... and now some thoughts for those concerned about Obamacare

Whatever your feelings about the recent U.S. election generally, if you rely on the Affordable Care Act (aka Obamacare) for insurance, you probably have some concerns about your coverage given that many of those elected ran on platforms that included repealing and replacing it.

As someone who relies on Obamacare myself, I am offering two lines of thought here that might offer some practical info. First is how quickly the repeal and replace effort might happen. Second is what you can do to anticipate gaps in your coverage.


How quickly could Obamacare be repealed and what would it be replaced with?
An outright repeal of Obamacare, which 22 million Americans purchase from state or national marketplaces, would be difficult, according to Julie Rovner, a reporter who has been covering the ACA from the very beginning. So big revisions to the law rather than an outright repeal seems more likely. The president-elect said on "60 Minutes" that overturning Obamacare won't happen in two days, but would certainly occur within the first two years of his administration. Whether that is within the realm of the possible/probable remains to be seen.

Obamacare--or at least parts of it--have been in place for six years. While Congress has voted to repeal Obamacare multiple times, replacement plans have been sketchy. All of the following have been proposed by various candidates: Health care savings plans (you set aside pre-tax money that can be put toward medical expenses); higher deductible plans; loosening Department of Health and Human Services definitions of "basic" coverage; reducing or eliminating subsidies on policies; and allowing insurance companies to sell products across state lines.

The president-elect has said that he wanted to retain extended coverage for adult children who live at home and continue to ban insurance companies from rejecting patients for insurance based on pre-existing conditions. These are aspects of the Affordable Care Act that many Americans like.

There's more analysis at the New York Times here.

What can you do to anticipate gaps in your insurance?
Having been uninsured for several years before Obamacare was offered, I can offer these tips that might help:

1. Write to your Congressional representatives and tell them what your predicament is. Politely ask them to consider the chronically ill and the cost of oral chemo as they re-examine Obamacare. Be sure to let them know that you vote. If you have insurance through the ACA, you can also tell your story to the New York Times at this link.

2. Consider telling your doctors NOW that you rely on Obamacare and ask them if they will still see you without insurance. This is hard, I know. It makes you feel like a charity case before you even become one. But I was relieved when I talked to my cardiologist last week that there would be a way for me to continue to see him and manage my heart condition, even if I have to pay out of pocket. I'll see my hematologist next week and hope she will be able to help me come up with a worst-case-scenario care plan also.

3. Discuss reducing general costs with your family doctor. Ask your family doctor if there are cheaper generic alternatives to any medications you take. Ask if yearly screenings could be done less often without compromising your health. During our period without insurance a few years ago, my family doctor said that I could get away with having my blood pressure checked in the office at my yearly physical as long as I promised to check my BP twice a month and report any readings that went higher than a certain reading.

4. Look for cheaper alternatives to everything. You may be able to get pap smears, mammograms, etc. at low- or no cost at your local health department. Pharmacies and grocery stores often have flu shots cheaper than the ones you get at your family doctor's office. Also see the links at right under "Need help paying for your health care?"

5. Research the price of your medication. Call local pharmacies to find out who's got the lowest price for your meds. If you can buy cheaper elsewhere, call your pharmacy and tell them you are planning to switch. I did this, and my current pharmacy offered to lower the price of my drugs rather than lose me as a customer.

6. Start setting aside money now to help you cover expenses later on. Right now, individuals cannot set aside pre-tax dollars for health savings plans, but having some money for unexpected medical emergencies can help.

Be well.

Home