Affordable Care Act Enrollment, the New March Madness? | Prairie Public Broadcasting

Affordable Care Act Enrollment, the New March Madness?

Mar 24, 2014

Monday (3/31) marks the deadline for uninsured individuals to sign-up for healthcare coverage under the Affordable Care Act. Leading up to the deadline, State Insurance Commissioner Adam Hamm says North Dakotans have not been strong to respond to the enrollment.

“…The numbers (from the federal government) as of the end of February are about 5,200 folks covered in plans in the North Dakota marketplace. When you actually go to the three companies selling plans and see who’s actually bought a plan and paid their first month’s premiums, the number drops to about 4,500.”

Neil Scharpe runs the Affordable Care Act Navigator project for North Dakota. He agrees with Hamm that numbers in the state are low… but --

“…If you take into account the number of people who have enrolled in the Medicaid expansion – which was part of the Affordable Care Act – it brings our numbers up and over the 10,000-area, which I think is fairly dramatic. And, again, if we are looking for people to access insurance who couldn’t afford it before, that is a pretty decent number.”

Scharpe encourages people to act soon to enroll. He says the closer we get to the deadline the busier things will be on the HEALTHCARE.GOV website. Those missing the deadline will have to wait until the next round of enrollment begins in November.

At the same time the Deputy Director of UND’s Center for Rural Health says he is disheartened by the way the Affordable Care Act has been rolled-out…

“I think as it has been done through the media, the average person’s understanding of what the Affordable Care Act is about – all it is about is something related to insurance.”

Brad Gibbens says when you start understanding the act, it’s a much bigger, more encompassing measure – but he says there’s a lot of things nuanced with statistics. Gibbens says along with giving people more choice in insurance coverage, there are also incentives for care providers and positive outcomes.

“…One of the things the Affordable Care Act is pushing is changing how we reimburse providers… Moving away from a strictly fee for service process to one that’s associated more with the outcome. It tends to be characterized as Value Over Volume. Right now, you and I and anyone else that goes into see a physician, whether we get well or not, that physician gets the same dollar amount. When you try to focus on value – there will always be “fee for service” -- but we want to try to pull out payments and that will mean as outcomes improve those providers, those health systems, those individual physicians will get a little more payment.”

Gibbens says another part of the act that is not fully understood is the strong focus on prevention. He says there are a number of provisions where healthcare providers can work with people BEFORE they get sick. He says with by putting prevention out front, we can reduce costs for the patient and the provider.