Inside This Issue - Opinion
ACA gives retail Rx an opportunity to step up
April 8th, 2013
Implementation of the major provisions of the Patient Protection and Affordable Care Act (ACA) occurs less than nine months from now. Although the sweeping changes, including the addition of some 30 million people to the ranks of those with health insurance, will impact every American in one way or another, there is a surprising degree of uncertainty about what lies ahead.
A study conducted in March by the Kaiser Family Foundation reveals that many people are still uninformed about the health care reform legislation, despite the yearlong debate in Congress that preceded its passage and the ongoing controversy that has surrounded the measure since it was signed into law by President Obama in March 2010. The poll shows that 57% of all Americans and 67% of the uninsured — the group that has the most to gain from the ACA — do not have enough information about what health care reform means for them.
Confusion about the content of the legislation is widespread. Two of the ACA’s highest-profile provisions, the individual mandate and Medicaid expansion, both of which were addressed by the Supreme Court when it upheld the law last year, illustrate the problem. While 74% of respondents to the Kaiser Family Foundation poll correctly say the ACA requires people to obtain health insurance or face a tax penalty, 17% do not think it does so and another 9% don’t know or refused to answer the question.
When the subject is Medicaid, the federal/state health care safety net for the indigent, the situation is even worse. Only 59% of those polled know the legislation paves the way for a significant expansion of the program (although the High Court ruled that states cannot be compelled to participate and a significant number have indicated that they will opt out). Twenty-five percent do not realize it, and 17% aren’t sure.
Of particular note for retail pharmacy operators is the murkiness that surrounds the ACA’s plan to bridge the gap in prescription drug coverage for senior citizens under Medicare. The study finds that although 81% of respondents favor closing the so-called doughnut hole, only 46% of them know that the legislation addresses the issue.
The state of uncertainty about what’s in the ACA and the persistent division over whether the law was a good idea in the first place — 40% still have an unfavorable view of the measure and 37% support it — represents an opportunity for community pharmacy. The Kaiser Family Foundation study makes it abundantly clear that many people will need guidance in negotiating the changing health care environment, a need that chain drug stores and other retail pharmacies are ideally positioned to meet.
With stores staffed by pharmacists, who are consistently ranked by opinion polls at or near the top for trust among all professionals, and located within five miles of more than 95% of the U.S. population, pharmacies can once again serve as a catalyst for bringing better health care to the communities they serve. Their skill in performing that function was demonstrated seven years ago with the rollout of Medicare Part D, which extended pharmacy coverage to seniors. When beneficiaries needed assistance in sorting through the various prescription drug plans available, many turned to their local pharmacist.
The industry stepped up and provided valuable information and advice to seniors who otherwise would have had a great deal of difficulty finding the right plan for their needs. In the process they earned the loyalty of those patients and the respect of government officials.
By performing a similar service in relation to the ACA, pharmacies can once again help their customers and raise the standing of the profession.