CHARLESTON, W.Va. -- Whether your presidential candidate won or lost, hardly anyone would deny that the 2012 campaign was too long, too expensive and too negative. Many issues were critical to the outcome, but even after the contentiousness of last summer's Supreme Court ruling, the Affordable Care Act (ACA), aka "Obamacare," apparently wasn't one of them.
Despite prior uncertainties, the Nov. 6 result virtually assures a future in which the ACA will remain the law of the land. As Rep. Phil Gingrey, R-Ga., put it, with an Obama victory, the ACA "sinks in, it gets roots, and it ain't going away."
Additionally, business forecaster Kiplinger Reports stated, "After the dust clears, nearly all states will expand their Medicaid programs, even though the Supreme Court recently ruled they can't be forced to make changes.... Diverse and powerful interests will win out in the end.... States will also find it difficult to walk away from Uncle Sam's money."
Even groups and individuals who for whatever reason don't like health-care reform realize that they now have to learn about it, if they don't want to miss opportunities. Sure, there will be winners and losers, but if you don't understand the law, you are much less likely to be a winner.
We know that "Obamacare," through major expansions in both public and private insurance in 2014, will cover nearly 30 million additional Americans (250,000 West Virginians) -- and will more highly regulate the health insurance industry, and begin the difficult transition to a higher-quality and more cost-effective health-care system. Yet, although the Massachusetts experiment provides some insight, we truly don't know what, if any, unintended consequences may arise when the law is fully implemented.
Being more specific, the AARP has reported that:
• The ACA is not going to bankrupt America. Rather, the Congressional Budget Office and the Joint Committee on Taxation, both nonpartisan entities, estimated that the law will actually reduce the national debt by $210 billion between 2012 and 2021.
• If you have no health insurance and can't afford it because of financial hardship (defined as when the cheapest acceptable plan exceeds 8 percent of your income), you will be exempt from the tax penalty. Even those who can afford it, but refuse to purchase it, will not be prosecuted. At worst, the IRS will give them a slightly smaller tax refund.
• Small business owners with less than 50 employees will not be required to offer health insurance. In fact, many small companies will be eligible for tax credits for insurance they already provide for their employees or subsequently elect to offer them.
To understand this complex and far-reaching piece of legislation, you need more than sound bites and punch lines. You must be aware of what new benefits are available and what new protections from insurance companies exist. You would be well-served to learn the basics of a health insurance exchange and how it might help individuals and small businesses. You should become acquainted with how Medicare and Medicaid will be changed by the ACA and how that might affect you personally. Finally, it is important to be aware of the facts about who realistically will be paying more taxes as well as who might be paying less.
Finding all this information in objective and easily digestible form is the real challenge. To get you started, I would suggest two reliable sources: Consumer Reports and West Virginians for Affordable Health Care. Consumer Reports has produced a pamphlet entitled "Health Reform: Seven Things You Need to Know," and WVAHC published the more comprehensive "The Affordable Care Act: Moving Forward in West Virginia." Both organizations also have excellent websites.
Just like Medicare and Social Security, this new cultural compact is a living document and almost certainly will be molded over time to become part of the fabric of our society. Furthermore, I'm convinced that, before we know it, we will wonder what all the fuss of the last three years was about.
Dr. Foster is a Charleston physician and state senator who focuses on health-care reform.