|  Affordable Care Act

Affordable Care Act

Cheryl L. Holder, M.D.Cheryl_Holder-JWBMS-President
President
James Wilson Bridges, M.D. Medical Society

“Doctor Holder, please come to Room 2 now!” my nurse asked. Hearing the urgency in her voice, I immediately excused myself from the patient in Room 1 and rushed to the other room. Upon entering, my nurse reported the patient was a woman with hypertension who had been recently discharged from the hospital after treatment for a suspected heart attack.

Three days before, she ran out of the medications they had given her and could not afford the refills. This morning she awoke feeling weak with chest discomfort. Her blood pressure was 200/120 and pulse 100 beats per minute. I immediately checked her blood pressure and confirmed the elevated levels.

“Call 911,” I told the nurse, then ordered aspirin, nitroglycerin, oxygen and an EKG. Within minutes, the emergency medical technicians arrived, took over emergency care, and placed her onto the stretcher and left the clinic.

Unfortunately, this patient was just one of the approximately 46 million Americans that are uninsured and unable to easily access health care. As my colleagues and I have observed in recent years, encounters with uninsured patients waiting until the last possible moment to seek care are on the rise. For poor, unemployed adults like my patient, who cannot afford to buy insurance, yet are not disabled to qualify for Medicaid, the system is broken.

On March 23, 2010, President Obama signed into law the Affordable Care Act (ACA) to improve our current health care system and allow approximately 30 million uninsured Americans access to health insurance. In 2014, regardless of your age or preexisting (previously diagnosed) medical conditions, you will either be able to access health insurance from Medicaid (if you are considered poor) or buy it at an affordable price.

Can my patient survive until 2014? I can only pray. As I think about my patient’s survival, I am also concerned about the survival of the new law. On Nov. 14, 2011, the Supreme Court announced they will review challenges to the law and by next year will decide if the ACA remains. But too many of us don’t even know what we stand to lose if ACA is overturned.

The Affordable Care Act gives Americans the opportunity to obtain affordable health insurance regardless of age, gender, geographic location or (preexisting) medical conditions. In 2014, people considered poor will receive Medicaid, and those above the poverty line but not considered middle class will receive government assistance to purchase insurance for as little as $50 a month. People who are insured through their jobs have the option to keep their health plans or buy other affordable plans. Like car insurance, everyone would have to have health insurance or pay a fine when you file your taxes. All health plans must provide a minimum standard of benefits essential to keeping you healthy. Insurance companies can no longer drop you once you become ill and cannot limit how much money they pay per illness.

Right now, the Affordable Care Act has helped many people, such as 25-year-old nephew, to remain on their parents’ health insurance plan up to age 26. He breathed a huge sigh of relief when his recent emergency room visit was paid in full by his parents’ health plan. Other parts of the law in effect now allow the insured to get preventive health screens like mammograms and colonoscopies with zero co-pay, allow children under age 19 with preexisting medical conditions to obtain health insurance, and allow the elderly to receive more money to pay for their medications.

Once (and if) it is fully enacted in 2014, the Affordable Care Act contains additional benefits such as: 1) providing money to train more doctors and nurses, 2) requiring insurance companies to spend more on actual health care, 3) monitoring the quality of care, and 4) paying doctors and hospitals based on keeping people healthy and not just for the tests that they perform.

If the Affordable Care Act sounds perfect, why would anyone want to see it overturned? Some people believe it is unconstitutional to force us to buy health insurance, others believe it will be too expensive, and others believe there are other ways to fix the old system. The National Medical Association (NMA) overwhelmingly supports ACA because our society benefits greatly when we are healthy and productive. America saves money when we prevent disease and promote wellness. Health care for all is the first step to achieve good health for all. Why should we pay $50,000 for my patient to go to the Emergency Room and be hospitalized or possibly die instead of helping her afford her health care and live?

You can learn more about ACA by going to www.healthcare.gov or www.familiesusa.org/health-reform-central.

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