Program Nov. 2013 – The Affordable Care Act

Thursday, November 14, 2013

The Affordable Care Act: Promises, Possibilities and Pitfalls

Doug Neville, Dr. Johnetta Craig; Ryan Barker and Samantha Liss

Doug Neville, Dr. Johnetta Craig; Ryan Barker and Samantha Liss

Panel Discussion -Featuring:

Ryan Barker, Vice President, Health Policy, Missouri Foundation for Health
Doug Neville, Attorney and Manager of the Employee Benefits Practice Group, Greensfelder, Hemker and Gale
Johnetta Craig, MD, MBA, Chief Medical Officer, Family Care Health Centers
Moderator: Samantha Liss, Health Reporter, St. Louis Business Journal

In a wide-ranging discussion, panelists explained the Affordable Care Act’s history and problems, and provided vital information about its future. Mr. Barker said that because of problems with the ACA website, the rollout has been disappointing, especially in the 27 states that opted to use the federal marketplace instead of establishing their own. But in recent days, navigators (counselors who help with the application process) with the Cover Missouri coalition have begun to enroll people in insurance plans.*

In Missouri some low-income people whose incomes are too high for them to qualify for Medicaid will still be without health insurance because they are not be eligible for ACA insurance. The coverage gap was created because Missouri chose not to accept about $8 billion in federal money to expand Medicaid to cover more residents. Dr. Craig said people who fall into the gap can turn to Family Care Health Centers to find affordable care. These centers receive a federal subsidy to provide care on a sliding scale based on income.

The ACA is here to stay, and employers should plan now for 2014 changes in insurance plans, said Mr. Neville. Employers with 50 or more employees must make coverage available to their employees or pay a penalty, he said. Audience members asked insightful questions:

  • Why have people’s existing health plans been canceled? Mr. Barker explained that a majority of the canceled plans did not meet ACA coverage standards. Although President Obama has now approved the option to retain these “tin” plans for another year, it is thought that many insurance companies will not continue them, he said.
  • Why are so many people against the ACA when it offers so many benefits? Panelists blamed social media’s constant coverage of governmental dysfunction, misinformation disseminated by opponents, and the administration’s slowness in getting information out to the people.
  • Why did President Obama not get insurance companies out of the health system? The physician who posed this question said that for-profit insurers siphon off 20 cents of every health care dollar. Panelists replied that in our capitalistic country, a single-payer system would never have been passed.
  • Is there any chance that the Missouri legislature will pass Medicaid expansion in the future? Panelists were pessimistic about it passing, given that 24 of Missouri’s 34 senators are Republicans. They also pointed out that, although Senate Republicans have said they want to reform Medicaid before expanding it, they are unlikely to focus on major politically sensitive problems: (1) huge costs are incurred at the end of life, and (2) 60 percent of Medicaid dollars are spent on nursing home care, not on children and families. Despite these difficulties, panelists urged the audience to contact their legislators and to send personal stories demonstrating the need for Medicaid expansion to the Missouri Foundation for Health. One story has received national attention, Mr. Barker said. Stories also may be sent to Missouri Health Care for All.

*Where to get help to apply for insurance online, order paper application forms, find a navigator, or learn more about the ACA: visit, or call 1-800-318-2596. You may also talk to insurance agents or brokers, or navigators at Family Care Health Centers.