the Affordable Care Act: a story told through television

There’s a humerous but extremely helpful story on boston.com this morning using the characters from eight television shows to explain the effects of the Affordable Care Act (aka Obamacare).  You can check out the article here, but I thought I’d list them out for you in case you didn’t want to travel to another website.

Show: Breaking Bad
Character: Walter White (played by Brian Cranston)
Problem: pre-existing condition (cancer)
Obamacare point explained: White could no longer be denied coverage for a pre-existing condition or could find coverage at a more affordable rate.  Additionally, Walter’s son also has cerebral palsy, a costly condition over the course of a person’s life.  Lifetime caps on insurance payments for chronic conditions are also going away.
 
Show: Modern Family
Character: Haley Dunphy (played by Sarah Hyland)
Problem: young adult without coverage
Obamacare point explained: Probably the provision that most people are familiar with, especially parents, young adults can be covered under their parents insurance plans until the age of 26.  Prior to passage of the ACA, young adults had one of the lowest rates of insurance of all age groups.
 
Show: Shameless
Character(s): The Gallaghers
Problem: unable to afford coverage, no employer sponsored insurance
Obamacare point explained: Without employer sponsored insurance, the Gallaghers would be unable to afford health insurance.  The Gallaghers would have two potential solutions – the show is set in Illinois which is expanding eligibility for Medicaid to 138% of the federal poverty limit.  If the Gallaghers happen to make more than that as a family, they may be eligible for subsidies to purchase insurance on the exchanges.  If the Gallaghers lived in a state that wasn’t expanding Medicaid, they may also have been eligible for a waiver to the individual mandate.
 
Show: The Newsroom
Character(s): the entire cast
Problem: higher premium costs, no out of pocket costs for preventative services
Obamacare point explained: With any legislation, there will be winners and losers.  People with employer-sponsored insurance will likely pay higher premiums as insurers have to cope with covering other individuals with pre-existing conditions and the removal of lifetime caps.  No one really knows how high those premiums will be, but even without the ACA, premiums would have risen as health care costs continue to grow.  The good news?  The cast would benefit from having preventative services covered with no out of pocket costs.
 
Show: 2 Broke Girls
Character: Max Black and Caroline Channing (played by Kat Dennings and Beth Behrs)
Problem: small business employer, individual mandate
Obamacare point explained: This one is actually a mixed bag. The law clearly stipulates that employers with more than 50 full time employees must provide health insurance.  Since the girls work at a diner with less than 50 employees, their employer isn’t required to purchase coverage.  Depending on their income, they may be eligible for Medicaid or for subsidies to purchase insurance on the exchanges.  If their employer happened to already be covering their insurance (like the cast of The Newsroom) they would benefit from having preventative services covered with no out of pocket costs, but their premiums would likely increase.  They could also chose to forgo insurance coverage and face the individual mandate penalty.
 
Show: The Workaholics
Character(s): entire cast
Problem: small business employer, individual mandate
Obamacare point explained: The cast of the Workaholics will likely face the same problems as the 2 Broke Girls, at least for next year.  In 2015, the Affordable Care Act requires employers with more than 50 full time employees to offer insurance coverage or pay a penalty.  It’s not clear what employers will do, as the cost of the penalty may end up being less than the cost of providing insurance for their employees.  Regardless, the cast would be uncovered for 2014 and would need to purchase coverage on the individual insurance exchanges (where they may be eligibile for subsidies) or face the penalty of the individual mandate.
 
Show: Hot in Cleveland
Character: Elka Ostrovsky (played by Betty White)
Problem: Medicare Part D “donut hole”
Obamacare point explained: Medicare beneficiaries are one of the clear winners with the Affordable Care Act.  Beneficiaries will see increased services in areas of preventative care with no out of pocked costs and a free annual wellness visit.  The law also slowly closes the Medicare Part D “donut hole”- passed by the Bush administration, the donut hole is a gap in prescription drug coverage that has left seniors paying full price for their drugs at certain spending levels.
 
Show: House of Cards
Character: Frank Underwood (played by Kevin Spacey)
Problem: health insurance marketplaces
Obamacare point explained: The Affordable Care Act requires Congress and staff to purchase insurance through the health insurance marketplaces.  But of course, nothing in Washington is ever that simple or easy, as the government will likely pick up the tab for members of Congress.  The fate of congressional staffers rests in the hands of individual lawmakers.
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About justgngr

the ramblings of a medical professional by day, judgmental ginger by night
This entry was posted in health policy, politics, television and tagged , , . Bookmark the permalink.

2 Responses to the Affordable Care Act: a story told through television

  1. BosGuy Blog says:

    How did I miss this. Love it.

    • justgngr says:

      you were probably still hungover from the chocolate chip cookie tasting yesterday. Glad you love it, now share it ;)

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