LEXINGTON — Small business owners from throughout Kentucky voiced concerns with the full-scale implementation of the Patient Protection and Affordable Care Act Tuesday, while a breast cancer survivor said the current health care system leaves many with pre-existing conditions to fend for themselves.
Opponents and supporters of the federal health care law, commonly known as Obamacare, testified before the U.S. House of Representatives’ Subcommittee on Health, Employment, Labor and Pensions during a two-hour meeting at the Lexington Public Library.
Federal- and state-run health benefit exchanges will begin open enrollment Oct. 1, and the nonpartisan Congressional Budget Office expects 7 million Americans will buy insurance through the system next year. That number is projected to hit 27 million by 2018.
In Kentucky, 640,000 uninsured residents are expected to gain coverage through Obamacare — 332,000 through Kynect, the state’s health benefit exchange, and 308,000 through expanded Medicaid eligibility.
Unanswered questions about the law’s impact, though, have caused some nail biting among Kentucky small business owners.
John Humkey, president of the Lexington insurance agency Employee Benefit Associates, said the federal health care law creates “winners and losers” because younger, healthier insurance customers could pay more to subsidize older, unhealthier patients under the program.
“Individuals will lose significant motivation to live a healthier lifestyle or for an employer to implement wellness programs within their company,” Humkey said.
John McPhearson, chief executive officer of LectroDryer in Richmond, said he’s concerned that the four tiered plans offered through the health benefit exchanges would become “de facto” plans offered by private insurers, thus hampering his company’s ability to attract and retain employees.
“While some of the features of the plans, like lifetime maximums, are improvements, we feel the overall coverage will deteriorate for most of our employees,” he said. “Our current plan co-pays and prescription benefits are better than those of the platinum plan we have seen offered.”
McPhearson said reporting mandates in the new health care law would add two weeks of work to the company’s human resources manager per year. He also cited concerns that premiums would increase under Obamacare.
Debbie Basham, co-founder of the Southwest Breast Cancer Awareness Group in Louisville, vehemently defended the Affordable Care Act during remarks that were sometimes emotional.
A breast cancer survivor, Basham said her illness caused her provider to lock her out of her family’s plan.
“No insurer would cover me because of my pre-existing conditions,” she said, noting she eventually gained coverage through state-authorized Kentucky Access at a monthly price of $1,500.
She said she has seen many women with breast cancer reach a breaking point when their health coverage proved inadequate, was canceled or became too costly to maintain due to illness.
Based on insurance coverage alone, Basham said she could tell which women would live and which would die from breast cancer.
“It has been 17 years since I first beat breast cancer, and yet I still can’t find an insurance company that will sell me a policy,” she said. “But because of the Affordable Care Act, that will never again prevent me or the millions of women like me across our country from getting the coverage and the care needed.”
Some in the audience heckled those who spoke against Obamacare and cheered its defenders, causing U.S. Rep. Phil Roe, R-Tenn., to threaten to have them removed and possibly arrested.
The debate on Obamacare has largely fallen along partisan lines in Washington, D.C., with some congressional Republicans eyeing upcoming budget and debt ceiling deadlines as possible ways to derail the federal health care law. The prospect of defunding the program is unlikely in the Democrat-controlled U.S. Senate.
U.S. Rep. John Yarmuth, D-Louisville, supports the health care reform package but told reporters after the subcommittee meeting that the Affordable Care Act needs some tweaks, such as changing the 30-hour threshold for full-time employment status under the law. Fixing aspects legislatively could “dramatically improve” the law, he said.
But defunding Obamacare would cause the program to run inefficiently because the law includes a number of entitlements that aren’t appropriated by Congress.
“Just saying we’re not going to provide money to defund it doesn’t really alter many provisions of the law,” Yarmuth said.
U.S. Rep. Brett Guthrie, R-Bowling Green, said the nonpartisan Government Accountability Office in July warned that the health benefit exchanges would not be ready by October because government officials missed key deadlines. He also cited security concerns, saying testing was delayed until Sept. 30, one day before the exchanges are scheduled to be operational.
Freshman U.S. Rep. Andy Barr, R-Lexington, said the employer mandate in Obamacare, which was delayed by President Barack Obama until 2015, should be permanently shelved.
“I think that the majority of the American people want to see this stopped,” Barr told reporters. “They want to see an incremental step-by-step approach to health care reform. The American people want health care reform, but they don’t want the government in charge, and they certainly don’t want their costs to go up.”