Answering consumers' questions about health reform

Published on
July 3, 2012

When you talk directly to consumers about the Supreme Court’s ruling on the Affordable Care Act, questions about how the law will play out politically, or what the ruling means for the legacy of Chief Justice Roberts don’t enter the conversation. Instead, people want to know how this affects them directly, what insurance will cost, what exactly the law promises to offer them and how they’ll go about signing up.

Naturally, the law’s future does depend in large part on politics; there have been and will continue to be plenty more written about that in the coming months, no doubt. Immediately following the court’s ruling, there have also been a number of well done stories addressing consumer questions. More of those, I think, are needed given how poorly the law is understood by the American public and how important it will be in the lives of millions of Americans. 

In the hours and days following the Supreme Court’s ruling, I worked to answer reader questions as part of my blogging activities as WebMD’s Health Insurance Navigator.  Below is a sample of the topics that most commonly came up following the court’s ruling, as well as over the course of the past year during which I responded to reader’s questions as the Health 411 columnist for the Los Angeles Times. 

I hope journalists interested in writing stories with a strong consumer focus will find this useful as they consider story ideas in the coming weeks. 

Costs: Topping the list of consumer concerns is the cost of insurance and what, if any impact, the law will have on premiums. If someone is financially strapped, will they be forced to buy a product they can’t afford or to pay a tax if they don’t buy insurance? 

People still need help understanding the subsidies that will be made available to them if they buy insurance through exchanges and how the court’s ruling impacted Medicaid expansion. What about people who make too much money to be exempt from the tax penalty but can’t afford insurance? 

Calculators like this one from Kaiser Family Foundation can be useful in helping people understand in a concrete way just what their costs may be. 

When it comes to the issue of money, people are also concerned about the financial cost of the law to the U.S. economy. How, specifically, will the law be paid for? Will it mean cuts to other benefits or programs upon which people rely? A basic explainer outlining those issues would be useful to consumers as well. 

Guaranteed coverage: Despite the fact that one of the central tenets of the health reform law is that insurers will no longer be able to deny people coverage or charge them more for a pre-existing health condition, I’m frequently asked whether people with medical conditions will now be eligible for coverage. People still don’t know and/or are skeptical that insurance will really be available to them starting in 2014.

Medicare: The distinction between how things operate for Medicare beneficiaries and people with private insurance isn’t clear to many consumers, which has led Medicare beneficiaries to ask if they now have to buy additional coverage or pay a tax (they don’t).

Many people are still unaware of the benefits already gained under the law (50% reduction on brand-name drugs in the “donut hole” and free preventive services, for example). 

Also, with payment reductions having been implemented for Medicare Advantage plans, increases in costs for high earners and efforts to reduce the growth of Medicare, many seniors are worried about the program being eroded under the law. They need help understanding those details and the direct impact on their care. 

Death Panel Myths: Finally, the notion of death panels, and the idea that some bureaucratic board will determine that people over the age of 65 can be excluded from treatment, is alive and well. Any information that helps to set the record straight about what the law does and doesn’t do is useful.

Small businesses: Small business owners need help understanding how they will be impacted by the law as well. Many are confused or totally unaware of tax credits made available to them, rules about  providing insurance to their workers and benefits of  the insurance exchanges. 

What is the size of the  small business community  in your area and what  are its  major concerns? How, specifically, will employees of small businesses be impacted? Will their benefits change? These questions and more are topof the agenda for people who own and work for small businesses.

And don’t forget to address those who are self-employed and buying insurance on their own. 

Work-based insurance: People want to know if their employer has the option of choosing to stop offering health insurance and just pay a fine. If this happens, how will they get health insurance? 

Also, many people are concerned about whether benefits they’ve already gained under the law (think adult kids up to 26 staying on their parents’ plans, for example) will remain in place. Will their coverage change, and if so, how? 

Insurance exchanges: Naturally, people are interested in knowing what’s happening in their state with regard to developing an insurance exchange. And few understand how they will operate (with good reason, perhaps, since they haven’t yet been built). Consumers are interested to know what an exchange will look like. Will there be a URL specific to their state? How will they know where to go when the time comes and who will help them?  How will they move through the site and what will they see? How will eligibility for subsidies be determined?   How many people in your state will qualify for subsidies? These and other questions are on consumers’ minds.

Insurers and hospitals: Talk with insurers and providers in your state or region and help readers understand how they fare under the law, what their concerns are and what changes they’re making that will directly impact consumers.  

If you live in a state resistant to expanding Medicaid, will insurers and hospitals be mounting a lobbying effort to make sure the expansion occurs? How many people in your state will be eligible for Medicaid and how will these folks be impacted if the state declines the expansion?


Illustration courtesy of Mike Licht,