Page 9 - Delaware Medical Journal - March 2016
P. 9
PRESIDENT’S PAGE
DOROTHY M. MOORE, MD
MSD President Dorothy M. Moore, MD is an Ophthalmologist who practices at Delaware Eye MD Associates in Wilmington.
Charity Care
Did You Know...?
The Patient Protection and Affordable Care Act (PPACA), or Affordable Care Act (ACA), was signed into law March 23, 2010 – six years ago. Nicknamed “ObamaCare” its goal is to give Americans access to affordable health insurance and reduce the growth of health care spending. It requires all for all individual and small group plans starting in 2014. Large group plans are not required to, but already do, offer an and treat illness, what is essential
to keeping our citizens healthy. Key preventive services and annual wellness visits are offered without copays or coinsurance.
One issue is that the coverage of other services may not be met by the plan until the individual has met the deductible. We have seen an expansion of high deductible plans to help lower premium costs while not necessarily lowering
the total cost to the patient. You are all familiar with the metals: Bronze, Silver, Gold, and the Platinum plans. These are real dollars for real patients. For 2015, the out of pocket costs were $6,000 for an individual and $13,200 for a family.1 For 2016, those amounts raise to $6,850 for an individual and $13,700 for a family before marketplace subsidies.1
I do not know about you, but I have many patients who struggle with these costs for the deductibles, coinsurances, and copays and, furthermore, it does not include the premium costs. Those with an income less than 250 percent of
Federal Poverty Level qualify for cost sharing reduction subsidies.
One of the provisions of the ACA is
the expansion of Medicaid and the Children’s Health Insurance Program (CHIP) to cover many of the poorest citizens of our country based on their income and family size. Delaware is one of the 36 states to expand these programs as of January 2016.2 However, even with the availability of the Health Care Marketplace, Medicaid expansion, and individual and employer plans,
not all Delawareans have access or are eligible. It was recently estimated by
the Delaware Health Care Commission that there still exist 4,000 patients in Delaware who are ineligible. It has been estimated by the Congressional Budget approximately 11 percent of our population, will remain uninsured by 2024.3 The National Association of Free and Charitable Clinics (NAFC) noted
in 2014 that over the prior two years,
the nation’s 1,200 Free and Charitable Clinics saw a 40 percent increase in patient demand.4 It was hoped that the ACA would have all Americans gain access to coverage, but many individuals still face barriers to this. Unfortunately, there is still a need for alternate programs – charitable programs – to because they are non-citizens (or as a patient recently put it, “I do not have papers.”), are seeking or receiving an ACA hardship waiver, or simply choose despite the rising penalties not to sign up for coverage. They need a safety net.
Del Med J | March 2016 | Vol. 88 | No. 3
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