About three years ago, a relative of mine went to the emergency room at Aspen Valley Hospital with stroke-like symptoms. He did not have health insurance because of a pre-existing condition and he did not have the ability to pay for emergency health care, but the hospital treated him nevertheless. Following a battery of tests, he was discharged from the hospital with a hefty bill. The hospital gave him three choices: pay the bill immediately in a lump sum and get a 20% discount; pay the face amount of the bill in installments over a period of a year; or declare himself a charity case and owe nothing.
By law as in effect for many years, hospital emergency rooms have been obligated to treat patients regardless of ability to pay. It’s an expensive approach to caring for people, but the misnamed Affordable Care Act is going to have little impact, in my view, on this situation. The availability of insurance, which is the principal focus of the legislation, is no guarantee of accessibility to quality health care at an affordable price.
Despite the disastrous federal exchange rollout (and serious glitches in a number of state exchanges as well), people seeking health insurance through the exchanges will eventually succeed in obtaining coverage. Many of these will be eligible for taxpayer-funded subsidies to enable them to obtain insurance at low or no cost or they will be enrolled in Medicaid. The newly insured will then be faced with a narrow group of overburdened and under-compensated doctors and medical facilities. Good health care will continue to be elusive for people cast into this system. Utilization of hospital emergency rooms is unlikely to diminish.
At the same time, we’ve begun to see the harm done by the legislation to millions of Americans who had health insurance and doctors they liked. One of the first reactions of the Obama administration to the widespread and continuing cancelation of existing health insurance policies was to blame the insurance companies, despite the fact that the ACA effectively mandated the cancelations in order to herd individuals onto the new exchanges.
The administration then said that the canceled insurance policies were “substandard,” meaning that they did not contain all the bells and whistles required by the ACA. We’ve learned that some of that coverage includes maternity care and contraceptives for women well past their child-bearing years, pediatric benefits for childless couples, and other items that many insureds will never need or want. We’ve also learned that in most instances where insurance has been canceled, the only coverage through the exchanges - even if people can succeed in signing up - comes at higher premiums, larger deductibles and narrower networks of doctors and hospitals than what the insureds had under their existing policies.
The ACA offers the false hope that insurance coverage for the underserved in our communities will lead to quality and affordable care. Prior to the ACA, the same relative of mine who went to the Aspen Valley Hospital emergency room with stroke-like symptoms and had no insurance because of a pre-existing condition was after that episode able to obtain insurance through Cover Colorado, the state’s high risk pool for people with pre-existing conditions. As a result of the ACA, he recently received a notice from the state telling him that the high risk pool will terminate at the end of the year. He’s gone on the state exchange website and the only insurance available for him comes at significantly higher cost and with a higher deductible and he won’t be able to continue to see his doctor.
Frieda Wallison is Chair of the Pitkin County Republicans.
A graduate of Smith College and Harvard Law School, she practiced law for more than 30 years in New York City and Washington, D.C. as a partner in major law firms, before retiring for the good life in the Roaring Fork Valley. Beyond serving as Chair of the Pitkin County Republicans, Wallison is Republican Chair of the Third Congressional District in Colorado and a member of the Colorado Republican Party Executive Committee. She is also the President of the Snowmass/Capitol Creek Caucus and a member of Aspen Rotary. In her spare time, Wallison is a real estate developer in the mid-valley. She is married to Peter Wallison, the Arthur F. Burns Fellow in Financial Policy Studies at the American Enterprise Institute, and they are parents of three and grandparents of five.
You can contact her at firstname.lastname@example.org
Her personal Facebook page address is facebook.com/frieda.wallison
You can find out more about the Pitkin County Republicans here: http://pitkinpolitics.org/