Are ACA enrollees happy with their coverage?
April 10th, 2014
Omaha, NE–Â Glenda Sorensen is one of 7.1 million Americans who has signed up for the Affordable Care Act.
The 49-year-old Omaha native sees this as the first step to a healthier lifestyle for herself and her husband, Kevin. The couple also has a daughter with autism who receives health care under Medicaid.
â€œI am absolutely thrilled because Iâ€™ve never had insurance this great in my life. Iâ€™m not kidding,” Sorensen said. “We were able to get an awesome plan. We were able to get an insurance plan that covers the doctorâ€™s visits and so on with an absolutely great deductible with a very low payment every month.â€
Sorensen and her husband pay $50 a month and have a $400 deductible.
Pete Damiano is the director of the Public Policy Center at the University of Iowa. Damiano said that although there is a lot of opposition to the idea that Americans are required to have health insurance, a study by the Urban Institute found that only about six percent of the population is directly affected by the individual mandate.
â€œItâ€™s really a small proportion and of that six percent our research shows that most of those people want coverage anyways, but they are in a situation where they canâ€™t afford it,” Damiano said. “About 80 percent of the uninsured are actually working people. They just happen to be working in lower wage jobs that donâ€™t provide benefits.â€
He said there is still a question mark around how to improve quality of care and reduce cost at the same. Â One percent of the population uses about 20 percent of all the healthcare costs; and about 10 percent of the population uses about 70 percent of the healthcare costs, according to Damiano.
â€œFor the first time weâ€™re really looking at how do we manage the health of populations of people for the healthcare delivery systems,” he said. “If we can really focus on those people thatâ€™s where weâ€™re really going to squeeze most of the savings. A poor mom and her children donâ€™t cost much in the scheme of the system but a person whoâ€™s diabetic with COPD and congestive heart failure– that person costs a lot.â€
Prior to enrolling in Obamacare, Sorensen visited the One World Community Health Center on an ongoing basis to treat chronic pain and depression. She said that paying anywhere between $50-$125 every visit became expensive, even on a sliding scale.
â€œA lot of the time youâ€™d call and plead with them, ‘Please refill my prescription,’ she said. “If I donâ€™t receive that particular care or medication, my whole world falls apart. I canâ€™t be as successful as I want to be in life.â€
Damiano said unfortunately, the distinction between healthcare and health is often overlooked. The Affordable Care Act is about providing people with insurance coverage thatâ€™s going to affect their financial access to healthcare delivery.
â€œBut if we look at what exactly affects our health, thatâ€™s only about 10 percent of what affects our health,” he said. “Fifty percent are behavioral issues like smoking, substance abuse and wearing a seatbelt. About 20 percent of our health is affected by environmental factors and about 20 percent is genetics. Weâ€™re not really affecting much of that 90 percent with the way we spend on healthcare in the U.S. and whatâ€™s going on with the Affordable Care Act.â€
Despite the imperfections of healthcare in the country, Sorensen said she feels secure knowing that if something happened– sheâ€™s covered.
â€œI donâ€™t have to worry, ‘Can we pay for this? Should we go to the doctor?’ because that was always the big thing, ‘Oh my gosh! What if I have to go to the doctor?’ now itâ€™s like OK go.â€
Sorensen said the fine they would have had to pay for not enrolling in health insurance is money better spent on their health and wellness.