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Understanding Changing Health Care

It is probably no surprise to any of in-Training’s readers that health care is changing. On October 1, the health insurance marketplaces opened for business … and then promptly became the victim of the largest Internet traffic jam in recent memory.

Obviously, people are looking for a better way (or any way) to afford medical care. It is the job of health care professionals to make sure that their uninsured and underinsured patients are educated enough to make the best decisions for themselves.

However, health care professionals (and students) cannot be good educators without first becoming knowledgeable about this new, complicated environment. So what are some of the most important things to tell patients? And who can benefit from this new system? Here is some information that might clear up some confusion for those unfamiliar with recent political proceedings:

  1. You can keep your doctor under insurances you buy through the marketplaces, despite what politicians keep yelling at each other. Just like insurance plans in the past, certain doctors and hospitals are covered under certain insurance plans. If you do a little research into the plans, you can make sure that you keep your doctor.
  2. The price will vary, so shop around. Premiums are lowest in the most bare-bones Bronze plans, which will cost you under 9.5% of your yearly income if you make up to 300-400% of the federal poverty level. Platinum plans unsurprisingly cost more, and they are capped at 12.5% of your yearly income. These numbers are attractive to average Americans, who have been paying 20% of their yearly income for health insurance. Shopping around is the best way to find out how affordable the Affordable Care Act (ACA) really is for you.
  3. There are considerations for younger people. Young adults up to age 26 are now allowed to stay on their parents’ insurance plans. A study recently showed that 36% of young adults ages 18-31 live at home with their parents, the highest proportion in the last 40 years. With crippling student loans and a poor economy taking tolls on people trying to start their adult lives, this should soften that blow. However, despite low-premium plans dubbed “catastrophic plans,” those under age 30 might see a slight increase in the cost of coverage because of the ACA’s reliance on payments from younger and healthier individuals to pay for the care of the older and sicker. Like it or not, many government-run programs work on this platform, including Social Security.
  4. Don’t rush! Do your research, and find the right coverage for you and your family. The October 1 marketplace opening generated so much interest that many state sites could not handle the volume of online traffic. As long as you sign up for the program before December 15, you will have coverage on January 1, 2014.
  5. Use all of the resources available to you. Many states have provided health care “navigators” to help people through the process of signing up for insurance through the marketplaces. These people are invaluable. They can help you find out your best options.
  6. Before anything else, check out how your state is approaching the Affordable Care Act. Some states are fully embracing the ACA, and some are rejecting most of its major directives. Some states are barring the use of navigators altogether, and some are just simply refusing government funding for the program. After a Supreme Court ruling, states are free to comply with the law in any way they see fit. Find out how your state is handling the new law here.
  7. Health care can be cute. If you doubt it, check out this website.

They say knowledge is power. Health care providers are responsible for empowering their patients with information about better and more affordable insurance. There is a lot of information out there, so here are some further resources to help you become educated:

Daniel Lefler Daniel Lefler (3 Posts)

Contributing Writer Emeritus

Cooper Medical School of Rowan University

Daniel Lefler is a member of the Class of 2016 at Cooper Medical School of Rowan University in Camden, NJ. He studied neuroscience at The College of William & Mary. His passion is the medical sciences, but he also enjoys the performing arts.