Simple Changes Could Make ACA More Affordable and Stop the Next Civil War

(Updated 6/9/2014) Phrase in the paragraph next to the picture near the bottom of the page changed from “$1100 per year versus $31,300″ to “$16,000 versus $31,000.”

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(Updated 11/15/13)

The Affordable Care Act (ACA) will decrease insurance costs for those who qualify for subsidies. Others will qualify for Medicaid. And some will see their premiums increase. PolitiFact, an independent fact-checking site, states that political claims of premiums going up for “virtually every person” are false.

H23 BB00934850 * $100 'star note'
TheAlieness GiselaGiardino²³ / / CC BY-SA

But before supporters start screaming “I told you so,” they need to admit the law initially does little to decrease the costs of care. The U.S. health care system ranked 46th in efficiency among 48 countries and first in costs among 13 industrialized nations in 2009.

Someone will pay the costs of adding 7 to 11 million people to Medicaid along with subsidies for individuals who qualify in the private market and small businesses who add coverage for their employees.

That someone might be you. Here are four taxes most likely to affect average citizens:

  • First there’s the mandate. Everyone who refuses to buy insurance if the federal government decides they can afford it will pay $95 per adult and $47.50 per child up to $285 per family, or 1% of their income if it’s greater. The tax will gradually rise to a high of $2.5% in 2016. The maximum will be no higher than the annual premium for a bronze plan in your state. The average cost of a bronze plan is $2988 per year.
  • Then there’s the increase in payroll taxes. Inspired by concerns over long-term effects ACA will have on the federal budget, last year Congress also voted to end Bush era cuts to the portion that employees pay for Medicare. An additional 2% has been taken from your paycheck, if you have one, since January 1 of this year. That’s an extra $1,000 per year on a salary of $50,000. Contributions for the self-employed rose from 2.9% to 3.8%. (Click this link for more information.)
  • Employers also will pay a 40% excise tax on high-end “Cadillac” health insurance plans. This provision will take effect in 2018, but some employers are already scaling back coverage. Employees and their families who have expensive medical conditions will have higher out-of-pocket costs if they decide to continue treatments that their new plans won’t cover. The ACA requires coverage for all conditions but not every treatment for every condition.
  • The threshold for itemized deduction of medical expenses will also rise to 10% from 7.5% of adjusted gross income. If you’re over 65, the change won’t affect you until 2016.
I bet they oppose education funding, too
erin m / / CC BY-NC

In spite of opposition to the taxes and other provisions of Obamacare, the popular name for ACA, it’s still the law of the land. The Supreme Court upheld it’s constitutionality last summer.

But war against the ACA has just begun. Former Libertarian and Republican presidential candidate Ron Paul fired the latest shot last week. At a campaign rally for Ken Cuccinelli, the Republican Attorney General who lost the governor’s race in Virginia, Paul said the constitutional “right to keep and bear arms” was not for hunting, but to allow rebellion against tyrannical governments,” according to Mother Jones.

How can we restore peace and extend compassion to citizens in need without causing financial hardship for everyone else?

  • Increase allowances for contributions to health savings accounts and flexible savings accounts, and allow leftover funds to roll over from year to year. Some contributors use these accounts to pay cash for all or most of their medical expenses. When coupled with the high deductible plans outlawed by the ACA until public outcry brought them back, these accounts provide coverage for accidents, payments for present expenses, and services from out-of-network providers. Why would anyone want to pay for products and services they don’t believe in?
  • Require the use of ABC codes by private insurers and government health care plans. Public and private insurers assign different codes for every product or service that goes through the medical system. ABC codes work alongside standard codes issued by the American Medical Association (AMA). They include services from alternative practitioners as well as services from nurse practitioners and unlicensed alternative providers who practice legally in many states.

Most private and public insurers only accept codes issued by the AMA, and AMA codes don’t cover alternative treatments. The Department of Health and Humans services reported a 50% savings on behavioral health claims that used ABC Codes during a five-year trial that processed more than 2 million transactions through Medicaid in Alaska.

The ACA eliminates insurer discrimination against providers who hold licenses issued by a state agency. That includes the alternative providers now listed in the health care workforce section of the law. No information is available about Medicare and Medicaid coverage for alternative services.

Why should we be concerned about access to alternative care? According to the Centers for Disease Control and Prevention (CDC), more than 75% of health care costs are for preventable chronic illnesses that respond best to lifestyle changes. Complementary, alternative, and integrative providers specialize in lifestyle change.

Jogger in pink and black
Ed Yourdon / / CC BY-SA

Let’s examine the cost savings for diabetes alone. The Annals of Internal Medicine reported that lifestyle changes for a patient with Type 2 diabetes cost $16,000 per year versus $31,000 for the drug Metformin. In 2007 the American Diabetes Foundation estimated that 17.9 million people had been diagnosed with the disease, while another 5.7 million had not yet been diagnosed and 57 million had pre-diabetes. (See Myths That Threaten Health Care Reform (Part 4) for more information.)

These simple changes will eliminate the need for new taxes because expenses for insurers, individuals, and businesses will decrease with more access to true preventive care.

Mr. President, please preserve the union by authorizing these simple changes.

Correction: Except for the beginning, this is almost a new article. Please start over to get a better understanding if you read a previous version. Sorry for the inconvenience, but this is a very important subject. Everyone needs to understand it.

© 2013 – 2014, Jacqueline Laurette Jones. All rights reserved.

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