Selling Affordable Care

Now that the Supreme Court has upheld most of the Affordable Care Act, Congressional supporters and President Obama have one final opportunity to sell the health care reform to the American people. Although they worked hard and long to pass the bill against Republican opposition in Congress, they failed to communicate the Act’s many benefits to the American people.

Instead, they allowed purveyors of misinformation to have a heyday, misleading the public about sacry “death panels,” coverage of illegal immigrants and, of course, the un-Constitutionality of the mandate. How could insurance be imposed on Americans?

With this historic Supreme Court ruling, the reformers have one last chance to make their case, to get the message out about what Affordable Care (not Obamacare) does and does not contain. To fail again in clearly communicating could lead to a second round of misinformation and, worse, to unrelenting efforts to underfund the Act’s provisions and/or to repeal the bill entirely. On the other hand, if the public were to understand and begin to support the reform, or at least to embrace its general direction and goals, then many might see the urgency of voting for representatives and a president who has the “general welfare,” that is, the common good at heart.

Supporters should emphasize the most popular provisions:

• requires health coverage for those with pre-existing conditions

• prohibits annual or lifetime caps on coverage, or dropping coverage of the ill

• allows parents to extend family coverage to include children through age 26

• subsidizes indigent individuals and some small businesses, allowing them to negotiate volume discounts, the way large companies do.

Other points should also be quickly and forcefully made:

Is Affordable Care a tax increase? Look at it this way: taxpayers already pay thousands of dollars each year for all the uninsured people who seek routine medical care in an emergency room for want of insurance. The Affordable Care Act changes that scenario; see that these people have coverage and insurers would pay for routine care in a doctor’s office or clinic, not a hospital.

Why the mandate? So that the insurance pool is as large as possible, which helps to keep insurance premiums low. The mandate is necessary as long as the system is based on private insurance, which Affordable Care is (it is NOT socialized medicine or care provided by government doctors). Insurance companies rely on premiums from the healthy to offset costs of medical care for the ill; the bigger the pool the lower the costs.

Coverage for the Uninsured. Most Americans are and will continue to be insured through employer-provided plans. Those with pre-existing conditions can now apply for coverage through their employer plans. Others—individuals and small businesses–could choose to purchase insurance from a competitive exchange, selecting what best meets their needs and budget.

Illegal Immigrants. Illegal immigrants are excluded and so are some immigrants who cannot meet all the requirements.

Prevention. Many preventive services, like mammograms and other types of check-ups, would not require a co-pay under the reform. That is because preventing illness and disease is much less expensive than treating illness and disease. It makes long-term sense for the government to promote preventive medicine.

Lower Health Care Costs. The reform does cut waste in Medicare and elsewhere; it does look at reforming the way doctors are reimbursed, not per test prescribed, but for treatments; it does include some research and experimentation to test effective treatments; it does promote prevention and electronic record-keeping. But overall, the intent is to extend coverage. Lower health costs will have to come later, when the research results come in and the best treatment models are known.

There is much, much more included in the Affordable Care Act—all of it aimed to help the American public and to promote health. Maybe that is why the Catholic Health Association and the American Medical Association have supported it.

Surely, our communicator-in-chief and all Americans who support affordable care should explain Mr. Obama’s signature achievement—before others explain it away.