What Your Health Insurance Card Doesn’t Say: Will Changes To The Affordable Care Act, Obamacare Impact You?

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For the silliest of reasons—what’s written on a plastic wallet card—many Americans are unaware that their health insurance coverage may be at risk if and when the Affordable Care Act, nicknamed Obamacare, is repealed —which the Trump administration has vowed.

Surprise! Your Own Health Insurance May Be At Risk

Everyone with health insurance has a health insurance card. But the health insurance cards that insurance providers issue don’t say “ACA,” or “Obamacare” or “U.S. Government.”

The actual card in your pocket just shows the name of the insurance provider with whom you’ve contracted —even if you obtained your insurance through one of the exchanges created by the Affordable Care Act.

Looking at the card, neither the patient nor the doctor’s office can tell whether a patient obtained insurance through the Affordable Care Act or not.

“Blue Cross Blue Shield of Michigan cards don’t indicate if they are under the ACA,” confirmed Helen Stojic, a company spokesperson.

In contrast, ID cards for Medicaid and Social Security (which offer direct government benefits, unlike the ACA) clearly say “Medicaid” and “Social Security.”

Twenty-Somethings At Risk

Several groups of people might be at risk.

Citizens in their 20s who have always been covered by their parents’ health insurance might not realize that they’ve been allowed to do so because the Affordable Care Act enabled them to stay on their parents’ plan until age 26.

“Some people get upset when their children reach age 26 and can’t stay on parents health insurance plan and they think it’s because of ACA,” said John E. McDonough, Professor of Public Health Practice in the Department of Health Policy & Management at the Harvard T.H. Chan School of Public Health. “They don’t realize it was the ACA that created the national requirement that children up to age 26 could stay on their parents’ plan in the first place. There was no such requirement prior to 2010.”

Describing a 26-year-old patient who had aged out of her parent’s plan, Manhattan-based gynecologist Dr. Joan Berman, Assistant Clinical Professor at Mount Sinai Hospital said, “she was supporting herself by working two part-time jobs which didn’t offer insurance, so her parents helped her sign up. The bills said ‘Aetna’ and the insurance card was identical to the one she had used before in my office. She was surprised to find out that I was not on her plan and didn’t really understand that it was from the exchange of the Affordable Care Act.”

Oh, and about those health insurance cards that don’t indicate that your plan is ACA-enabled? One might wonder why not. “There was concern that if the coverage was obtained through ACA, that it was identified as such, it could lead to differential treatment or stigmatization,” said professor McDonough. He would know; according to his Harvard bio, between 2008 and 2010 McDonough worked on the development and passage of the Affordable Care Act as a Senior Advisor on National Health Reform to the U.S. Senate Committee on Health, Education, Labor and Pensions.

Others who might not know that their health insurance is dependent on the ACA include spouses whose partners enrolled them and those who don’t remember well or who didn’t understand that the enrollment process.

Health Insurance By Any Name Is Confusing

Confusion cuts across all demographic groups, say the experts.

“There’s confusion about insurance across the board including among physicians,” said Jeffrey Abergel MD, a gastroenterologist practicing at Staten Island Hospital.

“I think we take as a given that there are many people confused about all manner of issues relating to the health care system. And this didn’t start with ACA,” said professor McDonough. “People have been confused about what is covered and not covered, going back decades.”

“We know there are many people who are not aware that they are eligible for Medicaid, ACA premium subsidies through the state exchange, or the 26-year-old provisions. Obamacare might have made it easier for some, but for others more confusing,” he said.

“I had one patient person tell me that they did not have Obamacare ― they were getting insurance through the Affordable Care Act,” said Dr. Berman. They are, of course, the same thing.

How To Find Out If Your Health Insurance Will Be Impacted By Obamacare Repeal

If you aren’t sure whether you are likely to be impacted by legislative changes to the Affordable Care Act, also known as Obamacare, you have two options:

  • Go to healthcare.gov. If you can’t figure it out, use the free 800 numbers to connect with experienced health insurance exerts who can help you understand your options.

  • Call your insurance carrier.

The Trump administration has not indicated what will replace the Affordable Care Act, which it has promised to repeal.

Who To Call To Complain

Health insurance policy changes —including repeal and replacement of ACA —will be structured by the U.S. Congress. So, to voice your opinion, make three calls: call your two U.S. Senators and the one member of the House of Representatives who represents you. (Find the telephone numbers of your Senators and Representatives online by state.)

National Implications For Coverage Loss

What happens if a large swath of the population loses their health insurance? The consequences can be severe for both individuals and the national healthcare bill.

Over 20 million Americans are insured under the ACA. “If many people lose health insurance they will avoid going to the doctor. So they don’t get preventive care,” Dr. Abergel said. “They may become mildly sick but ignore the symptoms, thinking, ‘lets see how this goes,’ and then end up in the emergency room if whatever they ignored becomes severe.”

The emergency room is the most expensive portal into the health care system. So, increased reliance on ER care for those who lose their ACA-enabled health insurance, or those for whom it is replaced with narrower insurance, will ratchet up national health care costs.