Election 2010: Health care reform

10.19.10

The need for reform has never been clearer

Our country’s health care system is broken – and it has been getting worse.  The number of Americans without health insurance soared to more than 50 million last year. (Census Bureau)

We spend roughly twice as much on health care, per person, as Canada, Germany, the Netherlands, France, or Sweden – but our people die younger.  The United States ranks 25th of 31 industrial countries in life expectancy, between Poland and Portugal.  In infant mortality, we rank 26th of 29, ahead of Chile but behind Slovakia. (Organization for Economic Cooperation and Development)

Some 6.6 million Americans lost employer-sponsored health insurance last year alone.  One in five working Americans (29.3 million) have no health insurance coverage. (Census Bureau)

Workers who have managed to keep their employer-sponsored coverage are paying more.  The average premium share paid by workers for family coverage is now $4,000, up 14 percent from 2009.  (Kaiser Family Foundation)

What health care reform really does

The health care reform bill signed into law in March is an important step in the right direction.

The voices of fear and division are spreading falsehoods about health care reform – everything from stealth tax increases to “death panels.”  These claims are nonsense.

In reality, the health care law:

• Reforms the insurance market to outlaw abuses and expand access.
• Uses incentives and penalties to encourage employers to provide coverage.
• Creates Insurance Exchanges so that individuals and small groups can purchase coverage, regardless of health status or preexisting conditions.
• Expands Medicaid for the poor and subsidizes premiums for the middle class.
• Closes the Medicare Part D “donut hole” for seniors.
• Establishes initiatives to improve quality and contain costs.

When the law is fully implemented, it will extend coverage to 32 million Americans who would otherwise be uninsured.

Immediate benefits for millions of Americans

While key provisions of the law will not take effect until 2014, many important reforms are already in place.

More than 1.2 million seniors in the “donut hole” have already received $250 rebate checks.  Starting next year, they’ll be eligible for a 50 percent discount on many prescriptions.

More than 2,000 employers and VEBAs that provide coverage for pre-Medicare retirees have been approved for a federal reinsurance program that will help make coverage more affordable.  That includes the VEBA covering retirees from Ford, General Motors and Chrysler.

Many insurance market reforms took effect on Sept. 23 (or, for existing plans, will take effect with the next plan year):

• Adult children who do not have employer-sponsored coverage can  now stay on their parent’s plan until they turn 26.
• Insurance companies can no longer discontinue coverage for  seriously ill people based on technicalities (“rescission”).
• Insurers must now cover children with preexisting conditions.
• Insurance plans cannot impose lifetime dollar limits on essential  benefits.  Annual limits are now regulated, and will be lifted  completely in 2014.
• Insurers must spend at least 80 percent of premium dollars (85 percent in the large group market) on medical and wellness services and quality enhancement – not on administrative overhead and executive salaries.
• All new plans must cover recommended preventive services at no out-of-pocket cost to the patient.