New Obamacare

As the battle for healthcare looms on the horizon it is all politics. If this keeps up not much will happen until 2018 and by that time it will be in dire straights since insurance companies are in limbo while they await whatever is coming. When The President came up with Obamacare he stated he would prefer a single payer plan run by the government similar to Medicare. This was not politically possible so he settled for what we now call Obamacare. Medicaid which was the government safety net insurance for those who could not afford insurance was expanded. It was designed to help children and adults who had children. There were no pre-existing conditions clauses so many people waited until they got sick to sign up. Many others were not even aware of Medicaid or how it worked. When Obamacare came in it expanded Medicaid to cover all low income people including adults without children and it also raised the income limits for those who would be covered. A lot of advertising and other methods of reaching out were used to let everyone know about the new plans and about 20 million people were signed up. This included those who were already on Medicaid and many more who did not know about Medicaid. It was a solid benefit and it was either at no cost or at a lowered cost using government subsidies to make up the difference. The next income group that signed up were those who did not receive subsidies and it is this group that is now in trouble. These people are mostly in the middle income group and see their premiums rising and their plans have very high deductibles so they are paying out of pocket for most of their medical needs. One approach the new congress is considering is to reinstate Medicaid but include all the new members with all the existing subsidies. Then set up private insurance to cover the rest of the people relying heavily on employers to subsidies employees. With the benefit of hindsight it probably would have been better if this were done from the start. If companies are allowed to use Health Savings Accounts they can purchase major medical insurance with a high annual deductibles and then offer their employees assistance in handling their regular out of pocket medical expenses. If the Health Savings Accounts are set up so that money not used can be saved and added to retirement, then employees will shop around for their health care and use it wisely and this will tend to lower overall health care cost.