By Kaye Burnet | The Duquesne Duke
More than 160,000 Pennsylvanians signed up for health insurance under the Affordable Care Act before enrollment closed Monday.
“The numbers in Pennsylvania are very positive,” Enroll America spokesperson Paydon Miller said.
According to Miller, Pennsylvania recorded the fourth highest enrollment in the country.
However, there are still over 1 million uninsured Pennsylvanians who are eligible to enroll under the ACA but have not done so, according to Miller.
President Barack Obama announced Tuesday that 7.1 million eligible Americans have registered under the ACA nationwide.
The government-sponsored plan covers what Miller referred to as “the 10 essential services,” which incorporate prescription drugs, emergency room visits, maternity care and “preventative services.” Preventative services include vaccinations, blood pressure tests, cancer screenings and certain contraceptives. The plan does not require any additional charges or copays for these services.
“So it creates a baseline of quality care that every Pennsylvanian and every American will be able to take advantage of,” Miller said.
According to Duquesne economics professor Antony Davies, the ACA has made several distinct changes to the United States health insurance market. Under the law, health insurance is now mandatory for every citizen. Citizens can keep their current insurance, apply for Medicare or Medicaid or purchase government-subsidized insurance through their state health insurance marketplace.
All insurance plans must cover certain procedures, give coverage to patients with pre-existing conditions and allow children to stay on their parents’ plans until they are 25 years old.
The ACA, also known as “Obamacare,” has been surrounded by controversy since being signed into law on March 23, 2010. It has clashed with the Catholic Church over the requirement that employers offer insurance plans that cover contraceptives, which the Church considers immoral.
It has also been accused of harming small businesses by forcing companies with more than 50 employees to offer health insurance plans.
When enrollment began in the fall of 2013, the healthcare.gov website experienced several technical difficulties, which still plague the website.
To raise support for the ACA, Obama pledged that Americans would be able to keep their old health insurance plans. However, according to a New York Times article from October, hundreds of thousands of Americans received notices from their health insurance companies that their plans were cancelled.
These cancelled plans did not meet the coverage standards created by Obamacare. Before the ACA, lower-income individuals could purchase simple, cheaper coverage plans. But now, “if I just wanted a bare-bones policy that would cover only in extreme cases for less money, I couldn’t buy it,” Davies said.
According to the New York Times, Obama’s response to these cancelled plans has been to argue that those Americans will receive better, if more expensive, coverage under the ACA.
Davies pointed out the flaws with this argument.
“Just because it’s better doesn’t mean the person is willing or able to pay the extra,” Davies said. “If that were true, that we always buy what’s better, we would all be driving Ferraris.”
Since health insurance is now mandatory, Miller said those who remain uninsured will be fined $95 or 1 percent of their income by the IRS in April 2015.
Davies said he is concerned that the fine does not provide enough incentive for young, healthy people to enroll. According to Davies, the ACA is partially “an attempt to shift costs onto the young people.” Since younger people are healthier on average, they pay more into health insurance systems than they get out of them. This brings down premium costs for the elderly and sick.
However, paying $95 is still cheaper than buying insurance for many young people. In Pennsylvania, only 29 percent of those who have signed up under the ACA are between the ages of 19 and 34, Miller said.
“We might have to use some different methods to reach young people,” Miller said.
Enroll America has worked with community colleges and student associations to try to register more youth by holding fairs and information sessions.
According to Davies, the pre-existing condition clause is also going to cause enrollment and finance issues for the government plan.
“The problem with the pre-existing condition rule is that it gives people the incentive to avoid buying insurance until they need it,” Davies said.
Miller also said 76 percent of those who have signed up have received some amount of federal financial assistance.
The next round of open enrollment for health insurance will begin Nov. 15, 2014 and end in Feb. 2015. Until then, the uninsured will have to face IRS fines, with a few exceptions.
“There has been a slight application extension for people who have already begun the process of enrolling,” Miller said.