Top officials of insurance companies that serve the Guam and CNMI markets likened Obamacare to a package filled with more “tricks” than “treats” for its citizens, especially for those living in the nation's territories.
This was the sentiment shared by Calvo's plan administrator Frank Campillo, NetCare Insurance's Jerry Crisostomo, Staywell's Francis Santos, and TakeCare's Tim Ogata at a recent presentation to the NMI Chapter of the Society for Human Resource Management.
Insurance officials pointed out that the Patient Protection and Affordable Care Act and Reconciliation Act, more popularly known as Obamacare, contains 92 provisions of which 59 require implementation. So far 52 of these provisions have been implemented since 2010 while seven will be enforced in 2014.
In his presentation, Crisostomo disclosed that after examining the 3,300-page document, they believe that many provisions remain unclear if they are applicable to territories and are convinced that it will bring more healthcare challenges to territories in the long run.
“There are many unanswered questions and for me, this law has more tricks than treat. Many provisions are still unclear if they apply to the territories,” said Crisostomo.
The Act's greatest impact is not only how insurance firms will do business from now on, but on some uniformity and standards that would result in some costs, he added.
Under Obamacare, insurance firms are barred from increasing rates beyond 10 percent without the federal government's approval.
The Act, according to Crisostomo, imposes a “Cadillac Excise Tax” on plans with rich benefits.
PPACA has three basic goals that include expansion of insurance coverage by 2020, which targets 94 percent of all Americans to have insurance coverage; to regulate insurance industries; and control costs, particularly for Medicare. The Act has immediate and long-term goals that were also discussed during the presentation.
“At this point in time, we don't know if the long term [requirements] are also applicable to the territories,” Crisostomo said.
According to Staywell's Francis Santos, one of the biggest impact to territories is in the area of Medicaid. “We're not part of the U.S. when it comes to healthcare.based on this Act! But the good news is, our congressional leaders (Gregorio Sablan and Madeleine Bordallo) are listening to us,” Santos said.
Obamacare, Santos said, wants to raise the Medicaid client base to unmanageable levels. By 2014, the national poverty guideline level of 133 percent will take effect.
“What does this mean in real dollars? A single person making $44K a year can qualify for Medicaid or a family of four with $88K annual income will be covered by Medicaid. This will not work out here because we have to come up with our matching share and we-Guam and CNMI-are struggling to find matching funds,” said Santos.
Calvo's Campillo said: “The bottom line is that the federal government is about to assume massive new powers. These powers include designing insurance plans, telling people where they can go for coverage and how much insurers are allowed to charge. How then are doctors and hospitals suppose to practice medicine?”
Obamacare was signed into law in March 2009.