Now that President Obama has been reelcted to another 4 year term, we can expect ACA to remain as well.  What does that mean for all of us?

For starters, the various 4,000 new health care regulations take effect at different times.  For a timeline as to when each regulation activates, you can go to: http://HEALTHREFORM.KFF.ORG/TIMELINE.ASPX

The act was meant to cover the uninsured while decreasing costs.  It does neither.  As the ACA was passed, we saw an increase in premiums from several well known insurance companies to cover the cost of high-risk patients with preexisting conditions and  that by the end of the decade there will be 84 million more Medicaid patients with expansion of the program.  But by a vote of 7-2, the Supreme Court decided that each state can decide whether to expand Medicaid or not since states will really only see 2 years of federal subsidy.

Thus, there are states that have chosen not to initiate the expansion feeling that they are barely fiscally solvent now.  This means that there will still be a great number of citizens that will not have insurance. (of course, the issue of illegal aliens becoming a financial burden on hospitals is not even broached since additional funds are not allocated for this.) Statistics also show that physicians are only reimbursed 60 cents for every $1.00 of care that is given.

Can doctors really afford to do this on a wide scale, or will they be closing their doors? So, more patients will have Medicaid coverage in this country, but who will they see?

Issues that were never addressed by the act were the ability to purchase insurance across state lines which would foster a competitive rates among companies.  In addition, the rate of increase for insurance companies is not regulated at all- companies can choose what they wish (at the same time that physicians are being told that reimbursements will be slashed). This does not reflect a situation where politicians are bought by lobbyists and are not working for the citizens at large, does it?

Another worrisome development that is slated to become enacted by 2015 (which is not that long away), is the formation of an Independent Payment Advisory Board as a means to reduce healthcare costs in Medicare , a budgetary black hole that sucks in an increasing stream of taxpayer dollars as the American population ages. This is a powerful cost-cutting mechanism within the new law.  The board’s decisions are automatically binding it wthat it will require a 3/5 super majority to overturn the board decisions.Appointees will be hand-picked by the president and must be approved by the Senate before they can take their seat.

They’ll be asked to make cost-cutting recommendations for Medicare whenever spending per person rises faster than the Consumer price index, something that seems more likely to occur than not.

The problem actually goes further.  It is not only the quality and availability of care that will decline as hospitals lose billions.  The facilities themselves will close due to lack of operating costs, thereby making medical options even more scarce.

Buckle your belts- we are in for a rough ride ahead!

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