the barn back in the 1960s, when President Johnson convinced Congress to pass Medicare and Medicaid. Practical and political realities dictate it’s not going to change.
The Affordable Care Act, or Obamacare, began with a consensus our healthcare system was both broke and broken. The ACA is a flawed result of the inability and unwillingness of providers, insurance companies, pharmaceutical companies and others in the private sector to fix the system, coupled with politicians who put special interests ahead of the public’s best interests. Obamacare neither solves the crisis nor contains costs, as it initially promised. It most certainly will be modified in the future but current efforts to defund or abolish it won’t happen.
Let’s focus on North Carolina. Our elected leaders chose, we think wisely, not to expand those eligible to receive Medicaid for two reasons: our own Medicaid program is in such disarray and, despite promises to pay 90 percent of the costs for the first years, few believe the federal government can indefinitely sustain payments for up to 500,000 more Medicaid recipients. North Carolina taxpayers would ultimately have to substantially increase the more than $3 billion we currently spend. While practical, their decision guarantees most of them will continue using the emergency room as their first (and most expensive) choice for primary care.
Leadership additionally decided not to establish state or joint federal-state health insurance exchanges, opting to accept federally mandated guidelines for these exchanges. These guidelines include mandatory coverage for services many previously opted not to include in their plans, explaining why so many are getting non-compliance cancellation notices. As we understand it, the federal exchange option also provides that insurance premium increases after 2014 would have to be approved by the federal government, so insurers decided to jack up premiums now, before Obamacare takes effect.
There is only one statewide insurer participating in North Carolina’s exchange – Blue Cross, Blue Shield, a not-for-profit company with a virtual monopoly in health insurance in our state. More competition would no doubt have resulted in the lower premiums many other states enjoy.
So thousands are now in crisis. Many families that don’t financially qualify for subsidies under health insurance exchanges are being forced to either find new insurance providers or figure out how to afford the budget-busting premium increases. It would be hard to argue this new healthcare system is better than what we’ve had. No wonder so many are furious and worried.
Campbell is the executive producer and moderator of NC SPIN, a weekly panel discussion on state issues that airs on WMYT “MY TV12” at 10 a.m. on Sundays and on WJZY “CW46” at 6:30 a.m. and 11:05 p.m. on Sundays and on WFMY-TV at 5:30 a.m. Sundays.