By Gary Puckrein
Posted on Opposing Views
On October 16, the new Martin Luther King, Jr. memorial in Washington, D.C. will be commemorated.
More than anyone, Dr. King understood that minority equality was something more than a platonic ideal – it had to be nourished with vigor and vigilance.
That kind of attention to every piece of legislation, every government program- since the Civil Rights Act was enacted – has brought America to a better place.
The Patient Protection and Affordable Care Act assures the right of every American to have health insurance coverage and proper treatment by medical practitioners and institutions.
However, the devil is in the details: Every piece of legislation Congress enacts has to be implemented by the appropriate federal agency through a series of regulations that interprets the objectives of the legislation. In the case of the Patient Protection and Affordable Care Act, the Department of Health and Human Services (HHS) is charged with writing those regulations.
One of the most important features of the Patient Protection and Affordable Care Act is the community exchanges that will be set up in each state. Among other things, these exchanges will provide a “marketplace” of health insurers agreeing to work under the rules of the Act. HHS has made public for comment the first draft of regulations for the exchanges.
Overall, HHS has done a fine job, but there are several areas that need improvement. The most critical one is also one of the most fundamental:
how minority and low-income Americans will be able to obtain information and enroll in the right health insurance plan.
The proper way to think about this is through the way we shop today. We get information about products and services through the mail, TV and radio advertising, store windows and displays, catalogs and – the medium that is rapidly becoming the ubiquitous and reliable – the Internet.
For years in the health care arena, private firms have operated web sites that have enrolled millions of individuals, including large numbers of the uninsured, into quality health insurance plans. One can think of them in the same way as “Kayak” or “Travelocity” for travel-a one-stop “shop” to compare prices and features, and purchase what a person needs with minimal paperwork.
Such sites are convenient, usually hassle-free, and reliable because the information you enter through your computer is registered in the provider’s computer at the other end.
Unfortunately, HHS’s proposed regulations are ambiguous on whether low-income individuals would be limited in their ability to use these Internet sites to get qualified health insurance. What is clear is that higher income individuals will have unfettered access to use the internet or “wed-based entities” to access health insurance. Without clarification, low income Americans would be severely limited and the health care gap in this country would continue.
HHS needs to clarify its regulations on obtaining health insurance through the Internet. As with any organization undertaking a national effort, HHS needs to make sure information and enrollment can be obtained through the many ways Americans are used to, including the web. That is consistent with the goal of the legislation-to maximize the number of uninsured individuals enrolled in qualified health plans.
A recent article by David Hogberg in Investor’s Business Daily points out
that some Americans who buy health insurance through new federally run health insurance exchanges may not be able to access federal subsidies meant to help them afford insurance.
The Affordable Care Act instructs state governments to set up health exchanges, allowing the federal government to establish federal exchanges where states are unable to do so.
But unfortunately, as the law is currently written, Americans who are enrolled in federal exchanges may not be guaranteed access to the same subsidies that people enrolled in state programs will be offered.
We at the National Minority Quality Forum (NMQF) are concerned that unless this problem is fixed before the health exchanges take form in 2014, Americans in states with federally run exchanges may not be able to access the subsidies they need to afford health insurance. This could be a significant problem, as early indications are that a number of states may not establish exchanges, thereby leaving federal exchanges as the primary option for those in search of insurance.
The way in which newly insured Americans will access their insurance should not affect whether or not they qualify for subsidies they need to afford their care. Everyone should have access to federal subsidies whether they access their insurance through a state exchange, a federally run exchange, or through existing web based entities which are websites that allow people immediate access to health insurance.