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CentraCare Woods Farmer Seed & Nursery Pediatric/Welch
Home Opinion Letter to the Editor

The affordable Affordable Care Act?

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July 17, 2014
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Stuart Bailey, Sartell

Last October, I voiced an opinion that, based upon what we knew at the time, I and my family could not afford the Affordable Care Act.  This belief was based upon what we knew and surmised at the time: There would be little in the way of benefits for us, and the costs to administrate the program would be astronomical.  Fast forward nine months, and from the looks of things, I was right on both accounts.  

Everyone is well aware of the failures of the federal and state web sites, and at the state level, audits and a re-build of the system have cost taxpayers tens of millions of dollars over and above initial projections. Hundreds of additional staff were added to reduce the unacceptable response times at added taxpayer expense. That’s the administrative cost. Has it improved? Probably yes, but only until the next enrollment period begins. And numbers? It depends on whose poll numbers you may believe. I had heard the goal nationwide was for 23 million enrollees, but after March 31, was it only seven million.

Since last October, the health-insurance plans provided by most private employers to their employees rolled over on Jan. 1, and plan premiums immediately reflected the changes brought on by the Affordable Care Act. Premiums rose to the tune of about 20 percent for our family. At our benefits meeting, the representative stated the increase was in part to the provisions of the Affordable Care Act. OK, tighten your belt, shift some things around and a family can absorb this. But that’s not all. We, like many others, take maintenance medications that are renewed on a 30- or 90-day basis.  Usually the money-saving generics are perfectly fine, but in some cases, the doctor prefers the use of a brand-name drug for their patients instead of the formularies. The doctor would make a request to the insurance company stating reasons for the preferred brand-name. Prior to the Affordable Care Act, these requests had been accepted by our insurance, and the cost of the expensive medications were reduced in line with formulary costs. Since Jan. 1, all of these requests have been rejected. Recently, we found out this practice of rejection is now the rule and not the exception for the insurance companies, due to the costs of the Affordable Care Act. Suddenly, it’s not a tighten-your-belt issue any more, it’s a matter of what does a family cut? I would guess our family is not the only family experiencing this crunch. I see no let up and no help down the road. So, what is the solution? Repeal or change this bad legislation, and don’t wait. So far, our family can’t afford the Affordable Care Act. Consider this my letter to the President. I’d be happy to sit down and have lunch with him and we could talk about it like Rebekah did. We could go to Val’s.



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