Gerber: Reform is here to stay

Sunday, September 15, 2013

photo Alison Gerber

Like it or not, America's health care overhaul is here.

Maybe you think it's the answer for millions of uninsured Americans; perhaps you view it as another subsidized program that will dig the United States deeper into debt. Maybe you see it as both.

You might call it the Affordable Care Act or Obamacare. Either way, it's a reality.

Starting Oct. 1, people can begin enrolling in the health insurance exchanges - called marketplaces - set up in each state so people can start shopping for health plans. Coverage begins Jan. 1.

Starting today, the Times Free Press will present stories that look at the issue and try to answer readers' questions about an enormously complex topic.

Business Editor Dave Flessner's page-one story today looks at how the Affordable Care Act may not be so affordable for the very poor. In fact, some very low-income Tennesseans are left out because the state chose not to expand its Medicaid program, something allowed under the ACA. (Gov. Bill Haslam hasn't totally rejected the expansion, but his alternative has not yet received approval). Meanwhile, people below the poverty line will not be eligible for subsidies to buy coverage in the exchanges, one of the plan's key methods for helping people afford insurance.

Turn to the Sunday Business section for an overview by The Associated Press of the new health care law. By the end of the month, insurers are expected to announce rates to participate in Tennessee and Georgia.

Between now and the end of the year, we'll bring readers stories on all angles of the ACA. Some of the stories will be by Times Free Press reporters and others from The Associated Press. But we'll do our best to give you the local or state angle in AP stories.

Certainly, there's plenty of opposition to the ACA in our readership area. In fact, in Tennessee, Georgia and Alabama, the federal government will run the markets because the states have refused to do so.

Regardless of your personal views of the ACA, the massive overhaul is at our doorstep. As a newspaper, it's our job to help explain it to our readers.

Short-term, we'll report on the ABCs of how you apply and whether you qualify; on how Tennessee, Georgia and Alabama are handling the law; on how residents here are impacted negatively and positively. We'll look at how the law will affect families, healthy 20-somethings, business owners, the self-employed, smokers, those with lifelong medical conditions, those on Medicare or Medicaid.

And we'll help you figure out the financial implications. While the marketplaces open up the option of health insurance to some segments - those who lack insurance through their jobs or those who have a pre-existing illness, for example - there's a cost. How much you pay for the insurance depends on your income and is tallied on a sliding scale.

We'll also explain the levels of coverage - bronze, silver, gold and platinum - and how they differ in terms of premiums, and out-of-pocket costs. We'll publish and timeline of how it'll all unfold, and a glossary of terms and ACA jargon

Long-term, we'll follow the impact of the law in this region. We'll examine the cost and look at whether the numbers of uninsured drops. Estimates say the nations' 50 million or so uninsured people could drop by 25 percent; we'll see if this hold true.

We'll also look at how our states' unwillingness to embrace the new law plays out compared to states such as Maryland, which was on the forefront of efforts to educate people about the law and enroll them. And we'll check on whether the so-called invincibles, those who are healthy and young, sign up. They're desperately needed in order to pay for unhealthy participants.

We'll also examine the affect on employers, hospitals, health care providers and insurers.

So as you make up your mind about Obamacare - a disaster or a panacea? - please let us know what you'd like to learn about this wide-ranging and very complicated law. We'd like to hear from you with your questions about the ACA, and we'd like to know what parts of it you think we should report on. Email health care reporter Kate Harrison with your comments, or drop an email to reader feedback@timesfreepress.com.

Alison Gerber is editor of the Chattanooga Times Free Press. Contact her at agerber@timesfreepress.com.