Is the ACA (Obamacare) working….yes, a little.

This blog has previously indicated the ACA will not solve the decades old problem of the 30 to 50 million uninsured Americans…and I maintain that position. However, it has made some inroads and offers a glimmer of hope.

Data is still extremely elusive with this White House and we generally get the cherry picked good news pieces rather than the full Monty. These selective data releases would indicate a modest inroad into the uninsured base of perhaps 15%…that’s a start. My question is at what cost? And no, I’m not talking money.

If there is any such person as a typical uninsured, he or she would probably be a low income individual who has a low paying or part time job which doesn’t offer insurance. This class will also include the previously employed, but now displaced workers. This allows them to enroll in an ACA plan and perhaps receive a substantial subsidy from the government to reduce the premium. Stories abound with monthly premiums of $100 or so per month for “full coverage”. The problem is defining “full coverage” or any coverage at all.

A look at a community I’m familiar with has approximately 250 doctors. I can only identify 8-10 primary care docs in this population who accept the predominate ACA plan in our area. The specialist community is even more restrictive, with no availability at all for some specialties and very little for others.

If we couple this extremely small network of physicians accepting the most prevalent plans, and the plans deductibles ranging from $500 to $7500 we have a problem….people with insurance coverage but none or few available doctors to treat them and deductibles that are not affordable, posing another roadblock to health care for them.

We need ACA amended, to make it more responsive to patients, insurance companies to be more responsible when dealing with physicians and more companies offering plans to foster competition. These changes will help reduce the vast number of uninsured Americans, a very noble and worthwhile undertaking, but will also give rise to a new issue…yet another tier of patient care…but that’s for another day.

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