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Can Obamacare fix what ails American’s health care system?

9/6/2013, 4:16 p.m.

Still, in 2014, Obamacare will add millions of Americans to the Medicaid rolls.

Those who oppose Obamacare also note that the expansion of Medicaid will pose a staggering cost to taxpayers, who will have to shoulder an additional $640 billion in spending over the next decade. States already spend more on Medicaid than on education, and the program’s costs are rapidly squeezing out other public priorities.

“With respect to the impact of Obamacare on the poor, I think the law will have a negative impact. The U.S. Supreme Court decision ruled that the federal government cannot force the states to expand their Medicaid programs. As a result, the Congressional Budget Office reduced its estimate of the number of people who will be eligible for Medicaid. If you earn less than 133 percent of the Federal Poverty Level, you are Medicaid eligible,” said Pipes. “Instead of adding 18 million to Medicaid, the new CBO number is 12 million. But more important, those on Medicaid are already finding it hard to find doctors to treat them. Nearly one-third of doctors, according to the Centers for Disease Control are not accepting new Medicaid patients. And, doctors are reimbursed between 34 and 42 percent below what they receive for treating private patients. Hence, the poor will be hit hard by Obamacare.”

As far as the middle class population who do not have employer-based care, Pipes notes that a wait and see approach is best to see what will happen under the exchanges. Twenty-seven states are not setting up their own exchanges but have handed the task over to the federal government. Seven will be partnership exchanges.

“I think that a lot of middle class people are going to be shocked when they find out the cost of insurance coverage in the exchanges and also on the coverage,” said Pipes. She adds that the young and middle class will most likely pay $95 or 1 percent of income penalty starting Jan. 1 rather than purchasing insurance. And this will put pressure on insurance companies who have to cover older and sicker patients.

“I think ultimately that the insurance companies will not be able to survive and will be crowded out of the market,” she said.

Some of Obamacare benefits came into effect prior to the 2012 election and include: children being able to stay on their parents’ plans till age 26, free preventive care, the beginning of the end of lifetime limits on what an insurer has to pay in claims, and insurers having to cover children with pre-existing conditions. Reform Medicare and Medicaid.

Jill Hanken, a health attorney with the Virginia Poverty Law Center (VPLC) is hopeful of Obamacare’s ultimate outcome.

“This is a very exciting time for our country because millions of uninsured Americans will be able to sign up for affordable, quality health insurance, when open enrollment begins on October 1st. In Virginia, there are one million uninsured people,” said Hanken. “They are mostly hard working adults who aren’t offered or can’t afford health insurance from their jobs. About half of them will be able to shop for and purchase health insurance from Virginia’s new Health Insurance Marketplace and get tax credits to help pay for their premiums.