Affordable Care Act Murkier or Better?

The Obama administration said that it now will allow each state to specify the benefits provided by insurers.  In other words, the federal government will not define a single uniform set of “essential health benefits”.    This is summarized quite well in this NYT article but I will give you the high points here.  Both supporters and critics of the law don’t know what to do with this move.   They both have points.  The Democrats wanted one big uniform security blanket that covers almost everything.   This changes that.   The Republicans think more and more mandates (from interest groups and lawyers) will appear that will bog down each state’s benefits.  That will make it more expensive.   Wow, this is getting crazy.

Here is how the government is explaining this.  The new law lists 10 categories of “essential health benefits” that must be provided by insurance offered in the individual and small-group markets, starting in January 2014.  Each state would designate an existing health insurance plan as a benchmark and the benefits provided by that plan would be deemed essential.  Then all insurers would have to provide benefits of the same or greater value  See how simple it is?   Well, this certainly isn’t  a single-payer system or even socialized medicine.  It is some type of “Frankencare” trying to make everyone happy or unhappy equally.  I actually think they should throw in the ability for people to shop for health insurance across state lines.  Heck, if we are going to make thinks murkier let’s go all the way.  Maybe, just maybe, real competition will come from this and then prices could come down.  Or, more realistically, that list of 10 categories of essential health benefits will expand tenfold like everything else in the government and this thing will burst into flames.   This is going to be a very interesting policy to watch. 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]