DFW medical providers, patients, employers and insurers prepare for healthcare changes [Fort Worth Star-Telegram, Texas]
By Jim Fuquay and Mitch Mitchell, Fort Worth Star-Telegram, Texas | |
McClatchy-Tribune Information Services |
That was viewed as good news by many
What the
The healthcare law also dramatically expands
In the aftermath of the decision,
They'll likely rush to implement a health insurance exchange -- a state marketplace for the public to shop for deals on health insurance that the federal government will instate if
But
Republican consultants say they think
Here is a sampling of how some local people and parties believe that the ruling will affect them:
Young adults
"What happened is I got a much-needed dose of empathy," he said. "I did not realize how important it would be to have insurance until I was involved in a medical emergency."
A suspected drunken driver veered into his vehicle and two others while he returned from a soccer match
Vonder Haar is one of 3.1 million young adults allowed to remain on their parents' insurance plans because of the Affordable Care Act, according to the
"I would have liked to think I would have bought insurance," Vonder Haar said. "But to tell you the truth, I was in a pretty bad way when I got home. Fortunately, my family had enough money to cover me with health insurance or else I would have been buried under a mountain of hospital bills."
Vonder Haar's mother,
Employers
Since the 1950s,
But it's not easy. And even with Thursday's ruling, the future is cloudy.
With about 60 full-time employees, Gamtex falls under the healthcare law's requirement that employers offer health benefits or face an annual fine of
"I'd say it's going to take a good three years to determine the true impact" on employers the size of Gamtex, Gachman said. And that's not good, from his perspective, because it's freezing companies' plans.
"Ultimately, we need to get these tax matters to the point everybody knows what's going on," he said. "I'd tell our policymakers, 'If you want us to expand employment, add to the economy, this act is a hurdle.'
"Employers trying to run a responsible and healthy business for their employees need to figure out a way to pay for it," Gachman said. But now, he said, Gamtex's health benefits keep rising by double-digit percentage points each year, "and that is almost choking us to death."
The commitment costs the company about
He shares Gachman's view of rising health insurance costs.
"They say there are two guarantees in life: death and taxes. Well, there's a third one -- your healthcare premium goes up every year," he said. "The strain that puts on us, it's tougher and tougher." Employees
The requirement for employers with at least 50 workers has prompted speculation that many of them will drop benefits and pay the penalty instead. But a big
"We don't see a mad rush to drop health insurance in 2014," when the mandate takes effect,
When employers add up the cost of the
"Although the tax penalty may be cheaper for an employer that cannot afford to offer health insurance, I believe employers would choose to find health insurance plans that meet the minimum requirements than to pay tax penalties," Lopez said.
Medical providers
He pretty much got what he wanted.
"It allows us to continue to move forward," Berdan, chief operating officer of
One complication, Berdan said, is the court's limitation on the federal government's power to compel states to expand
"That will be a big challenge in states, including
He said it's too early to determine the financial impact on hospitals if
Public hospitals
Even without the law giving more people access to healthcare, clinics in the JPS Health Network and the emergency department at
The daily census in JPS emergency rooms doubled in two years, from 175 people to 350, he said.
Once the law ramps up, Earley said, more growth will come, forcing changes in how healthcare is delivered.
"If growth is our future, then the hospitals have to focus on preventive care and on getting people in the system early before they show up at emergency rooms when their care is most expensive and their conditions are more advanced," Earley said.
He said the federal and state governments must focus on expanding training programs to fill the positions needed to take care of the new people.
"We've got to make sure that we have the physicians here to accommodate that growth," Earley said.
Insurance agents
It didn't take a
Her commission on policies she sells has been roughly cut in half since the law was enacted.
"A lot of carriers didn't wait to go ahead and cut commissions," Sullivan said. "We used to get 20 percent. Now it's 10 percent."
The law requires health insurers to spend at least 80 to 85 percent of premiums on medical costs or quality-related expenses, leaving the rest for administration, including commissions. Those that fall short have to pay rebates or reduce premiums; last year, that amounted to
"We've had a lot of agencies consolidate. A lot of people who dabbled in the business got out. It just wasn't worth it," she said of the lower commissions. She sells mostly individual and small group policies.
Sullivan is also worried that other provisions of the law will boost rate increases, which are already running "in the low double digits."
For example, maximum allowable deductibles will be capped starting in 2014. She expects the difference to result in higher premiums and prefers that individual customers -- including herself -- get to make the call.
"I'm on a health savings account policy with a
That runs counter to a general trend in the market, she said, of consumers opting for "high-deductible, catastrophic plans, because healthcare has gotten so expensive."
Not surprisingly, she's not a fan of the law and would have preferred seeing it struck down.
Patients
Hughes, who has a progressive nerve disorder, has a
"It has a
She's not sure whether she will get a rebate from
It would certainly be welcome. Hughes said she cared for her ailing father for years and never accumulated enough time in the workforce to qualify for full
There's also
"I'm very fortunate" to have health insurance at all, she acknowledged.
Going on
"I think the doctors say, 'Here comes another
According to a poll by the
If an expanded government program drives away even more providers, "that puts the individual age 65 and older in a precarious spot," Hughes said. "What's going to be there for us?"
This report includes material from
Twitter: @jimfuquay
Twitter: @stcrime
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