Purchase photos

Speaker points out changes

10/16/2013

By KALEY CONNER

kconner@dailynews.net

Hopeless. Frustrated. Stressed.

Those are a few adjectives Americans often use to describe how they feel when faced with purchasing a health insurance policy, according to Sheldon Weisgrau, director of the Health Reform Resource Project in Topeka.

Weisgrau was in Hays on Tuesday afternoon for a public presentation explaining some of the key changes and goals set in the federal Affordable Care Act, often referred to as Obamacare.

"I think most people's knowledge of this law comes from listening to politicians over the past three years," Weisgrau said. "That is not the best way to get information."

The Health Reform Resource Project is funded by several state foundations, including Kansas Health Foundation.

Weisgrau made it clear up front he was not in Hays to discuss politics. Rather, he said, he wanted to help shed some light on why the law was created and how it will affect Kansans.

"I really do not care if you like this law or not," he said. "Despite the (debate) going on the past couple of weeks in Washington, D.C., this law is not going to be defunded; it's not going to be repealed."

More than 100 people attended the presentation in the Fort Hays State University Memorial Union. Many volunteers with the Foster Grandparents and Senior Companions programs were in attendance.

One of the questions Weisgrau hears often, he said, is how the new law will affect Medicare beneficiaries.

"Take a deep breath," Weisgrau told the seniors in attendance. "This hardly affects you at all. If you're on Medicare, relax. You don't have to do anything different than what you're doing."

A significant portion of his presentation dealt with the intentions behind crafting the massive, 906-page legislation. The main goals, he said, are to make health care more accessible, more affordable and of a better quality.

"If you don't remember anything else I say today, remember this," he said. "Despite anything else you hear politicians say, we do not have the best health care system in the world. Far from it."

Nationwide, 48 million people are uninsured, including 360,000 in Kansas. Ellis County statistics, he said, suggest 14 percent of residents do not have health insurance.

The surrounding counties, he said, referring to a map, have a significantly higher rate of uninsured residents. High uninsurance rates can affect entire communities -- that is one factor that often makes it more difficult for some regions to attract health care providers, he said.

A significant problem with the American health care system, he said, is the exorbitant cost of services. Health care costs have been rising at two to four times the rate of inflation and wage increases during the last several decades.

Despite the high cost, however, medical outcomes suggest steps need to be taken to increase the quality of care, he said.

"There's a dirty secret in the health care system we don't like to talk about, and that's the number of people who are actually harmed by using the health care industry in this country is astronomical."

It's estimated approximately 100,000 people die in the United States each year due to hospital acquired infections or other complications, he said.

A main goal of the ACA in coming years is to begin shifting the health care system so patients are paying for quality of health care services instead of frequency of health care services, Weisgrau said. That change already is being implemented in Medicare -- hospitals no longer receive payment if a patient is readmitted within 30 days.

"At least a portion of what providers get paid will rely on how well they did their service," he said. "Outcomes and quality are going to count."

Beginning Jan. 1, the law also mandates insurance companies stop denying coverage based on pre-existing health conditions. That could be good news for Teri Casper, Luray, who has been without insurance due to health problems and is hoping to purchase coverage through the new health marketplace.

"I just (want) to see if there's any that we can afford," she said.

The federal marketplace went live Oct. 1, and will offer new insurance options for individuals younger than 65 who are uninsured or would like to change their policy. The federal website Kansans can use to access the marketplace, www.healthcare.gov, has experienced a variety of technical problems since opening day.

The most effective way to purchase insurance at this time, Weisgrau said, is to call a national hotline at (800) 318-2569. Tax credits and subsidies are available to help families between 100 and 400 percent of federal poverty level purchase insurance.

The open enrollment period will continue through March 31.