Obama's Spin on Health Insurance Misses Key Points

Greg A. Hood, MD

Disclosures

March 14, 2014

In This Article

Introduction

Greg A. Hood

During a riveting week in Washington, DC, President Obama sat down for an interview with WebMD consumer healthcare expert Lisa Zamosky. One day after his appearance on Funny or Die's show Between Two Ferns, Obama had a friendly chat with her, answering questions selected from thousands of submissions by WebMD viewers about the Affordable Care Act (ACA), or "Obamacare."

The WebMD interview was conducted less than a few weeks before the March 31, 2014, open enrollment deadline. That there are still so many people with so many questions at this late date underscores the uncertainty surrounding this mammoth piece of legislation and its associated regulations.

Does Federal and State Math Reflect Reality?

Healthcare insurance and expenses have long been the principle focus of sleepless nights around the kitchen table by families poring over their bills, trying to make ends meet. The financial hardships in the nation today remain palpable and enduring.

The President alluded to this reality when he said, "If they're really suffering some financial hardships, then they qualify for Medicaid." My state, Kentucky, was recently highlighted at the 2014 State of the Union address as overseeing one of the shining examples of Obamacare success, but our governor admitted on Meet the Press in October 2013 that 80% of Kentucky's enrollments have been in Medicaid.

Updated figures from kynect (the state exchange) on March 8, 2014, demonstrate that the ratio has not changed. Total number of ACA sign-ups is 280,468; qualified health plan (private insurance) enrollment is 57,090; Medicaid enrollment is 223,378. This ratio speaks to the financial plight of the enrollees. Ominously, it also demonstrates that there are not enough healthy patients enrolling for private insurance to adequately fund the ACA.

The Subsidies Decline

Speaking of the states, on the point of the federal match to the states, the President neglects to mention that the 100% federal match exists for the first 3 years only. After that, the subsidies are scheduled to be reduced. Given the federal government's indebtedness and budgetary practices, one might understand the concern on the part of governors who have elected not to depend on this federal promise as being more than merely political.

Indeed, if the national checkbook and purse strings are not addressed in a comprehensive fashion in the very near future, then headlines related to fiscal policy may well crowd healthcare news off the front pages entirely.

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