November 4, 2012 at 7:00 PM
Primer: what you need to know about health care and the 2012 election
How health care in the 2012 elections will impact your day-to-day life.
Tanning, abortions and your wallet.
These are just three things that will be affected by this election.
The federal government is rolling out the Affordable Care Act, also know as Obamacare, in stages. But the biggest changes are set to be implemented in 2014. That is, if the president is re-elected.
“This is the most critical election since 1964 as far as health care is concerned,” says Roger Stark, a health-policy analyst at the Washington Public Policy Institute.
Aaron Katz, a health policy professor at University of Washington agrees.
“The elections [this month] will determine the future of the [health care] reforms. Not just the presidential election but the congressional races as well.”
Both Katz and Stark agree that if re-elected Obama will carry out the Affordable Care Act while Romney would try to repeal parts of it or at the very least, de-fund the implementation of its provisions.
But, so what? How is this going to impact your day-to-day life? As we go into these last couple of days before November 6, here’s what you can expect from each candidate …
… If you are younger than 26:
Two years ago, Bijhan Valbeigi, now 23, had just finished his degree at Washington State University. He didn’t have his job at Safeway yet but he needed insurance. So he started comparing individual plans.
“It was daunting, to say the least. There were so many different things I didn’t understand,” says Valbeigi. “The language for the pricing and for the care was all gobbledygook, and that was with my mom who’s in the medical-billing profession.”
They didn’t get far before Obama enacted the young adult coverage provision of the Affordable Care Act. “It came just in time,” says Valbeigi’s mother, Clydia. This provision allows younger Americans, up to age 26, to stay on their parents’ plan even if they get married, move out of their house or enroll in school.
This is not one of the provisions Romney would repeal, as he told Jim Lehrer during the October 3 debate.
But, if your parents don’t have health insurance, or aren’t as generous as Valbeigi’s, keep reading.
… If you don’t get employee health benefits:
If re-elected, one of the provisions Obama will implement in 2014 will be the state-sponsored online health-insurance exchanges. These are promoted by the U.S. Health and Human Services department as a “one stop shop” where you can compare federally-approved health plans. You will also be able to find out if you qualify for tax credits, cheaper co-pays or deductibles.
But this won’t be much of a change from what is currently available.
At 27, Jenna Serghini needed to find health coverage after her year with AmeriCorps ended. Her new job didn’t offer her health insurance and her husband worked at a small start-up that wasn’t yet offering benefits.
She found E-Health Insurance, a private commercial health insurance exchange, and compared plans offered in Washington state.
“I wanted maternity coverage so that really limited it. I also wanted to find one that gave me a lot of options,” says Serghini.
She wanted to make sure she could have her baby at the nearest hospital, in Ballard.
“It started at $213 a month for just me,” Serghini says of the Regence plan she chose. “Now, with my son, we pay about $1700 every three months,” she explains.
Serghini chose not to sign up with her husband’s employer-sponsored health insurance when it was finally offered, even though it would have been better coverage.
“We thought about it,” she says, “But Sami was new, I’d just had my C-section.” They were worried that if her husband lost his job the whole family would be left without insurance.
Stark explains this is what Governor Romney will try to fix if he gets elected as President: “I think what he is offering is, let’s get away from the employer model. Have health insurance you can carry from job to job.“
In a recent speech in Orlando Governor Romney stated that he wants health care to operate more like a consumer market. This means that if you decide to purchase health insurance individually, like Serghini, you would get the same type of tax credit companies get for buying health insurance for their employees.
… If you get employee health benefits:
Included in the Affordable Care Act is the employer mandate, which requires organizations with 50 or more employees to purchase health insurance for each employee or pay a steep fine. President Obama said in June that Americans who already have insurance will be able to keep it. But it remains unclear what will happen, exactly.
“Employers, in droves, are going to drop employee health benefits simply because of financial considerations,” predicts Stark.
The Kaiser Family Foundation reports that companies spend about $10,000 per employee on health insurance while the fine is between $2,000 and $3,000 per employee.
… If you’re a woman:
You may have already noticed a few changes. Serghini did.
“My birth control was free last month,” she says. Since August, health insurance providers are mandated to offer full coverage for contraception. This means, if you already have health insurance, you won’t have co-pays for things like health screenings, STI tests and contraceptive supplies and services.
But that will not change the restrictions on federal funding for abortion services, reports the Kaiser Family Foundation. Under the Affordable Care Act, the state-sponsored health insurance exchanges must include at least one plan that doesn’t cover abortion services and no health plans that list abortion in their essential benefits package can participate. The law also gives each state exchange the freedom to ban health plans that offer abortion services, while also allowing states to offer plans that include greater access to funding for abortions. Employers will still need to pay for contraception, or face the fine, with a few very narrow exceptions.
If you have a pre-existing condition, your health plan, under Obama, will not cover abortions unless the pregnancy endangers your life, or you are the victim of rape or incest.
But if Romney is elected he will likely repeal or block these parts of the Affordable Care Act, according to the Foundation.
You might also see reduced funding for organizations such as Planned Parenthood. Romney states on his website that he’d stop federal funding for organizations that offer abortion services.
… If you have a pre-existing condition:
Under Obama, by 2014, it will be illegal for insurance providers to deny you coverage based on a pre-existing condition. Until then, the Affordable Care Act has set up temporary pre-existing condition insurance plans in each state. The plan in our state lists about 60 pre-existing conditions that will automatically qualify for you for coverage.
The Affordable Care Act will make it possible for health insurance agencies to cover anyone who applies by encouraging everyone to buy health insurance.
Romney says that his plan would also protect those with pre-existing conditions, too. In an op-ed for The New England Journal of Medicine Romney wrote that his plan would “prevent insurers from discriminating against people with pre-existing conditions who maintain continuous coverage.”
Either way, the future of the Affordable Care Act is wrapped up in the results of Tuesday’s election.