The Affordable Care Act And People With Disabilities - Forbes

 

“ACA changes the world for persons with disabilities and funds who will now have a choice between public or private health insurance. For significant financial as well as health reasons, we believe that private health insurance, not Medicaid, will be soup d’jour for the vast majority of (Special Needs Trusts) SNT clients. We cannot know for certain, but I would not be surprised to see persons with disabilities leaving public health insurance (Medicaid) for the private market in January, 2012.

The most obvious and most significant health industry reform important to our SNT clients is the elimination of pre‐existing conditions as a bar to purchasing private health insurance. However, ACA also eliminates annual or lifetime caps, rescission of insurance policies, non‐renewability, and higher premium costs for persons with pre‐existing conditions. For individuals with significant medical problems, elimination of cost‐containment ceilings is just as important as access to the door of private medical care. It is not unusual to see clients who have maxed out their lifetime cap and are now seeking public health insurance.

Why would clients opt to pay for private health insurance rather than “free” Medicaid? The two major reasons are first, securing health insurance without a payback on death and second, access to significantly better medical care…

Change makes most of us uncomfortable, but change is a constant in our lives. This is one time when special needs attorneys can both lament the negative impact of national legislation on our personal financial well‐being, but rejoice in the concomitant good fortune of our clients with disabilities who can now join the private health insurance market with the rest of us as equal citizens with their dignity intact.”

The Affordable Care Act And People With Disabilities - Forbes

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National Journal Online -- Health Care Experts -- Paying (Or Not) For Reform

National Journal Online -- Health Care Experts -- Paying (Or Not) For Reform - Uwe Reinhardt Response:

It didn't take long before one of several howitzers got dug in to shoot at the idea of universal health insurance. The one out now is the familiar 'we need to control health care costs in our bloated, inefficient health system first before we can bring yet other Americans under the umbrella of health insurance and into the system.' That cannon has served us well for over three decades now. I can imagine its roar already, even before the cannon is fully cocked.

To shoot this cannon, you must have a license, and the requirement for that license is that you must be well insured and, indeed, be one of the folks who have helped bloat the system and made in inefficient. And because we, the well insured bloaters, have come to love that system so, we’ll do everything in our power not to change the status quo, won't we?

The other cannon, still being readied, is the 'crowd out' or 'crowd in' cannon. It gets deployed whenever someone in Congress or in the White House identifies the year's 'objects of compassion' (OCs). For example, the OC's may be uninsured children, or unemployed adults over 50, or whatever. The compassionate originator of the idea to do something for the OCs may calculate that it will take, say, $2,700 per OC to practice compassion upon them. No sooner uttered than the computers at the AEI or NBER or RAND or wherever start to whirr, figuring out how many OC-look-alikes now privately insured will be crowded into the new public program intended mainly for the original OCs. And before you know it, the federal budget cost calculated as (federal cost per original OC plus federal cost per crowded in OC) divided per original OC is staggering. Bullet hits on the mark, OC plan is destroyed. Mission accomplished.

This is how America has always successfully warded off any impending threat of universal coverage. Maybe it'll work again this time.

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