The Good, The Bad, The Ugly

Brace yourself, change is coming.  The next 12 months should prove to be the most disruptive in the history of the health care and health insurance market.  Rarely is change viewed positively through the windshield, the true test is how it looks through the rearview mirror.

The Good

As of January 1, 2014, health insurance companies will be required to accept all individual health insurance applications.  Whether the number is 10,000 or 10,000,000, there are many responsible Americans that for one reason or another have slipped through the cracks of our current system and found themselves unable to secure coverage, at any price. 

The Bad

Cost, cost, cost... it's that simple.  When ill, we want the newest pharmaceutical, the most revolutionary test, the most decorated physician, and the most luxurious facility.  Our pre-PPACA (Patient Protection and Affordable Care Act) health care system restricted access to (health insurance) coverage but all had access to care (usually through a largely inefficient ER).  Our post-PPACA health care system should provide all citizens both access to care and access to coverage (Guaranteed Issue).  Whether it's right or wrong is for you to decide but covering the uninsured is costly. 

We'll see just how much starting next year.  Industry analysts suggest we should buckle up for major premium price increases in 2014.  It is forecasted that the small groups in Missouri (less than 50 employees) should expect an average increase between 25-50% on their premiums while large employers will be a bit more insulated with expected increases ranging between 20-25% over 2013 pricing.  The channel poised to see the greatest fluctuation in pricing is the individual market.  Carriers in the individual market are expecting average premiums to double in 2014... yes, you may now re-read that sentence to confirm it suggests premium doubling. 

Our only hope is that the dramatic pricing fluctuations are short-term.  However, my fear is that we have failed to address the actual cost curve; if only we had that magical crystal ball to see the future.

The Ugly

The politics of health care is downright toxic.  The stalemate in Washington, D.C., is best illustrated through our country's health care policies.  It is old news that the Democrats passed the PPACA through a controversial process called reconciliation which did not require nor achieve one Republican vote.  The result has been a Republican blockade on all policies health care-related. 

If my memory from 7th grade U.S. Government class is correct, both parties are meant to "work together" to better our country.  Passionate disagreement and boisterous debate are extremely healthy and, yet, should lead to pragmatic negotiation and compromise.  If only the world was as simple as middle school. 

One fact that both sides of the aisle agree upon is that the PPACA legislation is imperfect.  Unfortunately, neither party is willing to concede on any detail and we are therefore spending energy, time, and money implementing an economy-altering piece of imperfect legislation.