DAVID ROSMAN: The Affordable Care Act is doing what it is meant to do

Thursday, April 3, 2014 | 6:00 a.m. CDT; updated 6:53 a.m. CDT, Wednesday, April 23, 2014

Allow me to make one bold statement from the start: Whether you are one of the 118,000 Missourians who purchased coverage as an individual under the Affordable Care Act, are insured through Medicaid or have group insurance, all of you are covered under “Obamacare.”

April 1 was the deadline to sign up for medical insurance through the Affordable Care Act. More than 7 million people had signed up by the end of the first enrollment period.

Yes, the system was down because of maintenance. Yes, it was again overloaded with those waiting until the last minute to sign up. But overall, the health care act is doing what it is meant to do — get health insurance for as many Americans through the private market or Medicaid as possible.

As a result, another 9 million individuals are newly covered under the expanded Medicaid program. It is unfortunate that Missouri legislators have yet to approve a Medicaid expansion for our own citizens.

The health care act is not as confusing as many have made it out to be. Even those dead set against it for political reasons seem to like many of the provisions.

Listening to "The Diane Rehm Show" on Tuesday, it was evident that at least the liberal listeners — even those who had problems with sign-up — thought having better coverage for a few extra dollars was a good thing.

In fact, 75 percent of Democrats and at least 30 percent of Republicans seem to agree that the health care act is a good thing.

Rehm's guests — Robert Wood Johnson Foundation senior policy adviser Susan Dentzer, Kaiser Health News senior correspondent Mary Agnes Carey and Washington Post White House correspondent Juliet Eilperin — answered a number of questions about the coverage.

I found the most confusing aspects concerned life changes. “What happens when my COBRA runs out?” “I am on my parents’ policy now, but turn 26 in September; do I have to buy insurance now?”

Of course, conservatives do not like anything about President Obama, especially the health care act. I would expect no less. Or more, depending on whether you are glass-half-full or half-empty person.

I am lucky. I did not have to go through the process of signing up for insurance. My current employer is kind enough to provide good coverage even without the health care act requirements.

But more and more employees must take up the burden of premiums the employer used to pay. Many companies stopped offering health insurance well before the implementation of the law.

I did discover that if I went through the health care act at my current level of income, my premiums would be almost identical to what I am paying now. The only advantage is that my current insurance has a lower deductible.

I believe there is more misinformation out there than accurate facts about Obamacare. Misinformation about participating doctors and cost, for example.

There are also problems. We do not know, at least at this point, how many people are now insured who were not insured before.

We don’t know how many young people and families are now insured or how many people have pre-existing conditions or how many are paying more than they did with their original insurance or how may are getting more coverage for the same or lower premiums.

Too many questions still need to be answered.

David Rosman is an editor, writer, professional speaker and college instructor in communications, ethics, business and politics. You can read more of his commentaries at and and New York Journal of

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Mark Foecking April 3, 2014 | 7:47 a.m.

The thing I notice about the ACA is how few people are actually affected. If you're on Medicare or have a compliant policy through your employer, you don't have to sign up. And I'm also not sure about "soaring premiums" either - I can replace my current policy with one from the exchanges for about 10% more. As far as I can tell it's identical with my MU policy, and from the same company.

We need to step back and chill for a while, and see how things shake out over the next year or two.


(Report Comment)
Ellis Smith April 3, 2014 | 7:47 a.m.

As Mark Foecking has previously suggested, it could be rational to observe full implementation of the provisions of Affordable Healthcare before making final judgement.

The present situation is something like being enticed to view a hustered performance at a carnival: no matter what the huckster says, it's not possible for the customer to evaluate the performance until actially viewed.

(Report Comment)
Ellis Smith April 3, 2014 | 8:07 a.m.

PS: Or, as the Speaker of the House is supposed to have famously said while the legislation was being debated, "Maybe we need to pass it in order to find out what's in it."

Whether that was said or not, I doubt the framers of our Constitution intended such. They might also have looked askance at the present practice of painting with extremely "broad brushes."

(Report Comment)
Michael Williams April 3, 2014 | 12:08 p.m.

Rosman says, "It is unfortunate that Missouri legislators have yet to approve a Medicaid expansion for our own citizens."

David, why in the hell do you persist in spouting the nonsense that our legislators are the problem here?

The citizens of this State made their wishes quite clear. We voted on two legislative initiatives, one which "approved a law proposed by the legislature that prohibited the government from penalizing citizens for refusing to buy health insurance." Second, we "approved a law prohibiting the state from setting up a health insurance exchange."***[references provided]

Do you NOT understand that a majority of citizens of this State have decided they want NO part of this takeover of medical health and NO part of this law. SCOTUS gave us...MISSOURI CITIZENS...the option of expanding medicaid in our state. I'm pretty sure our legislators ARE FOLLOWING OUR COLLECTIVE WISHES TO THE LETTER ON THIS!

You want to blame someone, blame us. Our elected officials are simply following our wishes.

And, I support them on this. So blame me, too. And, note that if our legislators decide to grant your wishes, I intend to work hard and do my part to FIRE THEIR COLLECTIVE REAR ENDS.

But, I understand your willingness to make the legislature the boogieman. Far easier to attack a few than say all citizens of this state are utter boobs.

Of course, that's kind of a chicken way to make your argument.

Try and be intellectually honest in your arguments....FOR ONCE! Start blaming the right people!



(Report Comment)
Michael Williams April 3, 2014 | 12:35 p.m.

Mark: "The thing I notice about the ACA is how few people are actually affected."

First, do you believe the notion that 30-40 million people in the US is without insurance? If so, that's a lot. And only 7.1 million signed up for ACA (who knows how many paid or if the young/old ratio is correct?) and...according to Rosman....9 million into state Medicaid. How many does that leave?

Second, we don't know how many will be affected once corporate mandates kick in. Your evaluation is premature.

Third, while Rosman seems forgiving of utter incompetence in others we place in charge (maybe he's used to it, or practices it himself), I'm not. The chaos is horrific, not only among families whose policies were cancelled but in companies who have to now deal with this crap.

Fourth, Rosman failed to ask, "How many have paid?" and "How many will continue to pay?"

Fifth, we got our first letter the other day from a physician joining MDVip. That's concierge medicine and it actually looks like a good thing. We're considering it...because we can afford it. If we don't sign up, this doctor is unavailable to us. Same thing you and Rosman. I believe concierge medicine will grow into larger networks as physicians see their hard-won incomes go down the tubes. Can you say, "Stratification of medical access?" You might want to ask for a pay raise, 'cause you might find yourself left out.

Sixth, Rosman states, "Misinformation about participating doctors and cost, for example."

Really? So, tell me Dave: Is it "misinformation" that our own Boone Hospital is NOT an in-network hospital when it comes to a person choosing an Anthem plan through the ACA?


Or any other BJC hospital, for that matter? Oh, yes, you can go there....but you are OUT-OF-NETWORK which will cost you about double for out-of-pocket expenses PLUS your deductable. Head for UMC instead. Or choose Coventry. Point is....your choices are NOW LIMITED in this community.

Misinformation, indeed.

(Report Comment)
Michael Williams April 3, 2014 | 12:45 p.m.

Finally, may wish to divert your "misinformation" criticism to something much more insidious: NO information.

And you can start with this newspaper.

In this community so dependent upon medical, insurance, and universities, our local Missourian has utterly failed in its responsibilities to we citizens that support it. The Trib has done little better. At first, I thought our local newshounds simply didn't report information because they didn't like what they would have to report.

Now I think they just don't know because they are incapable of understanding it***

Well....They damn well should understand. It's their job! Resign if you can't do it, because we deserve better!

***, or have their head in the sand because "It's tooooo hard".

(Report Comment)
Ellis Smith April 3, 2014 | 1:57 p.m.


A catroon by Horsey recently appeared in the Los Angeles Times and was re-published in USA Today this week. The cartoon panels show a donkey, hung upside down from a tree, suspended using a hangman's knot.

1st panel: "As you know, we Deomcrats believe in the basic GENEROSITY and FAIRNESS of the American people..."

2nd panel: "When we told them Obamacare would extend healthcare to EVERY AMERICAN CIZIZEN, they said that was the right thing to do..."

3rd panel: "And when we told them Obamacare would give folks with PRE-EXISTING CONDITIONS the chance to be insured, they said that was GREAT..."

4th panel: "Then they found out all that good stuff will cost a lot of MONEY, and that they will be PAYING for for it. That's when they strung me up."

Political cartoonists are my most favorite people. I grew up three blocks from one who won two Pulitzer Prizes. Google "Jay Norwood Darling" or "Ding' Darling."

(Report Comment)
Skip Yates April 4, 2014 | 12:32 p.m.

Michael: Peggy Noonan's "Catastrophy Like No Other" in the WSJ says it all. And, you would find no editorial similar, ever, in the Missourian.

(Report Comment)
Ellis Smith April 4, 2014 | 12:57 p.m.

I predict that in any case Obamacare will be MADE to work, whatever it takes! Here we have a President whose eight-year administration is going to historically rest seriously on this one act. I am not implying that Obama is the only President in that category.

Consider for example the Lincoln administration. The Civil War (or War Between the States, if you please) was such a traumatic event in our history that we tend to forget the Morrill Act (aka Land Grant College Act), Homestead Act, and enabling legislation to build Western (transcontinental) railroads were signed into law by Lincoln. Those alone would have earned Lincoln serious positive historical recognition.

(Report Comment)

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