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Area residents see early benefits of ‘Obamacare’

Updated: September 11, 2012 6:07AM



I’m starting to better understand why House Republicans have tried 33 times to repeal the Affordable Care Act (ACA) and healthcare lobbyists are spending millions to convince us it’s bad. If they don’t do it quickly, people will actually begin to experience its benefits.

Clearly our healthcare system has been broken for a long time and the ACA is not a perfect fix. It is, however, a very good start. Among the advantages Americans will enjoy: insurance companies can no longer limit or deny benefits to children under age 19 due to a pre-existing condition. This means parents of sick children are not forced — as they sometimes were in the past — to choose between keeping their home or treating their child.

Another plus: kids can stay on their parents’ insurance until age 26. Some have suggested this is unnecessary. Perhaps they didn’t take any extra time to finish their education, because if you or your child is working a part time job without benefits while finishing college or grad school, staying on a parent’s insurance can make all the difference.

When I was in grad school, I could barely afford to eat, much less buy insurance. That meant when I broke small bones they were never properly set. Illnesses that might have been easily resolved, deteriorated into worse ones. When I had strep throat so bad I could barely swallow, I couldn’t see a doctor to get a simple antibiotic.

Chrisi Thanos of Yorkville knows what I’m talking about. She told me her brother, Tom Thanos, was very pleased to learn that his two sons in college now get to stay on his insurance. They are 21 and 24.

Even Jerry Jude, owner of the local restaurant, “Elmer’s Dog House” in Montgomery, had to admit this was a good rule. Though he had expressed disapproval of “Obamacare,”in the past, he believes this aspect has value. “Kids shouldn’t have to worry about healthcare when they’re just trying to get started in life,” Jude said.

Another benefit of ACA is the “Medical Loss Ratio” or “80/20 rule.” Last week was the deadline for providers to mail checks to their customers if the company did not spend 80 percent of premiums (85 percent for insurers of large businesses) on actual patient care. In the past some companies spent up to 40 percent of the money they charged us on administrative costs, salaries, marketing, and other non-medical expenses. Now at least 80 percent of the money they collect must go to helping patients — or companies must issue refunds. So right now 12.8 million American are receiving checks which total 1.1 billion dollars. Yes, I said billion.

Thanos told me her “brother received $78. Along with four million in the state of Florida, he was very surprised and happy to get the letter.”

Carl Martens of Geneva received a $400 rebate.

Brian Jackson of Aurora said of his $98 refund: “ I received mine last week from UnitedHealthcare. Didn’t know anything about it so I called our payroll department. It was a nice bonus even though I pay a fortune for coverage.”

Another piece of good news about the ACA is that companies will now have to go before an independent panel to justify premium hikes. So together with the 80/20 rule, companies can’t raise rates just to improve profits. It has to go to legitimate patient care.

“So many people aren’t aware of how the law, which the Supreme Court upheld, applies to them,” said Brandy Carrelli of Oswego, another rebate recipient. “We are seeing real, tangible benefits now: money in our pockets.”

So go ahead and call it “Obamacare.” It’s helping sick kids get treatment, keeping families from going bankrupt, and preventing insurers from raising rates to simply line their pockets. And there are more benefits to come.



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