Affordable Care Act: A look at healthcare changes

September 27, 2013 5:32:51 AM PDT
There are just a few days before the open enrollment for medical coverage under the Affordable Care Act. Thousands of people across the Valley are expected to use the state-run exchange called Covered California to buy health insurance.

The patient rooms at Kaiser Permanente in Northeast Fresno could become busier as a hundreds, or even thousands, of new members enroll in health insurance under the affordable Care Act -- leaving current members wondering if their coverage will change.

Kaiser member and Fresno business-owner Mike Rolph believes health care reform will affect people who are already covered.

"I'm expecting some changes but I feel responsible to do my own research, understand them," said Rolph, "As a business owner and a patient both, ultimately I'm going to be asking how much is all of this going to cost?"

That's one of the biggest questions being asked by employers across the Valley who gathered at a health care reform seminar in North Fresno.

Fresno-based benefits consultant, Sean Borchardt, said it will take time to sort out the changes. "Right now it's a very chaotic time because there are so many questions out there. And there are more questions than answers."

Borchardt said under the health care mandate, government fees and taxes will hit companies, which will raise their cost of providing health insurance.

Those who are already insured could shop around for a better price through the state run exchange, Covered California. But since the new health care law says no one can be denied coverage because of a pre-existing condition, insurance providers could raise their rates.

"An insurance company looks at that and says, 'Okay, we have a whole bunch of people out there that we don't know what they look like and it's an unknown risk and if we're being mandated to cover that risk, we have to charge accordingly for that and that's going to be spread across everybody's premiums,'" said Borchardt.

Kaiser Senior Vice President Jeff Collins is hoping to avoid that. He said Kaiser members will see little or no change in their coverage. "We're going in with all 250 local physicians, 7,000 physicians in Northern California. So if you're coming into Kaiser through Covered California, it's no different than if you've been with Kaiser for the last 10 years.

But insurance analysts say members of other HMO's could see coverage plans eliminated or replaced with other plans.

Not all plans are created equal under Covered California. So health experts suggest, before you decide on a coverage provider, check your access to the doctors and services under that plan because the choices could be limited under the exchange.

Insurance experts predict we will see years of policy changes as the government pursues the goal of insuring almost every American.


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