Joan has a lovely post up today that notes the progress made on Obamacare signups through February, and the real numbers might be even better than what's being reported.
I'm a healthcare provider, so I get a monthly "Blue Alert" from Blue Cross Blue Shield of Tennessee, which ensures a large percentage of Tennessee's self-insured population. The March 2014 Blue Alert reports the following:
Understanding "On" and "Off" Marketplace Terminology
Group Number 127600 indicates members purchased coverage "On" the Marketplace. When you contact BlueCross to verify benefits and eligibility, you may see this represented as "On Exchange."
Group Number 129800 indicates members purchased coverage "Off" the Marketplace, meaning they purchased a traditional individual insurance plan from an independent source - not through the Marketplace. When you contact BlueCross to verify benefits and eligibility, you may see this represented as "Off Exchange."
As a self-insured and self-employed person, I am one of probably millions who did what a lot of people do when they buy refrigerators or cars. I shopped online, then talked to a broker/sales agent to sign up for a policy off the Exchange.
This means that there are probably a lot more people who are benefiting from the Marketplace, the Exchanges, and the choice and competition created by the Affordable Care Act. While states like Tennessee are currently dominated by one insurance company, which diminishes competition, we can see that insurance companies are motivated to do their own direct outreach to consumers. This is further reducing the overall number of uninsured people, and expanding access to affordable coverage.
Win. Win. Win.
I'm one of those folks who earns enough money to not qualify for a subsidy. I'm actually paying more, as a healthy white man in his thirties who doesn't have any pre-existing conditions. I pay slightly higher premiums (about $330 a month), and I have a higher deductible (around $2100 annually, which is slightly less than $200 per month). And I don't mind.
As an American, a healthcare provider, a systems therapist, and a strategic planner, I know that we need to work on providing what the Affordable Care Act provides. We need more access to basic and preventative care. We need to bend the cost curve while still reducing the out of pocket maximums and creating better rewards for hospitals and providers that successfully keep people healthy.
I still think we need to do more to improve our sick for profit healthcare system. There is much more still to be done when it comes to rewarding providers who have solid outcomes and keep people out of the Emergency Rooms, off of costly prescription drugs, and actively involved in the workforce. And we need to do much better when it comes to serving underserved populations, especially through Community Health Clinics and other primary and preventative care mechanisms.
I think we can celebrate the successes, which are likely even better than the numbers on the Exchanges would indicate. This is especially true in states like Tennessee which are actively working against the Exchanges, failing to expand Medicaid, and subject to an intense campaign of disinformation from Republican lawmakers and their corporate puppetmasters. In spite of intense opposition and kneejerk hatred, Obamacare is working.
But we need to see much more from Democratic lawmakers when it comes to improving healthcare outcomes, expanding coverage, and reducing the burden on healthcare consumers and primary care providers.