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Health care reform advances, but questions remain

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WASHINGTON — The Obama administration is basking in what it sees as success with the initial implementation stage of the Affordable Care Act but remains mindful that challenges await the government’s health care reform efforts as they continue to evolve.

The National Association of Chain Drug Stores was among stakeholders and celebrity ACA supporters invited to a May 1 White House reception at which the president expressed his appreciation to such groups as NACDS for their work earlier in the year that contributed to smoothing the experience of Americans making the transition to exchange-based insurance plans.

NACDS and member companies worked with the administration to confront potential obstacles for the newly insured and for those adjusting to new health insruance coverage.

NACDS has emphasized the importance of putting patients first and helping them to understand the various aspects to the ACA’s implementation — an education effort similar to the initiative the trade organization put forth during the rollout of Medicare Part D.

“When it comes right down to it, patients will have questions about health care, and they will expect and hope that their pharmacies will have at least some of the answers,’’ wrote NACDS president and chief executive officer Steve Anderson in one column illustrating the industry’s role.

According to the White House, 8 million people have enrolled in private insurance plans in the federal and state marketplaces under the ACA. Importantly, it said that 35% of those who signed up in the initial open enrollment period were under 35; 28% are between ages 18 and 34 — a statistic short of the administration’s 40% target. That demographic group is considered crucial to limiting the costs of premiums and to offset the expense of insuring older and likely sicker enrollees.

The ACA mandates that every individual have health insurance or face a $95-a-year fine (or 1% of their annual income) for failing to comply. The law, often referred to as Obamacare, also calls for every insurance plan to cover 10 essential health benefits, including prescription drug costs. Insurers are now in the process of establishing rates for 2015.

After dealing with internal technology challenges that some — in many cases Republicans — charged demonstrated the failed planning of the ACA, the administration took action to move past those issues. But since then a new wrinkle has developed: People who had accounts on the enrollment website were warned to change their passwords because of the government’s vulnerability to the so-called Heartbleed Internet security flaw. The security hole, which is reported to exist on an expansive number of Web servers, had gone undetected for over two years.

Even supporters of the ACA concede that the campaign to sign up more enrollees won’t be much easier in the program’s second year. The Congressional Budget Office expects 13 million people will enroll in private insurance plans for 2015 using marketplaces created under the law. Even at that, significant numbers of uninsured Americans could be a reality. The Census Bureau says that in 2012 about 48 million people lacked health insurance and that few of them signed up this year.

And about 5.5 million of those who initially filed applications for insurance this year — and were informed that they were eligible — failed to complete the process, a figure that still baffles administration officials.


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