If We Pay You, Will You Like Health Care Reform More?

The Obama administration isn’t feeding you a line if they tell you the check is in the mail.  This week, many Americans will begin receiving letters informing them that their insurance companies failed to meet the new “80/20″ rule established by the Affordable Care Act — a rule that at least 80 percent of the money received by health insurance companies must go directly to providing health care.

As National Women’s Law Center explains, “Before the health care law, many insurance companies spent excessive amounts of our premium dollars on administrative costs and profits, including executive salaries, overhead, and marketing—and not on our health care.”  With the reform in place, more money must be spend directly on care, rather than pumping up executive pay and paying people to turn down claims.

For those companies who spent less than 80 percent, they are now required to provide a rebate check to make up the ratio, and that money will be divided among its customers.

Time.com reports, “The rebates will average around $127 for the over 3 million individuals who receive them directly. Small employers covering almost 5 million people will receive around $377 million (an average break of $76), while larger employers covering about 7.5 million people will get approximately $541 million (an average of $72). According to administration officials, employers are obligated to pass those savings onto their employees.”

But unless there’s a greater push behind the effort, will this small windfall make the general public any more accepting of the ACA?  Like so many of its other provisions, these reforms don’t seem to be making a direct connection with so many Americans who still haven’t bought into the idea of health care reform, mostly because they can’t see how they can really benefit.  I spoke with someone yesterday who worried about her retirement because she will have to purchase her own insurance once her COBRA expires but before Medicare is available, and she told me how worried she was that she would be turned down for preexisting conditions if there was any lapse in coverage.  As I explained that companies will no longer be allowed to do that because of health care reform, she wondered why no one ever mentioned that.

The more the actual tangible benefits of the Affordable Care Act kicks in, the more the public will be likely to support it.  It won’t always take a check in the mail.


Photo credit: Thinkstock


Lika S.
Lika P5 years ago

Well, you know, part of the reason why the American health care system is so expensive is that it seems that poor and uneducated people, with regular or state funded insurance spend their funds wrong. How many times have I heard of taking someone to the ER for a sinus infection rather than going into a doctor's office.

With the inception of walk in clinics, you'd think it would eradicate this practice, but it does not. That's the first part.

Then the fact that it's very fragmented, as in, if you live here, and you go there on vacation. You come in contact with something that makes you ail in some form or another that you have to go to the hospital. If you are unconscious, they don't know anything about you. There OUGHT to be something that your attending physician should be able to find out about you for the purposes of treating you on some mainframe that only you as the patient and the current care giver(s) are allowed to see.

Cut down on these costs, which eliminate duplicate testing, wasting time with the same info such as family history, personal medical history, etc, there are more funds available to be able to cover other items.

The Affordable Care would make it so that in the long term, it's less expensive, because it promotes preventative maintenance (an ounce of prevention) rather than paying out buku bucks (a pound of cure) when it's too late.

Robert Irons
Robert Irons5 years ago

Why does the United States always have to be the last great nation to provide full health care for it's citizens? Heck, even one of the worst places, Cuba, would treat any person citizen or not and never charge them.

Politics mixed with lobbying and money always gets us fighting against each other over this debate and for what? So that insurance companies and hospitals can dictate to us the level of care we deserve. What they are willing to give us as long as it doesn't interfere with their profitability. Lets not forget the mighty politicians who are getting their pockets lined and receiving free gifts and trips Oh and who do not even pay for their own health care.

Our politicians should be held to the same dictates that we citizens are.... Average income no more than $30,000 a year, they must pay, just like we do, a premium for their health and dental care and they should have to contribute to their own retirement not just be given one for life.

If we stopped lobbyist and put politicians under the same dictates that we citizens have to live by, this would not even be a discussion.

Sharon R.
Sharon Re5 years ago

I live in Massachusetts where we do have state healthcare and I recently overheard people talking about $2,000 deductible on their health plans. All this healthcare talk is about making people go out and get coverage. The poor can qualify for state aid, but the rest have to get it through work or through their own pocketbook. Meanwhile, the state deficit grows as more and more people turn to state aid, and plans are getting tighter and tighter with the money as they are forced to care for very sick persons (whom they can't refuse). We really need more time to study what works and what doesn't. This whole reform has been forced down our throats.

Robert H.
Robert Hamm5 years ago

Billie, I am just as sorry we have the health care we have now. But it isn't really Obama's fault. This was all he could get through. The Health care industry lobbied congress so intensely that Obama had no chance. This isn't the plan he wanted by any stretch. But it IS the plan the halt care industry wanted. THEY wrote it. When congress told Obama NO to what HE wanted he did the next best thing, He got a plan enacted. It will be improved on, if Congress ever allows that. You're right. We should all be on Medicare……we should all be in the health care our representatives have and are denying us. That was Obama's original plan. They shut to down even while enjoying it themselves. Calling this Obamacare is laughable. This is what the congress and the health care system crammed down his throat.

Billie C.
Billie C5 years ago

marilyn l there was no tea party when pelosi and reid rammed through obamacare. the tea party was started after that. obamacare being one of the reasons.

Marilyn L.
Marilyn L5 years ago

The American people have become lazy. How many times must they be told and shown the benefits fo ACA? Part of it is laziness, part of it is the GOP haw tried dumbing us down since Reagan, and part of it is they can't see the cost savings when all people are covered and preventative care kicks in, and part of it is some just don't give a damn about anyone else but themselves. We have been informed not only by politicians but by the media how ACA works and it's benefits all we have to do is listen, tune-out the GOP propaganda, and if that's not enough get off ones lazy backside and do your own research; but I would avoid Fox News and other right wing propaganda sites if you want the truth.

Linda McKellar
Past Member 5 years ago

Many good comments & lots of stars to go around. Universal care is the only. "Obamacare" as it is derogatorily called, just because people dislike Obama, is "Romneycare", the same as in Massachusetts & was a cave in to the insurance companies. Single payer period. Stop pissing away US tax dollars on foreign interference & big CEO salaries & return it to the taxpayers. That is WHY they are paying taxes, for the benefit of everyone. Who in hell would pay for something they don't get? The CEO's get what the taxpayers pay for. Would somebody making $40,000 a year buy a nice house for a millionaire? In essence, that's what you're doing as long as insurance cos provide health care.
I've frequently listed costs of care in the US vs Can. BR. FR, etc. The differences can be from 4 to 10 times, profit, not better care. eg cataract surgery, US $14,000 vs $1200 in Canada. WAKE UP!!! Can you Americans spell SUCKERS!!!

Ira L.
Ellie L5 years ago

The Affordable Health Care Reform law is not perfect, but it's the best President Obama could get passed from the obstructionist, greedy, racist, bigoted teabagger republican congress. There will be many good things to come out of it like pre-existing conditions protection. People should read the law to see what it really does and not listen to the lies and spin from Fox and their twisted goal to not do ANYTHING that might help the economy, healthcare, etc., for FEAR IT WOULD HELP OBAMA. We are the sickest society America has ever seen. The teabagger/republicans are a step away from creating Nazi Germany right here in America. God help us.

Billie C.
Billie C5 years ago

mary b i would love to pay only 60 a month for medicare. i pay double that and still have to pay for separate drug coverage. as of right now i'm in what's called the donut hole. i'm paying out over 500 a month in drug costs right now. makes it kinda hard to eat. forget doing anything else.

Billie C.
Billie C5 years ago

mary b romneycare isn't any better you are right. we would all be better off if we would just all get on medicare and be done with it. obamacare encourages insurance companies to have high deductible plans to keep premium costs down. don't ask me how that helps people i don't know. obamacare is just a giant freebie to the insurance companies.