Compass: Alaskans have much to gain by Affordable Care Act

By PATRICK CUNNINGHAMSeptember 20, 2013 

The Act will become operational in October of this year when Alaskans will have the opportunity to buy health insurance through an exchange created by the federal government. The law provides sliding scale credits toward insurance payment at up to 400 percent of the poverty level for Alaska. This represents about $44,000 for an individual and $90,000 for a family of four, who will receive insurance purchase subsidies. Gov. Parnell and his administration elected not to participate and accept federal funding to set up the exchange. Those opposed to the act focus on the mandatory requirement to purchase health insurance, but fail to elaborate on the benefits. The United States Supreme Court ruled that the Act was not unconstitutional.

Many Alaskans will benefits from this act. Women, seniors, and those who are sick, without insurance, stand to benefit the most. Insurance companies will no longer be able to charge women more than they do men, to the tune of an extra $1 billion dollars per year as estimated by the Kaiser Family Foundation. The act also requires new insurance plans to cover maternity care. Banned are deductibles and co-pays for birth control, breast feeding equipment, and screening for domestic violence. The act lowers the cost of medication for seniors by closing the "doughnut hole," which has required seniors to pay 100 percent of some drug costs. Adults having a pre-existing condition such as asthma and diabetes will not longer be denied insurance.

Other beneficiaries are adults under 26 who may remain on their parents' health insurance. This benefit has existed since 2010, and according to the Commonwealth Fund, about 15 million people from 19 to 25 have enrolled, in the past 12 months. A similar ruling ended the ability of insurance companies to exclude children with pre-existing conditions from coverage.

Approximately 4 million small businesses are eligible for tax incentives, if they offer health plans for their employees. The tax credit is 35 percent and will rise to 50 percent in 2014. People who want to maintain their weight, or who are overweight, will benefit from a provision of the law that mandates large restaurant chains to provide patrons with calorie and nutritional information. People who plan to retire early at age 55 or older may continue to be offered health insurance by their former employer, who will be reimbursed by the Early Retiree Reinsurance Program that is part of the act. If the employer doesn't elect this option, retirees may obtain coverage from the exchange and won't be excluded for a pre-existing condition.

The Affordable Health Care Act provides for the expansion of Medicaid, allowing more low income people to enroll, at no cost to them. About 20 states are declaring to not accept the expansion, despite no additional cost to them. Alaska, at present, is one of them. This will be a loss in the millions of dollars to health care providers, and a lack of coverage for those who would have been covered.

Native Americans and Alaska Natives are not mandated to obtain health care coverage because they have Indian Health Services. Those who find it difficult to access these services will be able to receive Medicaid, if they are within 133% of the poverty level, for Alaska. This is a win-win situation for Alaskans -- political ideology must not be allowed to prevent this expansion.

This act is a substantial improvement over the current health insurance arena, but needs more incremental improvements, until universal health insurance is available to everyone living in the United States, as it is in every other developed country. Imagine what could be done with the billions of dollars spent by business and individuals on health insurance if this burden is lifted.

Patrick Cunningham is an associated professor of social work at the University of Alaska Anchorage.

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