01 October 2013


LAST UPDATED: 02/06/2014
Today, the USA began its march towards real universal health coverage...

Aside from the availability of affordable health coverage to the previously uninsured, perhaps the next most important change this law ushers in will be the freedom from feeling "stuck" in an irritating job just because of the health plan that comes with it.

Ironically, it is the spate of large corporations (IBM, UPS, Home Depot, Trader Joe's, Delta Airlines, Papa what'sit Pizza...) kicking off, threatening to kick off, reducing, or altering their employees' existing health benefits - usually due to the increased cost, and sometimes to make a political point - that will actually lead to the average person learning that s/he actually pays the same or less to cover her/himself. In some cases, s/he will even qualify for a tax subsidy.

When your world is "Corporate America," this kind of progress is long overdue.

This law gives you the freedom to consider starting your own business, or returning to school, without the anxiety of how you'll continue paying for your family's insurance.

This alone will instantly improve the mental health of millions. Perhaps even the "sabbatical" may slowly become de rigueur here in America as a result of this new world. 

If the Republicans don't step up and begin to work with Democrats to help fix the inevitable glitches that will emerge, then this really will remain a Democratic achievement... A crowning one at that.

UPDATE 02/06/2014: With a little more than a month until the deadline to sign up for coverage under the new health care law, it is worth looking at what's happened since. Throughout March, the media will undoubtedly fill us in on that regard. Early reporting puts the program behind by about a month, put up against original expectations. The president said that himself a few days ago in his Rill O'Beilly interview.

But it is really worth paying attention to the recently released U.S. Congressional Budget Office (CBO) report, which provides the Government's early assessment and forecast. The report - and subsequent testimony about it by a CBO official to Congress - reconfirms exactly what I wrote originally: that American workers under this new law will have improved mental health thanks to this law. It is about staying healthy... and media are more and more beginning to report on this fact.

Reasonable people are not surprised by the generally positive outlook from the CBO. One need only look at "An Act Providing Access to Affordable, Quality, Accountable Health Care" for context. That was Governor Mitt Romney's own health reform law for Massachusetts, now almost eight years old. It is called the Massachusetts Health Connector. This report from the Kaiser Family Foundation took a look at the Massachusetts law back in 2012. It's worth reading for a glimpse of where we may be headed with ACA. Here are the main points, taken from their Executive Summary:
  • Massachusetts succeeded in expanding coverage to nearly all state residents.
  • Residents have experienced gains in access to health care services.
  • The state continues to struggle with rising health care costs. 
There is a fourth point about changes required in order to comply with the Federal law. Presumably, Massachusetts has already gone through those changes by now. The first two points bode well for the national version of the law. The third point too seems out of date. Because this report preceded the national law, which we already know has driven down costs in general. At the time of the study, Massachusetts had hit 98% coverage. While they did go into their new health law with higher-than-national coverage numbers, 98% is incredibly good. What's more, the provisions in the Massachusetts law increased the quality of the coverage for all Bostonians, when compared to the disjointed health plans they previously had - seniors especially, for whom premiums were rising much much faster than for any other groups, prior to 2006.

Speaking of Kaiser, their Health Tracking Poll, from January 2014, is worth reading as well. With so many uninsured still unaware of what this law offers, it is clear that ACA is in need of some good, penetrating outreach.