Most Americans don’t understand the Patient Protection and Affordable Care Act — the so-called “Obamacare” legislation that will take effect in 2014 — and most don’t want to, a human resources specialist told local business people Thursday.
Instead, they simply want to go to the doctor or hospital, present their insurance cards and get a bill later for what insurance doesn’t cover, said Howard Blackburn, senior vice president and director of human resources for Community Trust Bank, Inc.
Blackburn discussed PPACA and what it will mean for businesses — and by extension, individuals — with members of the Grayson County Chamber of Commerce during a morning meeting. While most of the presentation was geared toward businesspeople, several points were raised that most people will need to know.
He started the presentation with some sobering numbers: the amount spent on health care in the United States has grown from $27.5 billion in 1960 to $2.5 trillion in 2011, and has gone from consuming 5.2 percent of our gross domestic product to 17.5 percent in the same time frame.
If health care costs continue to increase at the same pace — about 9 percent annually — they will consume our entire GDP by 2030, he said.
And a lot of that increase is unnecessary, Blackburn said, with $750 billion, or nearly one third, spent annually on unneeded tests mostly ordered by doctors as protection in case they are sued for malpractice.
Like many states, Kentucky can expect to see some major changes as PPACA is implemented, Blackburn warned. The state now has about 15,500 practicing physicians and 131 hospitals, with more than 50 of its 120 counties considered medically underserved by the federal government.
Of those physicians, 26 percent already don’t see Medicare and Medicaid patients, and 36 percent aren’t accepting any new patients, he said.
With estimates that roughly 500,000 or more currently uninsured Kentuckians being added to the coverage rolls under PPACA, there are real concerns who will treat these patients, Blackburn said. Nationwide, the new law, physicians not accepting Medicare and Medicaid patients, and the pending retirements of a sizable percentage of U.S. doctors will likely compel a switch to more treatment by nurse practitioners
Besides seeing a nurse practitioner more often, health care consumers can also expect to see more of an emphasis on wellness and disease prevention under the new law.
And, Blackburn cautioned, they can also expect to share more personal information with the government.
Starting this year, employers will have to report the cost of employees’ health care coverage on W-2 forms. That information will be included next month on forms issued by companies with 250 or more employees.
Americans will now have to tell the Internal Revenue Service who in their families is covered by insurance, how much those plans cost, whether they had an offer of employer-provided insurance, or whether they’re considered exempt from having to buy insurance.
By 2015 people could face individual penalties of $95 per year for not carrying insurance, jumping to $695 or 2.5 percent of their income — whichever is greater — by 2016.
The IRS currently says it won’t use levies, liens or criminal prosecution to enforce the paying of the “tax” the law calls for imposing on individuals without health care insurance. Instead, it will match data on individual tax returns with information from insurance companies, and send letters to the uninsured warning they could have their tax refunds docked if they fail to buy coverage.
Blackburn said current plans to pay for PPACA include generating $460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1million; $400 billion in cuts to Medicare and Medicaid; $20 billion in new fees on the makers of medical devices such as blood pressure monitors and canes; $13 billion from limiting people’s contributions to flexible spending accounts; penalties paid by individuals and employers who don’t obtain coverage; and a variety of new corporate taxes and fees.
He advised businesses and individuals to learn as much as possible about the law in coming months and to plan for the changes it will bring.