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Column: After slow start, health care law working

Published: Tuesday, March 25, 2014 1:15 a.m. CDT

The Patient Protection and Affordable Care Act (ACA) is the most significant overhaul of the U.S. health care system since the passage of Medicare and Medicaid in 1965.  Reducing the number of uninsured individuals, a major objective of the ACA, is something for which public health has long advocated.

To say that the initial implementation of the enrollment process was challenging would be an understatement. However, here on the front lines of assisting people to compare and select plans, and complete the enrollment process, the tide has changed significantly.

Thanks to the patience of the enrollees themselves and the trained in-person counselors assisting them, the 5 million mark has been met nationwide, and we have enrolled more than a quarter of a million people here in Illinois. These numbers are increasing daily.

Some of these enrollees have selected a plan through the marketplace, and others have been able to receive coverage through Medicaid expansion. Illinois will benefit from a large amount of incoming federal dollars, because the state opted to participate in the expansion. According to the Robert Wood Johnson Foundation, this will help to offset adverse impacts of Medicare and Medicaid payment cuts.

I’m an advocate for the ACA for reasons beyond my belief that all Americans deserve the peace of mind of health insurance coverage. From a public health perspective, it stands to reason that someone who lacks coverage does not see a physician regularly. They might put off seeking help for a problem until it has become much worse, and more difficult or costly to treat. A person lacking coverage also is more likely to seek care in the emergency department, a much more costly option than a doctor’s office. These emergency room visits by uninsured individuals cost all of us because we, in turn, pay higher costs for care.

There has been a wealth of misinformation about and, in some cases, misrepresentations of the ACA. I don’t know any ACA supporter who would claim it is perfect. There have been and will continue to be aspects to be worked through. But rather than continuing to fight over what is now law upheld by the Supreme Court, I wish everyone would work together to make it the best it can be for all of our citizens.  The health care system as it was simply could not be sustained.

I’ll never forget the day our department’s in-person counselor was finally able to successfully enroll a resident into a marketplace plan, after weeks of unsuccessful attempts with the website. Her exact words were, “It’s ridiculous how excited I am about this.” I assured her I was just as thrilled. Adding to the exhilaration was the fact that the resident she had assisted gave her a big hug and cried tears of joy for finally having coverage.

It is my hope that the number of people covered continues to grow; that over time public health improves and health care costs decrease due to prevention or early detection through regular care and screenings; and that one day we will look back and wonder what the fight over the ACA was all about.

For information on the marketplace or to schedule an appointment to look at your options, contact Rebecca at the Lee County Health Department, 815-284-3371.

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