Affordable Care Act and the Alliance

Between September 30, 2013 and February 23, 2014 the Health Promotion Advisers at the Alliance spoke to 15,862 consumers about what the Affordable Care Act means to them.  There were many important lessons but the top ten were:

1. All consumers know that insurance is important to have.
2. The state you live in makes a huge difference.
3. Consumers like to know what are all of their options.
4. Technology is a great tool but it is not enough.
5. Mobile platforms are essential.  
6. If you have never had health insurance, or even if you did, the language of insurance is confusing.
7. Comparisons based solely on monthly cost is the wrong way to make a selection.
8. Co-pays should be more accurately described as "you pay"
9. Coverage for mental health needs to be upfront.  
10. Conversations with an informed and trusted source are key.

Uninsured ER Overcrowding . . . It’s a Myth

Perhaps the most frequent scapegoat for the crisis in our health system is the uninsured.  For decades the litany of attacks on the uninsured has been they are overcrowding emergency rooms and using scarce resources because they do not go in for regular ongoing care.  But buried in today’s newspapers, ensuring that it will get scant attention, was reporting on new research released by the Journal of the American Association (JAMA) that turns conventional wisdom on its head.

The study found that the uninsured are less likely than those with insurance to use emergency rooms.  In fact, while 17% of persons in our country are uninsured, they only represent between 10% to 15% of emergency room visits.

When you talk to people who are uninsured they tell you that they do everything they can to take care of themselves; after all not everyone gets sick leave.  They also avoid emergency rooms because they are already living at the edge and are concerned that the costs they incur from an emergency room visit will push them off the precipice to which they are clinging.

According to the JAMA study, insured patients represent the majority of increased use of emergency rooms over the past decade.   So while providing health insurance to those who cannot afford it is critical, it does not go far enough to make our health system what we know it should be.  Access is about more than having coverage.