Obamacare. What I've Learned.

It’s a classic case of mercy vs. justice. Both sides are right, it simply falls to which side you want to be on.

It had only been a few months since our wedding (to my first husband) when I started feeling sick. A quick, private moment with a stick from a pink box showed me that what I was feeling would be a nine month ordeal. And then some.

My ex-husband, along with his dad and brothers, had started a family business framing houses. Together they found an insurance agent to set the family up on a group insurance policy through their company. The only thing was my pregnancy created a “pre-existing condition” that stopped the entire family from getting any type of health insurance at all. They proceeded with the setup of the policy without me, leaving me pregnant and uninsured. There was really no other way to do it.

Instead of taking care of my medical matters on my own with the help of insurance, I was forced to apply for Medicaid to make sure the needs of my pregnancy would be covered.

Years later, as news of “Obamacare” started to filter into our brains through news coverage, I sat with The Man and and tried to piece together what it would mean for him as an employer. The recession had been less than kind to many construction contractors on all sorts of levels and though my husband had maintained solid work in framing houses (a coincidence that both my husbands had been working for themselves in the house framing industry) while so many other companies went under around him, the pay was far from what it had been and long days of hard work were barely paying the overhead of his company and providing for our family. Some months it didn’t even do that and the savings account that had been built up slowly became depleted. The thought of having to add insurance for his employees was a thought that was almost too much for us to bear.

People have a tenancy to fear what they don’t understand. And I found that I feared the changes  that “Obamacare” was bringing on one hand, but could understand how good and decent people could use it on the other hand. As I’ve studied out “Obamacare” the best I can, it’s near impossible to read the actual bill, but in searching other websites, articles, and posts that explain the act in lay man’s terms I think I’ve finally reached a basic understanding of the goings on of “Obamacare,” even if it is a rudimentary understanding of it.



And what I’ve found is that I’m still torn between the two sides of the debate, though I can honestly say that I no longer fear it. I can see that there are pros and cons to both sides, and I can see that each side has a valid point to the stance they’re taking.

I feel that what people need to do is get a grip on what it is that Obamacare is going to mean for them before they decide how they feel about it. I’m going to be citing and paraphrasing heavily from two websites:
this one and this one. I’d like to try and sum up both sides and hopefully help those who struggled with an
understanding of what “Obamacare” means, and more ideally what does it mean to you personally. I
think it’s important for us to not be afraid of these “unknown” changes, but learn about them and
decide where we stand with them. There are a few basic changes, like the 10% tax placed on tanning
bed use and making restaurant chains like McDonald’s place calorie counts on their menus. The rest of
the changes get more personal.

The people that are for “Obamacare” are the people who call for mercy.
The points in red have already happened. The points in blue will take effect in 2014 or later.

• The FDA can approve more generic drugs.
• There are more rebates offered to Medicare users (the elderly) to make their medicines cheaper.
• Insurances can’t discriminate against disabilities or victims of abuse.
• There are no more “life time limits” on how much help a person can get from an insurance in a life time.
• Kids can be covered by their parent’s policy until the age of 26. This greatly helps those starving college students.
• There are no longer “pre-existing conditions” for children under the age of 19. I’ve seen too many kids who have had to take on grown up battles with types of cancer. That will no longer haunt them as they grow up and try to have insurance of their own.
• Insurers have less ability to change the amounts customers pay for their plans. There are limits on how high of an annual deductible insurers can charge customers.
• Insurers can no longer drop people when they become sick.
• A limit is placed on just how much of a percentage of money an insurer makes can be profit, to make sure they’re not price-gouging customers.
• No more “pre-existing conditions.” Period. For anyone.
• If you can’t afford insurance you may now be eligible for Medicaid, which will be expanded to be used by everyone up to 133% of the poverty line. There will also be government subsidies to help you pay for private insurance.
• Doctors’ pay will be determined by the quality of their care, not how many people they treat.
•  All health care plans must cover preventive care.

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The people that are against “Obamacare” are the people who call for justice.
Insurance is being made broader and cheaper, someone has to be picking up the bill somehow.

• Employers need to list the benefits they provide to employees on their tax forms. Though it came as a relief for my husband and me to learn a few more details about companies having to provide benefits. First, this doesn’t apply to businesses with fewer than 50 employees, and small businesses get some tax credits for two years to help pay for the benefits. After that, they’re on their own. Also this may cause hardship for companies who are wanting to grow in size.
• If you make over $200,000 a year your taxes went up .9%.
• If you can afford insurance but do not get it you will be charged a fee. This is the mandate that people are talking about. Basically, it’s a trade-off for the “pre-existing conditions” bit, saying that since insurers now have to cover you regardless of what you have, you can’t just wait to buy insurance until you get sick. Otherwise, no one would by insurance until they needed it. If you decide to opt out of buying insurance, you pay the fee instead, unless you opt out because you can’t afford it.
• There will be a cap of $2500 placed on FLEX plans. This affects everyone.
• A new tax will be placed on pharmaceutical companies.
• A new tax will be placed on the purchase of medical devices.
• A new tax will be placed on insurance companies based on their market share. Basically, the more of the market they control, the more they’ll get taxed.
• The bar will be raised for how much your medical expenses must cost before you can start deducting them from your taxes.

My source on reddit also explained, “It’s argued by those who want to keep their money for their own use that ‘Obamacare’ forces us to buy insurance. On the counter argument it’s said that it’s not telling people to buy a specific thing, just to have a specific type of thing. Like our tax money paying for police and firemen, it would now also pay to ensure doctors treat people for illness and injury.”

Had this been in place when I found myself first pregnant and uninsured I could have continued on with getting my own insurance policy to help me with the coverage of my pregnancy and the birth of my baby. I could have taken care of things on my own and not had to rely on “the system” to get me through it.

But on the flip side, a stymie has been put on future growth for The Man’s business. It only enlarges the overhead that he would have to cover with growth. This hardly seems fair for people who work hard and have made opportunity for themselves. Also, we use our FLEX plan to pay for orthodontics for The Circus. Now that our FLEX plan is being capped, we’ll have to come up with the money elsewhere. And the threat of a fee for not complying is never an easy pill to swallow.

I can see that there are pros and cons to both sides. And again I state that it seems to me that this is a classic case of mercy vs. justice. I could have used mercy in my pregnancy to be allowed to have insurance coverage, and we now look for justice as my husband works hard to grow his company and take care of his family. Neither side is wrong, per se, but I ask that before you chose which side you want to be on, at least make sure you understand why you’re choosing that side.

I encourage you to not just take my word for what I've learned about Obamacare, but to look into it yourself.  There's still so much I can learn about it, I just hope that I can help strike an interest in people to start figuring out.  Don't be put off by the size of the bill.  There are a lot of websites out there that are breaking it up and explaining it.  Look into them and form your own informed opinion.

But as Levar Burton says, "Of course, you don't have to take my word for it."