Personally, I'm tired of hearing, reading and talking about the
Affordable Care Act. Obamacare as it is colloquially known continues to
roll through new phases of its implementation, with seemingly more
glitches than selections and solutions, but roll forward it does. Most
of the recent attention has gone to the foul-ups in the Healthcare.gov website
where individuals were supposed to be able to find easy-to-use
insurance options, prices, subsidies, and out-of-pocket costs.
as that's been I don't think it comes close to what we're about to come
to grips with in the new year. Whether you are a provider, employer,
employee or patient, the biggest challenge will be sorting out who is
covered for what and how any of the services people will want or need in
2014 will get paid for and by whom.
If you're on a group plan with an employer, and that plan hasn't
changed in the last year, you will be among the fortunate, but for
millions of others I expect more than the usual confusion. Here in Iowa
the problem will be somewhat muted by WellMark's (our largest commercial insurance company)
decision to allow individuals to carry forward their 2013 policy for
another year and the State of Iowa's belated but welcome decision to
auto-enroll roughly 100,000 Iowans who had previously been covered by
the Iowa Care program, versus having to re-apply for the Iowa Health and
Wellness plan. In other states many insurers cancelled millions of 2013
individual insurance policies because they didn't comply with 2014
requirements of the Affordable Care Act.
Then the President said they didn't have to, but state-by-state,
insurance company by insurance company, and literally plan-by-plan,
people had to go through a possible re-do of which plans could even be
offered in which state, which year, all in a month's time for a process
that each year takes, well, a year. You get the idea. After January 1
the first big problem will be even more confusion and the second big
problem will be the money. Who has it, who's responsible, how and who do
you ask for it and will it ever get paid.
All of which sounds terrible and perhaps depending on your point of
view, terrifying as well. The good news is there's good news. At least
here in the Corridor, here in Iowa, you can rest assured that people
will get the care they need, when they need it. Partly that will be
because it's part of Iowa's culture. Ours is a long and illustrious
legacy of taking care of each other in times of need and that is exactly
where we will find ourselves in 2014 when many are unsure about who has
insurance coverage for what. That doesn't mean everyone will get
everything they want when they want it, but it does mean cases of real
need do not need to worry about being abandoned.
Beyond the culture it is also the principle business model that has evolved here. St. Luke's Hospital,
both Mercy hospitals, and the University of Iowa not only have
emergency rooms always open to anyone in need, but even more important
all employ primary care providers who continue to take patients from all
government payment programs and the new health insurance exchanges.
That is access that is rare in many parts of this country and the same
is true for any specialists we employ.
We can also be proud in this region that virtually all our private
independent physicians, specialists and associated providers also
continue to see patients from government payers. Again this is less and
less true in growing sections of the U.S. We in the Corridor are among
We are not perfect, and none of us would claim healthcare is as
affordable or accessible to all as we would like. But whatever Obamacare
brings to us as a nation over the next few weeks and months, whatever
the changes the President or Congress, or the states come up to help an
incredibly complex and increasingly expensive health care system, the
businesses and residents of our community can be assured your local
providers will continue to meet these needs to the best of our ability.
Even when there is great confusion and uncertainty, you can count on us do the right thing.