IGS Conference Examines ObamaCare
In the 2008 presidential contest, candidate Barack Obama made healthcare reform a cornerstone issue of his campaign, and as president — despite fierce partisan opposition — was able to sign the Patient Protection and Affordable Care Act (better known as Obamacare) into law on March 23, 2010.
Now in 2014, a year after Obamacare’s first open enrollment period, the question that many are asking is: “Is Obamacare everything it was promised to be?” On October 8, IGS sponsored a half-day conference, entitled: Check Up for ObamaCare: Implementation and Prognosis, in the IGS library to explore and answer that question. Professor Will Dow (UC Berkeley School of Public Health) opened the conference with “A Status Report on the Affordable Care Act” that set the stage for understanding the policy issues, accomplishments, and future challenges associated with this landmark national health care reform legislation.
The first panel, moderated by Ann C. Keller, Associate Professor of Health Policy & Management at Berkeley, featured Katherine Schwartz (Harvard School of Public Health), Richard M. Scheffler (UC Berkeley School of Public Health), Jeffrey Rideout (Senior Medical Advisor of Covered California) and Gary Cohen (Gary Cohen Consulting). The four panelists discussed the ongoing implementation of Obamacare and how it has been changing the health insurance policies in California and the nation as a whole.
Scheffler summarized the situation, explaining that insurance carriers working with Covered California are now offering narrower networks that exclude high cost providers in an effort to reduce costs. While this could lead to a shift towards lower prices and increased benefits, Scheffler noted that the narrower networks make it more confusing and more difficult for consumers to find providers covered under their plans.
The second panel, "A View from the Trenches," was moderated by Lisa M. Suennen (Venture Valkyrie) and included L. Wade Rose (Vice President External and Government Relations of Dignity Health), David Douglas (CEO of Douglas Parking), and Ken Wood (Senior VP for Consumer & Senior Markets, Blue Shield of California).
Wood confirmed Scheffler’s comments by speaking about Blue Shield’s experience in rebuilding their provider networks. “We decided we wanted to approach all our providers, 65,000 providers, and see if they were willing to work with us recognizing the required lower reimbursement rate to get there... and we have 60% of our doctors now in a network.”
Douglas contributed a different perspective by describing how his company has benefited from Obamacare. Douglas Parking used to be one of the few parking companies to offer insurance to its employees, but with the new changes, they’ve been able to do away with company insurance policies and now reimburse most of their employees for their own policies. This reduced costs significantly and removed the hassle of paperwork and enrollment periods for the company while keeping it competitive.
In the last presentation of the conference, moderator John Ellwood (RWJF Scholars in Health Policy Research) discussed the public reception and its effects in politics with Mollyann Brodie, (Senior Vice President of the Henry J. Kaiser Family Foundation), Peter D. Hart (chairman emeritus of Peter D. Hart Research Associates) and Thomas E. Mann (senior fellow at the Brookings Institution).
The common theme of the third panel’s discussion and the conference as a whole was that there are very few people who truly understand the changes. When polled, according to Brodie it appears that public opinion has not changed much since the Affordable Care Act was signed into law four years ago. Hart continued this stream of thought saying that healthcare has taken a backseat in debates and that there are more pressing issues that will dominate national politics and the upcoming midterm elections. Mann described efforts by congressional Republicans to repeal Obamacare as a tactic to mobilize its base, influence swing voters, and keep the status of the ACA in doubt.
On moving forward in terms of dealing with healthcare, Rose of Dignity Health said that when he was helping to promote the ACA, one question they asked themselves was, “what is it in the American psyche that has prevented [America] from doing what we know should be done [in healthcare].” They polled Americans, asking, "How do you image health care?” And the general response received was “It’s the single physician with a bag and he’s got a white coat…. You open the bag and the guy’s got a stethoscope -- but he doesn’t have an MRI device, he doesn’t have gene therapy, he doesn’t have electronic medical records. So the reality is that the metaphorical image of health care has to change in order for people to get comfortable with change.”