How physicians can fight obstructivism over Obamacare

Soon, millions of uninsured Americans will be able to enroll in qualified private health insurance plans offered through their state marketplaces, with federal dollars to help them afford it.  The state marketplaces, created by the Affordable Care Act (Obamacare) will begin enrolling eligible people on October 1, and eligible persons will have until March 31 to sign up.   The coverage and subsidies for those who sign up will start on January 1, 2014.  As a result, an estimated 7 million uninsured people are expected to get health insurance next year.

Yet instead of this being a cause for celebration by Obamacare’s supporters, and perhaps grudging acceptance (if not acquiesce) by its foes, the political fight over the law’s future continues to rage.  The fight is fueled by opponents’ unrelenting crusade to do anything and everything they can think of to try to stop it.   Some members of Congress have threatened to shut down the federal government on September 30 if President Obama and Senate Democrats refuse to go along with their demand to defund the ACA.  Some interest groups are actively discouraging uninsured people from signing up for health insurance offered by the marketplaces.

Worst of all is the effort by some states to sabotage and even nullify Obamacare by enacting legal barriers to its implementation.  Several states have passed laws to try to make it impossible for federally-certified trained navigators to help people sign up for coverage.  At least one state has made it illegal for state and local employees to help people sign up for Obamacare.

Others have proposed arresting federal employees who try to implement it in their states, and several states have said they will refuse to enforce Obamacare provisions that make it illegal for insurance companies to turn down people with pre-existing conditions.

How crazy and wrong is this? The idea of state nullification of federal law was commonly used in Southern states in the 1960s to resist federal civil rights law.  Since then, the idea that states can nullify federal laws they disagree with had been soundly discredited, as a matter of both law and justice.  Until now, that is.

The reality is that neither the efforts in Congress to defund Obamacare, nor state laws to impede its implementation, will succeed.  The ACA is here to stay.  But such efforts will make it harder for people to sign up.   They will be the real victims of the efforts to defund, delay, obstruct and even nullify Obamacare.

What can be done?  I hope that physicians will stand up to the obstructivism over Obamacare by telling federal and state lawmakers that  is wrong and unjust to enact barriers on people signing up for coverage.  But there is something even more important that you can do, which is to help your patients sign up.  Reach out to your uninsured patients.  Explain to them that they may be able to get affordable coverage through the state marketplaces created by the ACA.  Point them in the right direction for help.

To make it as easy as possible for physicians to help their patients enroll, ACP recently launched a new web resource center on the ACA’s marketplaces, which includes  state-specific guides for physicians and patients on how to sign up for coverage.   By making such information available to your patients, physicians will not only do the right thing by their patients by helping them get affordable coverage, but they can also become the most effective counterweights to the agents of Obamacare obstructivism.

Bob Doherty is senior vice-president, governmental affairs and public policy, American College of Physicians and blogs at The ACP Advocate Blog.

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  • ErnieG

    Mr. Doherty- I guess you have not been reading the comments to your past posts. I am not sure this is the right place to rally the physician troops to the Obamacare cause. Your posts don’t really resonate with physicians (unless the goal is to irritate them).

  • LeoHolmMD

    How can physicians get involved in fighting obstructivism to patient care? Is there any physician organization that will help overturn insurance company precertifications and backdoor denial of care, hospital non-compete clauses and all the hassles HHS comes up with? Yes, let us stand up to obstructivism! Bloated fedral program to the rescue!

  • Tiredoc

    Next time you sign up to DJ a mosh pit, leave the Polka at home.

    May your best efforts come to the attention of those in authority over you.

  • buzzkillerjsmith

    Bob has had some foolish previous posts, and we physicians have rightly pilloried him for having no standing to comment on these matters. Now he’s telling us what we want to hear.

    Don’t buy it. It is a transparent attempt, at least to those of us who understand political behavior 101, at brown-nosing. Ignore his opinions.

  • morebuzzkills

    Nobody listened to physicians (or the public for that matter) when they raised issues with the ACA. Now physicians are supposed to blindly subscribe to something that many spoke out against? As for physicians doing the right thing, I’m sure most physicians won’t actually drive patients away from the exchanges if they ever get set up. But asking physicians to get behind something that many are opposed to would be like me asking you to support the marketing rights of tobacco companies just because they government allows them to exist. The ACA extends a broken, fragmented, and incredibly expensive health care system to many millions more people. It’s limp effort to target the cost of health care is by encouraging innovation (define that as you will)…namely through technology mandates that don’t facilitate the actual practice of medicine. I can’t see why any physician would have some issues with that…hmmm?

    Interestingly, I noticed that the other kevinmd buzzkiller made a comment that disappeared. What’s going on there?

    • ninguem

      What’s up with all the buzzkilling on this site?

  • ninguem

    And you work for the American College of Physicians?

    No wonder organized medicine membership is plummeting.

  • Anthony D

    When we all start losing our jobs,

    because OBUMMERcare costs employers too much …..

    who’s gonna pay for Obama’s “Gravy Train”?????

    No Job = No taxes = No more free stuff!

    Happy dumpster diving the next 3 Years!!

    • Alice Robertson

      LOL Three years? That’s optimistic….I don’t know that we can repeal this mess, or if it will be defunded. At this point it’s just on the lay away plan. And they need worker bees and Queen bees to pay for it so we can pay for the healthcare exchanges that even the poor can’t afford (the cheapest Metallic plan has a deductible of $3000 and it’s a 60/40 plan). Which just means those working get to pay for the expansion of Medicaid, but may very well be fined for not getting the healthcare on the exchange they can’t afford. The next election should be interesting….gosh…how much hope and change can we afford or handle here?

      • Alice Robertson

        Well the buzz today is that Cleveland Clinic (Ohio’s largest employer they say) needs to cut 3,000 employees because of Obamacare (the headline at yahoo is: Cleveland Clinic announces job cuts to prepare for Obamacare…but I haven’t read it. I am quoting from people who work there). I wonder if this will become a trend? So much in lost labor caused by this bill. Which I understand they are going full guns after in the morning in the House with a very serious challenge to defund.

        • querywoman

          There will new jobs to enroll created to enroll people in the Affordable Care Act.

      • querywoman

        The cheapest Metallic plan is absurd!

  • macbook

    Can someone briefly discuss pros/cons of obama care from the perspective of doctors vs society?

  • PoliticallyIncorrectMD

    Mr. Doherty – who exactly does the ACP represent ?

  • NormRx

    “The idea of state nullification of federal law was commonly used in
    Southern states in the 1960s to resist federal civil rights law.”

    Absolutely, just who do the states think they are. Nullification of federal law should only be used by Obama.

    • Mandy Miller

      “Checks and balances on Federal over-reach is totes over-rated!”
      … said no Founding Father, ever.

  • Tiredoc

    “Sire Obama, the physicians are revolting!”

    “Of course they’re revolting, they’re physicians!”

    (Apologies to MP)

  • Mandy Miller

    “Several states have passed laws to try to make it impossible for
    federally-certified trained navigators to help people sign up for

    Because Obama’s “navigators” don’t even have to pass the most basic of background screenings, duh!

    Do YOU want anonymous strangers with no background checks to have full and free access to all of YOUR private medical records, employment and banking details, and social security number?

  • GT

    The title of this article is “How physicians can fight obstructivism over Obamacare”.

    I’m sorry, but when did it become private physicians’ job to fight the Democrats’ battles for them?

    Why should a doctor’s office become a battleground for highly divisive partisan political issues?

    I am not interested in having my patients remember me as that doctor who strong-armed them into buying a lemon. If they ask me how to sign up for Obamacare, I’ll point them in the right direction, but I won’t violate my position of trust with my patients and become a salesman for a product I don’t have any faith in.

  • querywoman

    Tonight I had dinner with a friend who lives in the Bethseda-DC area. He has money, and he is currently paying around $600 month for COBRA.
    I chatted with him some about the new plans and said I’d research them for him. He has the money.

    So I came home and started googling. After getting past the nosy marketing questions for which I made an alibi, I started getting quotes: $200 to $500 month.
    And I’m sitting cross-legged in front of my computer wonder if these are the new Affordable Care Act plans???

    • Guest

      I doubt they were the new ACA-compliant plans. It’s hard to find out just what those are going to cost, at this point. I have a low-premium high-deductible ($8,000 out of pocket) “major medical” policy with USAA which I am really happy with, but that plan is not ACA-compliant because it does not cover pre-existing conditions, and I can’t find out through their member portal how much the new policies are going to cost. If you go there and work through “give me a quote”, it’s still listing very reasonably priced policies, but since they exclude pre existing conditions, I’m sure that once they’re no longer able to do that, prices will necessarily go up. But until then (my current policy doesn’t expire until May 2013), I have no idea how much to budget for health insurance for next year.

      • querywoman

        I’m with you that they are not ACA compliant policies. You seem to be one of those who also has enough money to buy insurance, but can’t budget due to the uncertainty.
        My Medicare D has been messed up since its inception, and I don’t see much point in complaining about the last truth I realized about it, because it’s only going to get worse.
        My personal hope is that the new administrative messes don’t interfere with the way my own medical care is currently delivered through Medicare, like causing problems in continuing to see my doctors.
        I don’t anticipate many of the lower income masses will actually buy into it. There are too many confusing new layers.

  • querywoman

    Been researching the Affordable Care Act. Many lower income will get advanced tax credits to cut their monthly insurance premium cost.
    I’ve worked for the IRS, so I know this will be reported at tax filing! What lunacy! Another area to make mistakes on it tax filing!
    The first year the penalties for not enrolling won’t be too bad. They will go up every year.
    But if an insurance “fine” cuts a tax refund by $100 to $700, there will be squawking then.
    I can’t believe how hard tax filing is for so many people. When I worked there, I got calls from people who lost their telephone e-filings and were terrified they’d have to do paper or online returns. Now the IRS got rid of phone filing.

  • doc99

    Mr. Doherty’s epistles make the convincing argument for leadership of Physicians’ organizations by physicians, not hangers on.

  • querywoman

    Last night I listened to a lower income employed person’s fears about the ACA. She gets some SS money, and she also works for a large discount store chain that doesn’t have very good insurance.
    She is currently getting insulin through a drug company program and is afraid that she won’t be able to do it in the future. Medicare D also forced people to switch from drug company programs to its own systems, and the states were not ready for the onslaught in order to set up assistance programs.

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