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Obamacare (ACA) Impact On Surgical Assisting

Obamacare (ACA) Impact On Surgical Assisting

By Dan Bump SA-C, CSFA: With so many pages in the law that most legislators didn't even read them before voting on it, the Affordable Care Act (ACA, sometimes referred to as Obamacare) has left many students, prospective students, and graduates of Surgical Assistant Programs confused and concerned about the future of the Surgical Assisting profession.

So the goal of this blog post is only to comment on whether or not Obamacare is good for our profession not on the politics or whether or not it is good for some people. Thankfully, proponents of Obamacare didn't get what they really wanted, which was 'Single Payer' or 'Medicare For All.' That could have done some real damage to the profession. Medicare doesn't pay for Surgical Assistants when they are employed by surgeons or when they are self-employed unless the assistants are doctors, PA's, or NP's. Medicare does indirectly pay for Surgical Assistants through the global payment made to the hospital for services provided to the surgical patient.

Single Payer therefore could have potentially marked the end of Surgical Assisting as we know it. I've got to believe, and this is the cockeyed optimist in me, that Congress would have come together as they sometimes do in an emergency. The goal? Make Surgical Assistants approved Medicare providers so they don't all lose their livelihoods and saving money on the healthcare budget in the process. The alternative would be to spend a lot more money so that MD's, NP's, or PA's could provide the very same service.

In the end, the single payer idea didn't pan out. Instead, we have healthcare exchanges or health insurance marketplaces. This is still private insurance! Healthcare exchanges are not insurance carriers but organizations that facilitate the purchase of regulated private health insurance plans that are eligible for government subsidies. Therefore, they pay for Surgical Assisting services the same as they did before.

Actually, to make Obamacare work, you need all the mid-level healthcare providers you can get. So the government would be well motivated to pass the legislation needed to keep Surgical Assistants working. It appears surgeon shortages are inevitable. When they occur, more not less Surgical Assistants will be needed to take the pressure off the remaining surgeons and the healthcare system. If surgeon A is performing surgery with his favorite Surgical Assistant, then surgeon B, instead of assisting, is free to do his own surgeries or handle the overload.

One of the promises made in Obamacare was that healthcare would be less expensive and families would save on insurance premiums to the tune of $2,500 per year. Well that didn't turn out to be true. Quite the opposite! Unless your premiums are being subsidized by the government (really your taxpaying friends and neighbors), you've probably seen your premiums go up substantially.

That puts the Obama administration in a dilemma. Apparently they didn't anticipate that providing health care to more people would cost more and drive premiums up. Now what to do? Surgical Assistants raise the quality and lower the cost of surgical care. Increased utilization may even help the politicians keep their promises regarding reduced insurance premiums.

Surgical Assistants and our profession are currently thriving. However, if Obamacare is fully implemented, self-employed assistants may take a little hit because of declining insurance reimbursements. Maybe not. Worst case scenario, we'll have to get paid by the surgeon or the hospital instead. Surgical Assistants will still be paid more, which makes it a savvy career move any way you look at it. The entrepreneurial spirit is strong among Surgical Assistants and, if the current business model falters because the rules have changed, we are driven to create new, out-of-the-box business models that will forge the way to even greater opportunities.

I think the future looks bright for Surgical Assisting almost no matter which way the political winds blow. So stick with it and let us know if there is anything we can do to help. Please be sure to comment so your questions, thoughts, and professional opinions can contribute to this important conversation.

Are you interested in becoming a surgical assistant? Contact ACE Surgical Assisting today to request more information and to learn more about advancing your career.