Healthcare Reform and You

Too many Americans are uninsured. This is why “The Affordable Care Act was passed by Congress and then signed into law by the President on March 23rd, 2010.” The Supreme Court of the United States upheld this decision on June 28th, 2012. (

Whether one ideologically agrees with the law that was passed and upheld or not, the changes are going into effect as of January 1st, 2014. In the Opinion Offered, Chief Justice Roberts stated, “In 2010, Congress enacted the Patient Protection and Affordable Care Act, 124 Stat. 119. The Act aims to increase the number of Americans covered by health insurance and decrease the cost of health care. The Act’s 10 titles stretch over 900 pages and contain hundreds of provisions. This case concerns constitutional challenges to two key provisions, commonly referred to as the individual mandate and the Medicaid expansion.”

“The individual mandate requires most Americans to maintain ‘minimum essential’ health insurance coverage…Beginning in 2014, those who do not comply with the mandate must make a ‘[s]hared responsibility payment’ to the Federal Government.”

Like it or not, it’s law now. So how does one move forward with a tentative understanding of a document 900 pages long about a topic as intricately difficult as the Insurance industry, and as interesting as watching grass grow? Truth is, mostly no one understands the intricacies of the document, including many from within the actual industry.

One of the things that most people fail to realize or understand is that simply being insured, does not mean that financial ruin cannot be achieved should the unexpected occur. As a matter of fact, according to a recent Harvard study, “60% of all U.S. bankruptcies are from medical bills. 77% had health insurance.”

So as one may be able to see, having health insurance is not the end-all, be-all when it comes to protecting one’s future. Take Ms. Dillard’s unique situation for example. Young, intelligent, and well educated, Ms. Dillard is the poster child of the formidability of Americana. Her aspirations to gain her MBA from an accredited institution are a testament to that fact. Ms. Dillard’s professional aspirations are however hampered by various financial obstacles, which were out of her control. When asked what is the most challenging obstacle in reaching her financial goals, she had this to say,

“Hard to pinpoint on thing because it is basically all intertwined. You work so hard to make it through college but then what good is a $45k/yr education when there are hardly any jobs out there that will allow for the insane amount of loans to pay off, balance the cost of living at the same time, yet be actively saving at the same time?”

“In my case I was forced to take a year off of school in ’09, and came back to almost a full ride, but then had no choice but to medically withdraw 3 semesters later because my back pain was unbearable. I could not get out of bed, but I needed to work full time for the insurance. It came down to school or work. Work prevailed because I knew I was looking at $150k surgery…”

Ms. Dillard’s situation, though unsettling, is not a unique one. Her insurance is very competitive and frankly, keeping her from going belly-up. But what most fail to grasp, is that as well as insurance may be protecting the livelihood and future of the masses, there are gaps where the true strife becomes evident as Ms. Dillard was so gracious to illuminate,

Insurance is great, but even if 90% of the bills are covered from them…10% is still an outstanding amount of money…It’s a never ending cycle of wanting so badly to succeed in life, but feeling like you have the weight of the world on your shoulders…I am 25 years old, no degree, an entry level no skill job, 2 spinal surgeries and no clue when I will ever really be able to start the life I expected to have when the train to success is perpetually being derailed due to funds.”

Being insured with a 10% deductible is obscenely generous as mostly anyone will tell you. And when the individual mandate is put into effect, that will undoubtedly be the highest level one may be able to be enrolled in. But there are gaps. There will always be gaps. That being the problem, what is the solution?

Being a benefits consultant, I am blessed with the ability to fill these gaps in a multitude of ways that will coincide with Healthcare Reform as we know it, without causing changes to one’s own insurance. As a matter of fact, if utilizing the strategies formulated, one may be able to scale back on the level of insurance they subsequently need, as the gap will be exponentially smaller with the benefits offered. You heard correctly, you would actually be able to save copious amounts of money as an enrolled individual, if you formulate the correct benefits strategy. We all know that insurance premiums are rising, and will continue to rise, particularly with the advent of a mandate. So don’t put off for tomorrow what you can achieve very easily today.

Ms. Dillard is one of the lucky ones. She had the foresight to be insured appropriately, and was able to have what needed to be done, be done by the best. Not everyone has been, or will be as lucky. For all those people, including Ms. Dillard, there is help; there are options.

To know what options you have, please feel free to follow this publication on twitter, and like the Facebook page. We can all breathe a little easier. Let me show you how.


One thought on “Healthcare Reform and You

  1. Pingback: Healthcare and Invincible Twenty-somethings | Vaginas and Video Games: Advice and Stuff for Gamers

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