September 27th, 2013
October 1, 2013, is not the most important date in Affordable Care Act implementation history. The most important date is November 4, 2014, when the next members of the House of Representatives and 1/3 of our senators are elected or re-elected. The nation’s collective judgment about the ACA will be on the ballot then even more than it was in the Presidential election year of 2012 and will be again in 2016.
October 1, 2013 is an important milestone for the progress of health reform, for it ushers in a new era of insurance market rules, rules that are considerably more in the consumer’s favor. Not completely, and not costlessly, but more in the consumer’s favor than ever before. For the first time in our nation’s history, insurers can neither refuse to sell to someone with an existing health condition nor charge them more than a perfectly healthy person of the same age. For the first time in our nation’s history, lower-income working people without access to tax-subsidized employer-sponsored insurance (which most people reading this blog post have) will be eligible to buy relatively comprehensive insurance at relatively affordable prices (by all accounts at least some premiums in every market are way lower than feared and actually cheaper than a typical group policy today), due partly to the competition engendered by the new market rules and partly to new income-based subsidies.
For the first time in our nation’s history, a combination of federal and state policies (in some states) will make it possible for every American citizen to afford decent health insurance and thereby greatly increase equity in access to quality and effective care, which should ultimately enable us to abolish the fear of financial ruin from out-of-pocket health costs and to become a healthier nation. These are all very big deals in the evolutionary improvement of our democratic republic.Read the rest of this entry »