Healthcare for All: How Obamacare Impacts Nursing

Nurses General Nursing

Published

  1. How has the ACA impacted your job, nursing in general, and healthcare overall?

    • 11
      The ACA has affected my job positively
    • 38
      The ACA has affected my job negatively
    • 22
      I'm unsure how the ACA has affected my job
    • 9
      The ACA has affected nurses in general positively
    • 32
      The ACA has affected nurses in general negatively
    • 19
      I'm unsure how the ACA has affected nurses in general
    • 16
      The ACA has affected the overall nature of healthcare positively
    • 42
      The ACA has affected the overall nature of healthcare negatively
    • 22
      I'm unsure how the ACA has affected the overall nature of healthcare

211 members have participated

2014 has certainly been a year for the history books as far as healthcare is concerned. With the implementation of the Affordable Care Act, (ACA) the very nature of the business of healthcare in the United States has fundamentally changed.

As enrollment in the colloquially-named "Obamacare" closed in the spring of this year, the White House reported around 8 million enrollees. Of those estimates, a high percentage of those were previously uninsured.

Now, whether you're impressed by, or skeptical of the Affordable Care Act, it goes without saying, the level at which Americans are receiving medical benefits has dramatically shifted.

So, we toss the question to you nurses; how has the rollout of the ACA affected your job? Has it affected your work at all? We'd like to hear your thoughts!

Please complete the poll by voting in each of the 3 areas - personal job, nurses in general, overall health care. Then please tell us how the ACA has affected you personally, nurses in general, and the nature of healthcare.

Specializes in Med Surg, Specialty.
But not everyone is eligible for those credits. You have to make a certain amount. In some states, if you make less than a certain amount, you are required to either apply for medicaid, or, if you choose to receive your health care from physicians/health plans of your choice, pay the full amount of the monthly premium, along with co-payments and deductibles. Without the credit the premium can be $600 a month for an individual, and the yearly deductible can be $6000.

I had insurance through healthcare.gov earlier this year and I was paying $489 for a family plan for a $6000 deductible plan, with no credits, and there were cheaper plans available.

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Specializes in Critical Care.
But not everyone is eligible for those credits. You have to make a certain amount. In some states, if you make less than a certain amount, you are required to either apply for medicaid, or, if you choose to receive your health care from physicians/health plans of your choice, pay the full amount of the monthly premium, along with co-payments and deductibles. Without the credit the premium can be $600 a month for an individual, and the yearly deductible can be $6000.

You could pay amounts similar before Obamacare, but I can't find anything like what you're describing now. Even in the most expensive county in the U.S. to be insured in, Summit county Colorado, a $2,000 deductible open network plan will cost you about $400/month (without subsidy). A PPO plan in that county with a $5,000 deductible is about $200/month.

If you look a state with more "average" coverage costs like Ohio, plans with a $2,000 deductible are about $225/month (without subsidy).

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As someone who woks in a surgical setting, all I see are tons of people who have these fantastic insurance plans that nobody will take.

I have no idea what good these plans are doing them, if they cant have surgery anywhere.

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Specializes in Critical Care.
As someone who woks in a surgical setting, all I see are tons of people who have these fantastic insurance plans that nobody will take.

I have no idea what good these plans are doing them, if they cant have surgery anywhere.

To become a licensed plan they typically need to meet minimum coverage requirements which includes participating facility requirements. Usually the cheaper the plan, the fewer participating facilities since that's why the plan is cheaper, the plan has limited it's coverage to providers and facilities that offer the lowest costs.

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It has caused me to have to spend twice as much time on Prior Auths and Precerts.

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Specializes in Med Surg, Specialty.
It has caused me to have to spend twice as much time on Prior Auths and Precerts.

How is Obamacare increasing your preauths time? Part of my job involves pre auths and the only difference I've noticed is that some of the plans have high prescription deductibles.

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Specializes in Med Surg, Specialty.
As someone who woks in a surgical setting, all I see are tons of people who have these fantastic insurance plans that nobody will take.

I have no idea what good these plans are doing them, if they cant have surgery anywhere.

Yes this is one of the frustrating things about private insurance, there are so many variables and caveats that will get people. If healthcare workers have a hard time understanding it all, the lay public will of course have a worse time of it. On the Healthcare.gov Marketplace, I saw two plans which looked exactly the same, but one was much cheaper than the other. I called Blue Cross and found out that the difference between the two was the network. How would I have known that though if I hadn't called? I looked up each of my providers and they happen to all be on the smaller network anyways so I went with the cheaper plan.

As I mentioned in a previous post, part of my job includes prior auths. Some pharmacy benefit managers have such specific requirements that unless you work with it you wouldn't even know to ask. For example, I had it happen with two different insurance plans where a patient was required to go to one specific pharmacy to get their medication... I don't mean a network of pharmacies, but one specific location. It took me forever to find out that information so I could help the patient. I could go on and on. I feel bad for patients who don't have a doctor or nurse 'in-the-know' about how to work through the insurance craziness. I've seen a lot of patients hurt by delayed treatment or exorbitant bills because they don't know how to navigate the system.

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My brother who could not afford health insurance before ACA now says he will pay the fine instead of sign up for the insurance offered by the ACA. It is more expensive than the fine will be. The same level of illness is still coming through the hospitals, I don't see the patients being more involved in their care which I thought would happen. I don't think we have seen the whole effects of the ACA yet. The levels for medicaid qualifications are less than before, pts can only have $2500.00 in assetts which is not very much. I have seen an increase in limits on DME supplies which does affect how the pt is recovering at home.

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Specializes in ER.

I'm a prime example of how the Obamacare doesn't work..at least not for people like me. I was laid off due to plant closure at the chemical plant. I made a good salary. I also received severance, bonus, and retention bonus for helping with the closure and staying on a little longer due to necessary skill sets I provided. These bonuses and severance payments were taxed at 40% lump sum tax. Once company paid COBRA ($664/mo) was over after 4 months, it was time to look at options. I decided to change careers and go back to school. So working was out. I checked out the Obamacare, and I was floored!!! They wanted me to pay $335/month PLUS $7,400 deductible...and the deductible would have to be paid before I could start making co-pay only payments. Even the short term insurance wouldn't work, because it doesn't count. So I decided to not pay them for insurance just so that I could avoid paying a lesser penalty. Penalty is only 2.5% which comes to a little over 2K.

Glad it works for some, but it doesn't make sense for me.

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