Let’s Check-In with The Affordable Care Act

Health Insurance Header

Why the Affordable Care Act is doing well, but not THAT well.



The Affordable Care Act (ACA). Some people refer to it as Obamacare, others as the harbinger that will bring destruction onto the modern world.


“On the bright side, everyone pictured at least has health insurance.”



Regardless of what you call it or what your feelings are towards the legislation, many agree that the success of the program is directly connected to the number of people that signup. That’s why you get such desperate ads focused on individuals that are glad to be covered when their stomachs are pumped later on in the night.


Obama Care Ad


Or parents being told their children are now invincible due to health insurance. Because based on this kid cutting that pumpkin with a machete, his parents have clearly stopped giving a fuck!


pumpkin kid


Now between those ads and this BuzzFeed video of President Obama, you may be asking yourself, “when did the Obama administration become Gil from The Simpsons?” And to be fair, that would be a valid point. Much like those terrible Eagle Man commercials from Chicago, these gimmicks make me less likely to buy insurance from you, whether it’s a grown-man in an eagle costume laying an egg on someone’s car or the Leader of the Free World practicing Blue Steel in front of a mirror.


Obama Blue Steel

“Lookin’ good Mr. President. Lookin’ REAL good.”



With all that said however, none of this looks to be hindering signup numbers.


Signups for health insurance under the ACA ended last week and in the law’s second year of implementation the numbers look promising. The Obama administration ended up signing 11.4 million people with an estimated 9.1 million paying their premiums throughout 2015. It’s impressive considering the original goal by the Obama administration was 11.2 million and there could be more considering there are potential late signups that have yet to be counted. Though to be fair, the Congressional Budget Office may have originally over estimated with 12 million sign-ups by 2015.


Even so, on the surface everything looks to be going copasetic. I mean even the White House is touting these numbers to everyone. If signups are meant to determine the success of the ACA, then it’s going fantastic! You know what, let’s live it up! IT’S A CELEBRATION BITCHES!


Party Hard


Well maybe not EVERYTHING is copasetic…


Reports have surfaced that from a technical perspective the Healthcare.gov site isn’t nearly working as well as it should be, costing work-hours and money to keep a mediocre site running. Problems include subsidy payments not being automated making insurers getting payments based on estimates and not actual values. Even adding simple information like marital status or a birth of a child can be convoluted.


But you know what, organizing everything so it works seamlessly is such a MASSIVE endeavor for any governmental program. Considering it’s the freaking Affordable Care Act, I mean to have this much success is still impressive. Let’s bring the party back a little, but this is still a celebration! KICK OUT THE JAMS!


dance party


Hold on what? What do you mean there’s a court case?!


Oh yeah, the Supreme Court recently decided to hear arguments on whether the federal government can extend program of subsidies to people who want to buy health insurance. That’s basically the backbone of the ACA. If the Supreme Court finds this unconstitutional, then health insurance would be cutoff to millions of people who signed up. Also Politico recently talked to many state governors on what they would do if federal subsidies for the ACA were cut off and many had the same answer; they didn’t know. Considering federal subsidies make these state market exchanges work, it really is hard to see how the ACA – as we know it – would survive if the courts rule it unconstitutional. It’s a scary thought because many of those 11.4 million that signed up would suddenly not have access to health insurance. That would be a problem.


But hey, we can’t worry about that now. The ruling isn’t till June and even though there are a few bumps in the road, overall ACA is still strong. Instead of having a full out celebration, let’s bring it back a little more and party down!






What is it states? WHY ARE YOU STOPPING THE MUSIC?!?


Roxanne No


ALRIGHT… alright, there’s a problem with the states as well.


A number of states have recently refused President Obama’s Medicaid expansion with the ACA. There are currently 22 states that opted out of Medicaid expansion due to many state governments saying the foundation of the Medicaid system is broken. Even though under the ACA those under Medicaid would be reimbursed in full by the federal government, among governors – especially those aligned with the Republican Party – it’s a contentious issue in which they worry their conservative base would go against them and oust them out of office come election time.


With Medicaid numbers increasing – even in states without the ACA expansion – this puts a strain on many state governments. For those states that aren’t part of the Medicaid expansion, they use the traditional model of the federal government paying for 57% and the state putting in the rest. President Obama recently has asked many governors that aren’t part of the expansion to reconsider. The problem is around 8.5 million adults are uninsured due to many of these states not opting into the ACA Medicaid expansion.


As you can see now, the ACA is a lot like German Chocolate Cake. Sure the fundamental ingredients and its look make it seem awesome, but put it altogether and it’s a bloated mess. A crime against deserts if you will.


German Chocolate Cake




Now there is blame to go all around in regards to how the ACA has performed thus far.


Some of that blame definitely does go to the Obama administration, because let’s face it, if you can create such a high-tech fundraising campaign where articles were calling it “The Amazing Money Machine” but can’t create a simple CMS where people can easily enter basic information like marital status or birthdates, then that’s on you. In this situation the Obama administration is that deadbeat dad where he sends you a gas station birthday card with a $5 bill before installing that $500 tailpipe for his pickup that whistles when it goes down the street!


But then again, come on Republican governors! I get it, you have to win elections so going against anything that you can tack on the words “Obamacare” to is an easy political victory for your base. But you’re telling me you can’t politically spin lower income adults getting health insurance in your state?! Multiple GOP governors have politically spun bad economic records saying things like it was “a moribund economy” before they got to it, similar to how a doctor who is being sued for malpractice would say “hey, if you didn’t want that sponge to be left in his chest, then you shouldn’t have asked me to perform surgery!”


Sponge Bob Xray

“That’s my lucky Sponge Bob keychain I left in you. Other than the terrible infection rampaging through your body, you have become infinitely more lucky! You’re welcome.”



Ok, so with all that said, there are still aspects that we should celebrate about the ACA. It has got a hell of a lot of Americans insured under it and is working relatively well thus far. While there are major challenges ahead cough that Supreme Court case cough that doesn’t mean we can’t celebrate! It just has to be more reasonable than the Obama administration or the new enrollment numbers are making them out to be.


Ben Celebrating


Yeah, that’s more like it.



(Photo Credit: WhiteHouse.org, Good Eats, Google Images)


1 Comment

Filed under Features, TPT Originals

One Response to Let’s Check-In with The Affordable Care Act

  1. SkepticalDoc

    There are also other issues with the ACA. Very significant issues. It is great that so many people are now insured, but very few private medical practices accept Medicaid thus effectively funneling all those newly insured patients through existing safety net systems (like County hospitals). This puts a lot of stress on those existing systems. For one, wait times increase for non-emergent conditions. The government already provides incentives to attract more primary care doctors however then the bottleneck is at the specialists because many accept only small numbers of Medicaid patients. So you may be able to see a primary care doctor but finding a specialist will be tough (I have heard of wait times that exceed 200 days). So one way to reduce this jam is to increase Medicaid reimbursement rates and as you can imagine, they will tell you there is no money for this to happen. I believe the Europeans offer healthcare to everyone because of higher taxes. We are unwilling to have our taxes raised, but I’m sure there are other ways to put more money into Medicaid (like reduce waste elsewhere). All of this, mind you, is so that we take care of health problems before they land you in the emergency room requiring surgery which would cost more than preventive care. The good news is that many of us working in healthcare, especially working in those safety net hospitals, are looking for clever solutions every day.

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