|By Patrick McCreless, The Anniston Star, Ala.|
|McClatchy-Tribune Information Services|
The Affordable Care Act requires states to either create their own health insurance exchanges or accept one created by the federal government. States must have plans in place for the exchanges by early 2013 and have them operational by 2014, according to federal deadlines.
"The state must enact a state-based exchange," Rep.
However, some state lawmakers have objected to certain provisions in the bill, such as the requirement that carriers must offer plans in every county of the state. Legislators are worried the provision could give a monopoly to
"This legislation is premature," Ardis said. "The federal government has yet to establish clear guidelines for a health insurance exchange."
Ardis added that the
However, a current provision in the bill states that if the
Exchange helps those in middle
For some health care industry experts, a health insurance exchange would mean lower health care costs and proper medical coverage for many uninsured Alabamians. Still others suspect such an exchange would simply shift health care costs elsewhere and not do much good.
According to statistics to from the
The state's health insurance exchange is designed to help those uninsured who make too much money to qualify for
"If a person's income is at the federal poverty level or very close to it, they'll be given the option of at least two years of federal subsidies and probably after that as well to help purchase a plan," Ellington said. "The intention of the financial assistance is to help bring people in who might not be able to afford insurance now."
"The biggest impact from that would be on the uninsured themselves," Garfield said.
Garfield said uninsured people tend to wait as long as possible before getting treatment, meaning they'll likely need to undergo more expensive procedures than had they sought help earlier.
"That can lead to bankruptcy, credit card debt ... and sometimes the uninsured can't pay and then that becomes uncompensated care that gets absorbed in various ways," Garfield said.
Emergency rooms pay the price of delay
One way that cost is absorbed is through hospital emergency rooms, which many uninsured people tend to use when they can no longer postpone treatment, Ellington said.
Ellington said keeping low-income people out of emergency rooms is one of Arise's priorities.
"By not just going to the ER and instead having a person track their health on a regular basis, they will probably get care faster and be treated earlier," Ellington said. "And without a medical history, people go into an ER as a blank slate and then the doctors have to do certain things that add to the cost."
"People who don't have health coverage utilize the ER for medical care and not only is that inappropriate, it creates a backlog for people who may need immediate care," Blackmon said. "And a lot of times, if the uninsured don't get primary care, they will come into the ER with conditions that can be life-threatening and that can end up costing a lot more."
Blackmon noted that hospitals are also concerned about what will happen if the
"There's no funding mechanism," McCormack said. "It all sounds good on paper. But when you put it into practice, it may not work the way it's supposed to work."
Star staff writer
(c)2012 The Anniston Star (Anniston, Ala.)
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