Baby Boomers' Health Insurance At Stake--- A Must READ!

Nov. 1, 2012, 6:00 a.m. EDT

Boomers’ health insurance at stake at the polls

Medicare isn’t the only major health program in play. The future of the “Obamacare” reforms could have a big financial impact for some older workers

By Elizabeth O'Brien  via http://www.marketwatch.com/story/boomers-health-insurance-at-stake-at-the-polls-2012-11-01

We’ve heard a lot this campaign season about proposed changes to Medicare, and indeed there are big differences in the presidential candidates’ visions for that program for anyone age 54 and under. But for some older Baby Boomers—particularly the self-employed and early retirees—possible changes under the Affordable Care Act, otherwise known as “Obamacare,” could be a much bigger deal.

 

And no matter who wins Nov. 6, how Obamacare is handled by the federal government and the states will have big implications for boomers’ health and financial security.

Republican challenger Mitt Romney has vowed to repeal the Affordable Care Act right away if he’s elected. But many experts say a Romney victory wouldn’t derail the law in its entirety, at least not right away. “Forget about the politics, certain provisions are popular,” said Gary Lauer, CEO of eHealth, an online health insurance provider.

For example, consumers have embraced the provision, already implemented, that lets children stay on their parents’ plans until age 26. And while it hasn’t taken effect yet, a separate provision that will prohibit insurers from denying coverage or charging more to adults with pre-existing conditions will likely prove equally popular, Lauer said. That element of the law is a major boon to hundreds of thousands of older folks who don’t have job-based coverage and are not yet eligible for Medicare—especially for those who currently struggle to get insurance because of pre-existing conditions.

According to Census Bureau data, 16.3% of people age 45-64 were uninsured in 2011, compared to 15.7% of Americans overall. And in 2008 (the most recent year surveyed), 29% of individuals age 60 to 64 who applied for non-group insurance were denied coverage based on their health status, according to the Kaiser Family Foundation.

But many analysts say that extending more insurance coverage to those older Boomers will depend heavily on another major element of the Affordable Care Act: The implementation of health insurance exchanges, currently slated to take effect at the beginning of 2014. Many states have already begun laying the groundwork for these exchanges. (If a state decides not to establish an exchange, under the law the federal government will step in and run it for them.)

In general, states run by Democratic governors have shown more commitment towards implementing the exchanges than their Republican counterparts, said Lauer, who has consulted with states on the technology infrastructure needed for the exchanges. Many Republicans have opposed the exchanges as a federal intrusion into their state operations, and leaders of some states have balked at the estimated cost of implementing the Affordable Care Act.

The exchanges will likely run more smoothly, at least initially, in the states that have gotten an earlier start in establishing them, experts say—some cite California and Maryland as examples. But whether “smoothly” also means “affordably” is a different question altogether. Gene Zaino, CEO of small business service provider MBO Partners, said his discussions with insurance companies and brokers suggest that insurance provided through the exchanges will be expensive, because those seeking coverage through them will be the sickest and most costly to insure.

Supporters of the exchanges counter that if effectively implemented, the individual mandate, which requires everyone--including healthy young people-- to either buy insurance or pay a fee, will balance out the system’s costs and risks. Stephen Shortell, professor of health policy and management at U.C. Berkeley, said the way the individual states structure the exchanges will factor into the cost for their residents, although it’s too early to predict exactly how.

As for Romney’s vow to repeal the law, doing so would be complicated. For starters, would need the cooperation of a majority of both houses of Congress. If that’s not possible, Romney could find other ways to impede the act’s implementation, such as denying funding under the federal budget.

Even then, there’s the chance that some of Obamacare would be left standing. There is some talk, for example, that under a Romney administration, the no-coverage-denial provision would stand—though, with no individual mandate or exchanges, coverage for older boomers would still be expensive. And Romney, who famously enacted a precursor to Obamacare while serving as governor of Massachusetts, has also been also a vocal proponent of states’ rights. As such, Shortell said, he’s more likely to support state-by-state differences in healthcare delivery—even if that means letting them implement elements of Obamacare.

The bottom line? No matter what happens on election day, the state where you live will likely play an increasingly important role in how you get health insurance and how much you pay for it.