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Published October 19, 2013, 10:08 PM

Drs. Oz and Roizen: Drilling into the Affordable Care Act

Q: The Affordable Care Act is so confusing. Can you clarify, PLEASE! – Renee C., Briggs, Texas

By: Dr. Mehmet Oz and Dr. Mike Roizen, INFORUM

Q: The Affordable Care Act is so confusing. Can you clarify, PLEASE! – Renee C., Briggs, Texas

A: We’ve gotten lots of questions about the Affordable Care Act, so here are the basics. But remember, some regulations apply to everyone in the U.S., while others differ from state to state. For detailed info, go to www.healthcare.gov and select your state.

How do ACA exchanges work? If you don’t have insurance through work, can’t afford insurance or what you have doesn’t meet the law’s minimum standards, an exchange is a marketplace that lets you compare costs and coverage to get what’s best for you. Happy with your insurance or want to buy through a broker? Don’t change a thing.

How can I choose the best plan? The plans are ranked Bronze, Silver, Gold and Platinum. Bronze is least expensive and pays about 60 percent of costs; Platinum is most expensive and covers about 90 percent. There’s catastrophic coverage – for hospitalization only, if you qualify. Determine how much you can pay every month and if that kind of plan offers you the protection you need from medical expenses. In addition, make sure your doctors accept the plan you want to choose.

Will costs go up? Or down? 11.5 million Americans with an income of less than $15,000 (individual) or $31,000 (family of four) will become newly insured under Medicaid, and annual out-of-pocket expenses could fall from $1,463 to $34. Not all states have agreed to expand Medicaid; in those states, the poorest may see costs rise.

People without insurance from work who earn around $46,000 (individual) and $94,000 (family of four) get discounts through the exchanges. And if the cost of your employer-provided insurance exceeds 9.5 percent of your income, you can buy insurance through the exchange and may be eligible for Medicaid help.

The biggest cost increase hits the newly insured who earn at least $44,680: Around 3.3 million consumers may spend $7,202 annually, compared to a typical expense of $5,368 if the law were not in effect.

For everyone newly insured: Pre-existing conditions are covered; your plan can’t boot you off if you develop a condition or disease; preventive care is covered 100 percent (mammograms, colonoscopies, etc.); and there are no annual or lifetime caps on essential health benefits (hospitalization, prescriptions and maternity services).

Q: Half the time I’m constipated, and the other half I’ve got diarrhea. It’s been going on for months. What could cause this? – Sarah Q., Danville, Ill.

A: It takes guts to ask. Only a small number of the 10 percent to 20 percent of people in North American who suffer, like you do, from irritable bowel syndrome – or IBS – ever ask their doctor how to handle the their constipation, diarrhea, cramps, bloating, weight loss and gas. But lately we’ve learned more about IBS, and there’s a good chance you can get it under control.

We now know IBS has many causes. It may happen because the intestines’ muscles or nerves make food move through your gut too slowly, causing constipation, or too quickly, causing diarrhea. The balance of bacteria in your intestines may have been upset by a high-fat or high-sugar diet, infection, antibiotic use or chronic stress. And sometimes IBS may result from an immune system intolerance to your gut’s biosystem. These problems also can cause excessive gut permeability – molecules that should pass out of your body irritate your intestinal lining and enter your bloodstream, triggering digestive distress as well as fatigue and brain fog.

So follow these steps:

• Take a daily probiotic that contains a mixture of strains. Experts say you want about 4 billion bacteria per dose.

• Stop eating processed foods and any grain that isn’t 100 percent whole, and nix all added sugars or sugar syrups. If that doesn’t help, eliminate gluten. Still troubled? Stop eating red meat. For some folks, those changes ease symptoms.

• Exercise regularly. Walking 10,000 steps daily can regulate bowel contractions. Stay well hydrated. And meditate for 10 minutes daily.


Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic.

Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.

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