Gov. Jerry Brown’s eagerness for California to be the first state to implement the federal Affordable Care Act is being reported matter-of-factly by state newspapers. Completely absent is any big-picture explanation of what this will mean for health providers, companies and individuals in the Golden State. We’re less than a year away from the state implementing policies that give employers a financial incentive to stop providing health coverage and that give individuals, especially the young, an incentive to not buy health insurance. I wrote about these enormous looming headaches last week for the U-T San Diego editorial page:
• Beginning next Jan. 1, most companies with at least 50 full-time employees have to offer health insurance. But if they don’t, the fine is a pittance -– $2,000 per employee per year –- compared with the cost of providing health insurance. This creates a gigantic incentive for businesses to drop health coverage and push their employees toward getting insurance though government-run exchanges set up by Obamacare. If a struggling company could swiftly become a prosperous one by offloading 70 percent or more of the cost of providing health coverage, many thousands are going to do it. Some might face shareholder suits if they don’t.
• Also beginning next January, individuals without employer-provided health insurance will face fines under an income-based formula that mandates a penalty of less than $1,000 for those making under $40,000 a year. That $40,000 is significantly higher than the median household income for adults younger than 35, a subset that’s much healthier than older adults. All adults will have an incentive to only buy health insurance when they get sick; under Obamacare, they can no longer be rejected for pre-existing conditions. But these young, healthy adults will have a gigantic incentive.
Aren’t these angles, yunno, news? Not to most of the media in the Golden State, which focus on the logistical headaches of setting up the state health exchange in which people shop online for insurance. Why not focus on the larger problems with the Affordable Care Act? No idea, but my working theory is that not just sheep but incompetent sheep follow the herd.
Want an appointment? Tough luck
How bad is this refusal to say a discouraging word about Obamacare? Consider this angle, which should be a front-page story and which invariably surprises people when I mention it to them:
“California already has both shortages of family doctors in most regions and the nation’s oldest cohort of family doctors, with nearly 30 percent older than 60. If you add 2 million people to those being treated by these family physicians –- the minimum California increase expected in 2014 because of Obamacare -– what happens? It becomes far harder to get an appointment, and the headache gets progressively worse as more aging family doctors retire.”
This has gotten some coverage from the Golden State’s media. But given the importance of health care in everyone’s lives, one would think it would get far, far more coverage. We already have a shortage of family doctors in most parts of the state — and it’s a shortage that’s about to get far worse because of physician retirements and Obamacare.
Huge news? Of course.
But not to the sheep in the herd.