NEW PORT RICHEY — Jim Daly is in the same situation as a lot of folks when it comes to the changes to the health care landscape caused by Obamacare.
"My wife works at Target," he said. "And we have three kids. We'll be without health insurance." The Minneapolis-based retail giant recently announced it would stop providing health insurance for part-time workers to save money and because those workers could find a policy in the federal marketplace.
Daly, who works for insurance agent Richard Modglin, was fortunate because he had the knowledge to find a backup plan. But the folks who filled the conference room at Pasco-Hernando State College on Tuesday were in search of answers to basic questions about how the Affordable Care Act affects them, both as small-business owners and consumers of health care.
They listened patiently as a panel of four experts answered questions posed by a moderator as part of a seminar during the West Pasco Chamber of Commerce Business Development Week. The group was made up of Morton Plant North Bay Hospital administrator Michael Yungmann, Regional Medical Center Bayonet Point CEO Shayne George, insurance agent Modglin and accountant Todd Unbehagen.
Panel members said it's impossible to foresee all the ramifications of the law, but they did offer background and facts.
The main goal, George said, was to insure the nation's uninsured population.
"There are sticks and there are some carrots in there, too," he said.
The primary sticks were the requirements that everyone buys health insurance and that employers with more than 50 workers provide coverage, although the employer mandate was delayed until 2015. A carrot was a tax credit for small businesses (those that employ between 10 and 25 workers) that choose to provide insurance. Another, Modglin pointed out, is that companies can't turn down customers with previous health problems.
"That's a huge improvement whether you save money or not," he said. "People who have not been able to get insurance because of conditions like diabetes will now be able to buy it and won't have to stay with a particular company or business to keep that insurance."
Yungmann said some changes will affect how hospitals and doctors deliver care.
"We are going from a volume-based business to a value-based business," he said. "Hospitals are required to keep track of things like readmissions and are rewarded for having fewer of them. And patients will be surveyed on the quality of care they receive from doctors, with the results being public record."
"You can compare on them on the internet," George said.
Yungmann said North Bay has prepared for this by expanding its facilities and health care networks to better track patients' progress and keep them healthy.
Panelists were asked how the government would keep track of all the new data as well as those who have failed to sign up for insurance. Unbehagen said the IRS has beefed up its technology in recent years.
"We've seen an evolution in the IRS over the past five years," he said. "They will evolve to become more efficient."
Audience members asked whether people who didn't qualify for policies in the marketplace or for Medicaid, which Florida chose not to expand, would face penalties and whether the law amounts to socialized medicine. The panelists said the folks who fall the through the cracks on Medicaid, which in Pasco is estimated to be 12,000 to 16,000 residents, won't be penalized. But as Yungmann said, they "will put an increased burden on our health care system."
Another man wondered whether enough young healthy people would sign up, which is a critical component to keep the system afloat. Wasn't it counterproductive, he asked, to let them stay on their parents' policies until age 26? Modglin countered that higher family premiums due to the adult children being covered would still help the bottom line.
Cardiologist Rao Musunuru, one of the only doctors in the room, criticized the plan for being riddled with loopholes. Why didn't Congress "just have the backbone" to institute a single-payer plan now if that was the intent, he wondered.
"Unless you get that extra income, the system won't work," he said. "They made so many loopholes. You keep making exceptions for political favors the system won't work."