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One-on-one with the Affordable Care Act

SPRING VALLEY — Dan Eiten, an in-person counselor with the Bureau and Putnam Counties Health Department, knows the ins and outs of the Affordable Care Act.

He is one of several who are hitting the streets and visiting public places to help educate citizens on what the new healthcare system offers and to bring assistance to people who once weren’t eligible for benefits now get enrolled for health coverage.

A huge change the ACA brings is the expanded coverage eligibility and income threshold, which will allow more people the opportunity to have health insurance.

Open enrollment began Oct. 1 and goes until March 31. Citizens who enroll between now and Dec. 15 are expected to have benefits and Medicaid by Jan 1. People who enroll later than Dec. 15 will still receive coverage, but could face a waiting period after Jan 1 for it to kick-in.

While there has been a lot of negative speculation about how the ACA will affect the healthcare system, Eiten believes people forget the ACA was brought along to address issues that were in dire need of fixing.

“It’s unfortunate that people seem to be more misinformed,” he said. “There’s too much bad information out there. In the hesitation, it seems like it has opened the door for all this misinformation speculation to kind of run wild.”

Eiten explained the reason the new system seems tough to understand and take in is because Americans are coming from a “horribly complex healthcare system.”

“You can’t change a system this complex and this big and not expect a few problems,” he said.

Eiten listed the three most urgent healthcare issues the ACA is expected to cure.

“The changes to Medicaid will help address the issue of uncompensated care,” he said. “Prior, a person had to be low income and have a qualifying condition such as disability, blindness, pregnancy, etc.”

Eiten said Medicaid reimbursement will increase to match Medicare, which will improve access to care for Medicaid recipients.

The second issue ACA will address is the out of control healthcare costs.

“Healthcare inflation is and has been two to three times regular inflation. Usually attributed to more healthcare resources being spent on aging baby boomers, people living longer and uncompensated care,” he said.

The third issue ACA will conquer is the excessive rules and regulations for insurance companies.

“They can’t deny a persons coverage or charge them more because of a pre-existing condition. New rules say that insurance companies must spend 80 to 85 percent of your premiums on healthcare, not keeping it for profit or promotion,” Eiten said.

Although the changes sound good, the transition to ACA won’t necessarily be an easy one and is even expected to take at least two years to see how it really manifests.

“Right now it’s a challenge. It’s even a challenge to be optimistic, because we’re coming from such a bad system,” Eiten said. “We spend about $8,500 per capita on healthcare. The next country on the list spends about $3,400 to $3,500, so we’re outspending per capital $5,000 and our health outcome in the rankings is 25 or 30. So that extra spending doesn’t translate to better care.”

As for now, a current challenge Eiten is coming face-to-face with is connecting with people of lower income or lower health literacy that don’t understand ACA will give them health coverage.

“They see my pamphlet and understand in the past they weren’t eligible for things like Medicaid,” he said. “But that’s all changing. We’re trying to overcome that thought. “

Citizens are strongly encouraged to use social media websites like Facebook in order to connect with resources like their local health department, to find out how they can get in touch and signed-up with the ACA information.

“We anticipate spending most of out time outside the office,” he said. “We will be taking our laptops to libraries, community centers, village halls, you name it. We’re going to be working hard to help people sign up within their community.”

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