This week President Obama and Congressional Democrats are making a final push to pass health care reform. If all goes well for them the health care reform bill will be the law of the land by the end of the week. The average American could care less about filibusters or reconciliation or the various details inside the some 2,000 page bill. Instead what most care about is how the bill will affect them and their health care.
The most idealistic of reform supporters view the bill as the savior of health care in America. Some believe the bill will provide insurance to all, reduce costs, and increase the quality of care at the same time.
On the other hand reform opponents see the bill as something slightly (but not much) better than the devil himself. To them the bill will usher in a new era of government controlled health care which will increase costs and dramatically reduce the quality of care for all.
The truth is of course neither of these extremes. In truth the reform package will not dramatically affect the insurance or care of most Americans. Most of the population already have insurance and those that do usually get it from their employer. For those people reform will have little to no immediate effect as they will simply stay on their current plan. The bill (a full copy and summary can be read here) exempts current plans from most of the regulation which would take place immediately. By 2011 insurers would be required to spend a portion of premiums (85%) on actual care. Many plans already do this and those that do not would be forced to reduce their profits and administration costs (generally seen as a benefit to consumers).
In addition the most dramatic provisions of the bill (such as the individual mandate) do not go into effect until five years after passage. So those people who were “forced” to buy insurance would not have to do so until 2014. Even then they may not be effected if they qualify for an exemption or pay a small fine (around 2.5% of income).
Those that would actually “feel” the passage of reform right away would be a small but significant minority of Americans who are currently falling through the cracks of the private insurance system. Here are the provisions which would apply to these people:
(1) The act would provide $10 billion over the next five years for community health centers in places where health care services are most scarce right now.
(2) The act would immediately provide $5 billion in assistance for those with pre-existing conditions who can not currently afford insurance.
(3) After six months the plan would require health insurers to stop using pre-existing conditions as a reason for exclusion of children. The ban on pre-existing condition exclusion for adults would not happen until 2014.
(4) Early retirees would be eligible to re-purchase their employee health plan after their retirement.
(5) Small businesses will be eligible to start receiving tax credits in exchange for providing health insurance for their employees.
(6) Parents will be able to keep their children on their plan until they reach the age of 26. This will keep many college students and recently graduated college students on their parents’ plan.
(7) For those who enroll in “new plans” a number of other benefits will be provided within six months of passage. Included are protections from policy rescissions, the elimination of lifetime coverage limits, and the establishment of an appeals process regarding insurance company decisions.
So that is what is really on the line in the upcoming vote for reform. Later I will be writing an article on the long term effects of passage which are much more significant than the above list.
For more info: Health care reform fact or fiction series, Latest updates on the push to pass health care reform.