Insurance experts worry bigger problem looming with ACA

BATON ROUGE, LA (WAFB) - With the Affordable Care Act or ACA, came sweeping reforms for both healthcare and health insurance.  Experts with the Louisiana Healthcare Education Coalition say it's good for residents.

"From an overall wellness standpoint, I think you will see a healthier population because they're going to be doing things that they haven't been doing in the past," said LHEC Program Coordinator Doug Wilkinson.

More people than ever should be able to afford health insurance, and have better access to care. However, others fear that the new world of health care insurance will not be as affordable as some would hope.

"Even with the exchange that was promised, a low-cost insurance and even with the premium subsidies, if you look at the total picture, it's really costing the individual much more than they anticipated on," said insurance agent Thomas Sanders.

Sanders has been in the insurance business for more than 30 years.  These days he is on the road a lot trying to explain the ACA to other insurance agents. He says a flaw in the ACA is that there is little motivation for young, healthy uninsured citizens to sign up, because the penalty they will pay is still cheaper than a basic individual health insurance policy.

Without healthy people in the insurance pool, insurance companies cannot balance out the cost of clients with high medical expenses, something called spreading the risk.

"If you insure a pool of people and you are spending as much or more in premium out pays than what you are taking in, it's an unsustainable future without continuing to raise rates," said Sanders.

Another big aspect of the ACA is promoting preventative care, which Wilkinson says will lead to healthier residents.

"Draw the logical conclusion, if more people have insurance, then more people will utilize, which means more people will go to the doctor on a regular basis," said Wilkinson.

However, Sanders says that what is considered preventative can change.

"The ACA delivers that message a lot of preventative care, it's also delivers another statement:  At the discretion of the director of the health and human services, so at their discretion they can interpret how they will implement the ACA," said Sanders.

For help and resources on the ACA, follow the links below:

Louisiana Healthcare Education Coalition,

Affordable Care Act,

Health Agents for America,

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