Last week, Congress failed to repeal the Affordable Care Act or to replace it with a bill that would have upended Americans’ access to healthcare for the second time in the last few years. As noted on this blog, the American healthcare system has been in a never-ending state of upheaval for generations. Political “fixes” have been frequent and ineffective. The end result has been a series of unpleasant models that tried (unsuccessfully) to reverse the course of dramatically and exponentially increasing costs.
At the same time, politicians in Tallahassee have introduced a bill to upend the “No Fault” automobile insurance that has been in place in the State for generations. PIP – or “personal injury protection” – covers the first $10,000 (ten thousand dollars) of medical expenses and wage loss when Floridians are injured in motor vehicle accidents. Regardless of who is at fault. Hospitals, doctors, emergency responders and other health care providers rely on PIP for payment of their important services following car wrecks that occur everywhere, everyday throughout our State.
Florida health care delivery changed dramatically and repeatedly over the last thirty years. Those changes were caused by two primary factors: the market and the law. In some instances, market changes caused a reaction by the Legislature. In others, the Legislature initiated changes (usually at the direction of the insurance and health care industries that fund political campaigns).
Whatever the cause of the change, health care consumers and the Courts have been forced to adapt quickly (and repeatedly) to the ever-changing health care delivery systems forced upon us by the market and the Legislature.
As an example, thousands of sick and disadvantaged Florida children recently lost their health care as a result of the State’s refusal to accept the Medicaid expansion that came with the Affordable Care Act nationally. The refusal to get on board with the new health care plan has had disastrous effects in Florida for consumers and health care providers.
When Florida lurches from one healthcare system to another, patients across the State face consequential decisions. In the past, families wrestled with HMO’s and PPO’s (victims of the ever-changing landscape preferred by the market and legislatures) – with their restrictions on the ability to get timely referrals for specialist treatment when needed. In the recent past, there was also the problem of “pre-existing condition” exclusions in health insurance policies. If your health insurance carrier chose to deny payment of significant health expenses raising this exclusion, you were effectively uninsured. Millions of the sickest Floridians learned this lesson the hard way. It is no coincidence that uncovered medical expenses has been the number one cause of bankruptcy.
The Affordable Care Act was supposed to solve some of these problems. But with politics standing in the way, the consumer’s path to access is made no easier. To the contrary – new problems for the consumer arise out of the political dustups following in the wake of ‘Obamacare’. The framework within the ACA exists to reduce costs and increase access beyond the 40 million uninsured who have accessed insurance. The only question is whether our elected representatives will show the willingness to improve our lives rather than upending them (again).
If the legislators in Tallahassee are any indication, access to healthcare will continue on an uncertain and ever changing path – without cost reductions – set by political considerations rather than the needs of citizens. All in service of special interests trying to squeeze profit margins at the expense of Floridians.
In this uncertain and complex environment, make sure to hire a personal injury lawyer with knowledge and experience negotiating the ‘ins and outs’ of the changing healthcare landscape. It will make the difference between a full recovery and something less.