Federal Health Care Policy: Past, Present and Future

Wednesday, October 23, 2013

Barack Obama signing the Patient Protection and Affordable Care Act at the White House. March 23, 2010 (Pete Souza/Wikimedia Commons)

The Obama administration faces mounting criticism over the Affordable Care Act (ACA) rollout, as prospective consumers refresh their browsers and wonder if their confidential health information made it into the right hands.

The ACA marks the most comprehensive change to federal healthcare policy since President Lyndon B. Johnson signed Medicare into law back in 1965. Yet the federal government has redesigned its health policy in the decades since, with varying degrees of success.

Helen Levy, research associate professor of economics at the Ford School of Public Policy at the University of Michigan and former senior economist to the President's Council of Economic Advisers, compares the ACA rollout compare to past federal overhauls. She examines the state of the ACA exchanges, and how future administrations might improve upon President Barack Obama's model.


Helen Levy

Produced by:

Jillian Weinberger


T.J. Raphael

Comments [4]

Joseph Bell from Downtown NYC

Kudos for this story. I have worked in the insurance industry for many years and this is the first story I've heard that has the ACA roll-out in perspective. It is very reminiscent of various Medicare innovations such as the introduction of Part D several years ago. BTW The Government runs a somewhat similar plan comparison and enrollment website for Medicare (only)plans at medicare.gov. There are usually a few glitches at the beginning of the annual enrollment season, but things always work out and everyone is able to obtain coverage. Enough with the website hysteria! The program is a whole lot bigger than just a website.

Oct. 24 2013 07:08 PM

My understanding of the Affordable Care Act (Obamacare) and the health insurance marketplace is there are a few insurance plans offered called a platinum, gold, silver, bronze, and catastrophic. All health insurance plans offered on the marketplace must offer as a minimum the same set of services called the “essential health benefits”. The silver plans are the plans which offer any tax credits for which the person may qualify. The plan level guidelines are platinum is for someone in poor health, gold is for fair health, silver for good health, bronze for excellent, and catastrophic for persons 30 years of age or younger.
Platinum is lowest deductible and highest premium, bronze lowest premium and highest deductible. Several private insurance companies will offer the various plans to the individual. Inquiries about specific plan coverage or premiums to be paid are made directly to the private insurance company. The person should select a plan based on their needs, and the network of doctors, services, and hospitals offered and not the lowest premium. Based on household income and family size, many people are expected to qualify for tax credits. If a person qualifies for a government sponsored plan like Medicaid or Chips, those will also be offered to the individual as an insurance plan option.
The “essential health benefits” offered by the Affordable Care Act includes prescription drugs, lab work and blood tests, preventive services like counseling, screenings, and vaccines, doctor and clinic visits, emergency services, overnight stays in the hospital, prenatal, maternity and pediatric services (including kids dental and vision), habilitative and rehabilitative services for persons with disabilities and chronic conditions, and mental health and substance use disorder services.
Persons offered insurance coverage through their employer can shop the health insurance marketplace in search of a plan which might be deemed as a more “affordable” plan. Open enrollment dates are October 1, 2013 through March 31, 2014. “Exemptions” from health insurance coverage are available for those that qualify. All of this information is available on the healthcare.gov website.

Oct. 23 2013 02:28 PM
Sue Roh from Philadelphia, Pa

It seems that there is this common problem with effective communication, specifically this assumption that the general public is too dumb to be able to make sense of the various aspects of the healthcare roll-out. It shouldn't be too surprising given how the Obama administration has responded to concerns and criticisms of the ACA, from day one.
I saw Kathleen Sebelius on Comedy Central's Daily Show about two weeks ago which I see as a prime example of the lack of frank communication and the tendency to believe that short repeated soundbites would suffice. If Health and Human services wants to attract younger cohorts, needed to meet the intended purposes of ACA, tell the truth and admit your shortcomings and trust that the audience can understand complex matters. Anything less is simply insulting.
Three words: Know Your Audience

Oct. 23 2013 12:43 PM
Larry Fisher from Brooklyn, N.Y.

I took a job at Trader Joe's for the Health insurance. It gets cut in January. I had to get x-rays on my back today for some cyst, or cancer or something.
I assume that my cost will be higher if I come in with a per-existing condition to the affordable care act. I should have waited to drop dead, before I get health insurance.

Oct. 23 2013 12:15 PM

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