Who knows Obamacare? Not even experts
Up for some bedtime reading?
Try settling in with the Patient Protection and Affordable Care Act, otherwise known as Obamacare.
That’s just the law itself.
Since the ACA was passed, the federal government also has issued thousands of pages of regulations guiding its implementation.
(Estimates range from 5,000 to 20,000 or more pages, with the larger figures coming from opponents of the law. This Washington Post article attempts to ferret out the truth.)
Whether you support or dislike Obamacare, there’s no question that it’s the biggest overhaul of the American health system since Medicare debuted in the 1960s.
Right now, state and federal governments are in a mad scramble to decode the law’s complexities and make the system work – all under extreme time pressure.
“It’s a landmark reform law shifting the entire nation’s delivery of health care. Then you try to graft that onto our existing infrastructure of state regulations and state laws,” says Anne Gonzales, a spokeswoman for Covered California, the state’s new health insurance exchange, where people will be able to buy health plans starting in October. (Depending on their income, some Californians will receive subsidies to defray the cost of premiums).
So why am I telling you this?
As many of you know, I write a biweekly column called Ask Emily, which aims to break down the law into understandable and accessible bites. I want to tell people, in the simplest terms, what the ACA means for them.
The need is there. I have received hundreds of queries from all over the state. Though the column is geared toward Californians, I also hear from readers in Virginia, Hawaii, Utah, Indiana, other points in the USA and even overseas.
People just don’t understand what Obamacare is or does. They’re confused.
So are some health care experts, it turns out.
Answering reader questions accurately – even the seemingly straightforward ones – often devolves into a convoluted game of he said/she said. That’s because I commonly receive contradictory answers from health policy and government gurus, the people I rely on to tell me what’s what.
One of my first reporting eye-openers came when answering a question about Medicare for my third column.
A reader – from Wyoming – wanted to know whether having Medicare Part A coverage alone (limited primarily to hospital care) would meet the Obamacare insurance requirement.
So I called a source here in California who is a Medicare expert. Her answer? No, Part A alone wouldn’t suffice.
Then I called another to double-check. Her answer? Yes, Part A will suffice.
What was intended to be a pretty simple question and answer became a drawn-out effort to sort out conflicting information. I finally got the correct answer confirmed from a source in the federal government: Yes, Medicare Part A will do.
This scenario has played out over and over since then.
The most recent came as I reported my latest column about how the Affordable Care Act will impact young adults and college students.
To address one small piece of one question, I wanted to know whether college students with access to college health plans will be eligible for tax credits from the health insurance exchange if they want to buy there instead.
What I got was four different answers. It took me days, many more phone calls and more pestering emails to fish out the correct one.
I’m going to name names here. One of the sources that initially gave me incorrect information was Covered California, the health insurance exchange itself.
What does it mean that the state agency that will be implementing a huge piece of Obamacare in California also is confused about what the law will and won’t do?
It makes me uneasy that the roll-out will be messy and difficult. It worries me more that people who may be eligible for coverage won’t get it.
To Covered California’s credit, the law is new. It’s big. It’s evolving. In fact, the federal government had just issued guidance last month clarifying the answer to my question.
Gonzales says staff members were in the process of analyzing that information when I asked my question.
“The regulations … can be hundreds of pages long and take our team many hours to read, interpret and then layer that onto existing state laws to understand the effect on Californians,” she says.
Still, it’s imperative that they get it right. Not just for me, but for the public who will be coming to them for answers, help and health insurance.
Gonzales assures me they’re trying.
“We are working really, really hard here to not only figure this out but to get the right information out to the public,” she says.