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May 14 13 6:11 AM

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Don’t Let Republicans Scare You About Obamacare

We talked to health experts all over the city for the May issue’s guide to the Affordable Care Act. And guess what? We’re not scared anymore.

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For the past few years, my colleague, health and fitness editor Emily Leaman, and I have worked together to produce our annual “Top Doctors” feature. This year, when we sat down with editor in chief Tom McGrath to plan what we’d do, there really only seemed to be one option. As Tom put it, “This is the only time we’ll ever be able to introduce our readers to Obamacare.”
Emily and I found the prospect … daunting. That 900-page act! The lawsuits! The thousands of pages of explanations and regulations! But as we began our research, a funny thing happened. “This act has a lot of really great stuff in it,” I remember Emily saying not long after we began—and I had to agree. As we read all we could find about the act, and called on the remarkable resources available to us—the dozens of super-helpful contacts we have locally in the medical and insurance fields—it became more and more clear that America is standing on the threshold of a new dawn in how we care for our most vulnerable populations: the elderly, the mentally ill, the chronically ill, children, the indigent. For the first time ever, this nation is taking steps to see that health care is available and affordable for everyone who needs it.
Nobody we talked to said that it’s going to be easy. On the contrary, our experts all foresee a long, hard haul ahead, as a health-care system that evolved to be volume-based—meaning that hospitals and doctors made more money the more patients they cared for—changes over to one that’s value-based, in which payment depends upon results. Hospitals will be rewarded for treating patients right the first time, so they don’t have to be readmitted. Preventive care—vaccinations, mammograms, colonoscopies, diabetes screenings—will be free, without co-pays, so we’ll all see medical professionals before there’s something wrong. Insurance companies will no longer be allowed to screen out those with preexisting conditions. There will be no more lifetime or annual limits for those with catastrophic health costs. Mental health coverage will have to be as comprehensive as that for physical health. And, as those of us with young adult children just starting out in life already know, those young adults can remain on our insurance policies until they turn 26.
Sure, it’s a convoluted act. It had to be, to try to effect the seismic shift it aims for. And the fact that it has so many moving parts makes it vulnerable to those who are out to thwart it, even if their only real goal is to have the President look bad. Hospitals face the loss of funds they now use to pay for patients without insurance—but the act presumed that states would shift those patients onto Medicaid rolls, since the incentives to do so are so generous. (The federal government pays 100 percent for the first three years and 90 percent after that.) But Republican governors have turned down the chance to expand Medicaid, or, like Governor Corbett, are dragging their heels, unwilling to do what’s right by the citizens who elected them, and who trust elected officials to look out for them. Why? Because those politicians would rather see citizens go without the health care they need than see Obamacare succeed.
The more Emily and I learned about the Affordable Care Act, the more we liked it. Almost all the experts we talked to like it, too. And there’s one thing everyone—insurers, doctors, hospital administrators, nurses, public-health advocates—agreed on: Health care in America had become so bloated, inefficient and expensive that something had to be done. Is Obamacare perfect? No. No one we talked to was naïve enough to believe that. But the consensus was, this thing can work, if we put sufficient will behind it and are patient with what Obama has called the “glitches and bumps” that lie ahead. Emily and I invite you to read our nonpartisan, non-political take on Obamacare in the May issue. Don’t let the fearmongers scare you off. We think the more you know about it, the more you’ll like it, too.