"Obamacare": What ABCCR Pastors Need to Know

Terry RosellBy Tarris Rosell, Ph.D., D.Min.
Professor of Pastoral Theology--Ethics & Ministry Praxis

An HVAC technician repaired my heat pump the other day. He billed for 15 minutes, but spent another 45 minutes telling me his life story. This happens. 

"John" delves a bit into his political leanings, and initially seems unhappy about “Obamacare.” Then he mentions his own considerable and longstanding health issues. He says that as of this very day, November 1st, he has insurance coverage "for the first time in 8 or 9 years!" All this while John had been working full-time. But recently, his employer had fallen under a mandate to provide employees an insurance benefit. I suggest that maybe Obamacare is working for him after all. John is begrudging about that fact, but doesn't deny it.

Indeed, it is working for John, if not yet for all.

The 2010 federal legislation known as the Patient Protection and Affordable Care Act (PPACA) has generated more political drama and debate than anything coming from Washington in recent memory. We could speculate on causes, but more helpful to pastors may be a brief response to this question: What do we need to know about "Obamacare”? Here is my short list.

·      Currently uninsured or under-insured congregants and pastors have more opportunities to get new or better coverage. For some, this is on account of PPACA prohibition on insurers from engaging in the practice of denying you coverage for pre-existing conditions. I know more than one pastor and spouse who are feeling better protected already. 

·      Some millions of other uninsured folk will continue to slip through the cracks and remain uninsured in 2014. This is, however, due mostly to state legislatures like ours being unwilling to expand Medicaid eligibility in conjunction with the PPACA rollout. What about those adult congregants, or pastors, who are too poor to afford monthly insurance premiums and yet are not poor enough, young or old enough, or disabled so as to qualify for public insurance like Medicaid or Medicare? They are still out of luck in places like Kansas and Missouri. Some politicians say the Church should do more to take care of the uninsured in times of need? Should we? Will Christian hospitals and providers do so? And how? No one knows what will happen. 

·      As of this writing, the federally run insurance marketplace online sign up system for state health exchange policies has been a disappointing frustration for all but a few new enrollees. An IT friend says it is likely because the rollout was not staged at a rate that the government servers could handle. Mistake. Anyway, major repair efforts are underway by a sheepish administration. I'm guessing their contractors eventually make good on their promises, and that IT fixes are forthcoming. In the meantime, snail mail, in-person, and telephone enrollment options reportedly have been implemented. 

·      The PPACA never did include anything like a "death panel." That was an unfortunate miscreation of a former presidential candidate's Facebook page, posted disingenuously in the fervor of 2008 campaigning. I saved it as a JPEG file, if anyone is interested. Apparently, many people are interested. Harris and other national polls have indicated that nearly half of Americans were led to believe the falsehood that Obamacare involves “death panels” aimed at deciding the fate of elderly persons and those with disabilities. [See http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-september-2013/, http://thehill.com/blogs/healthwatch/health-reform-implementation/258753-poll-four-in-10-believe-in-health-law-death-panels.] ABCCR pastors should know and propagate the truth of that matter, and all others pertaining to the PPACA.

About four years ago I received a call from a middle-aged farmer out in western Kansas. He was searching desperately for anyone who could help. "Billy" had found my name associated with "ethics" in a Google search, and thought his case had something to do with what I do, and maybe I could help. He had numerous health issues for which prescription medications were necessary, he said. But then his farm income dipped and he couldn't afford to pay both for a doctor's visit and meds. Eventually, he couldn't get an appointment or a prescription. And he couldn't get insurance because of pre-existing conditions or an astronomical premium for the state’s high-risk pool. 

I wasn't able to be of much help to Billy except to confirm that his case did have something to do with ethics—with right and wrong, good and bad. I hope the help available to him now via the PPACA has not come too little, too late. 

* * *

Resources for better understanding the PPACA: 

Kaiser Family Foundation

·      "Summary of the Affordable Care Act": http://kaiserfamilyfoundation.files.wordpress.com/2011/04/8061-021.pdf

·      "Where is the PPACA Making a Difference?": http://kff.org/health-reform/fact-sheet/summary-of-new-health-reform-law/ 


Kansas Health Institute

·      "The Impact of Health Reform: Resource Document": http://www.khi.org/impact_of_health_reform_resources/

·      "Insurance Coverage": http://www.khi.org/news/insurance/

·      " Insurance Marketplace Now Open: Plan and Cost Options for Kansans":http://media.khi.org/news/documents/2013/10/01/marketplace-brief.pdf

(Rev) Tarris Rosell, PhD, DMin

Professor of Pastoral Theology—Ethics & Ministry Praxis

Central Baptist Theological Seminary

Rosemary Flanigan Chair at the Center for Practical Bioethics