Posts Tagged ‘Happy Birthday Health Care Reform’

Happy Birthday Health Reform, Part 3: Three Things You Probably Don’t Know About Health Reform

March 26, 2012 at 2:59 pm

Two years since President Obama signed the Affordable Care Act — health reform — into law, opponents continue to make many of the same false claims that they made before Congress passed it.  Repeating those claims hasn’t made them true, but it may have obscured some simple facts about health reform, like these:

FACT #1: The vast majority of Americans will continue to get coverage through private insurers under health reform.

Contrary to claims that health reform is a “government takeover” of the health care system, the overwhelming majority of Americans will get coverage through private insurance companies, just as they do today.

Employer-sponsored health insurance will continue to be the dominant source of coverage for workers and their families.  Many people who can’t get insurance through their job and can’t afford to buy it on their own will get tax credits to help them buy quality coverage through health reform’s “exchanges,” marketplaces where people can compare and buy health insurance.  The plans offered in the exchanges will all be private plans.

Health reform will expand Medicaid to cover low-income families who wouldn’t be able to afford private insurance even with a subsidy.  But, in most states, private insurers cover Medicaid patients.

All in all, health reform builds on the insurance system we already have, but it reins in some of insurance companies’ most egregious practices by establishing important consumer protections (as our last post explained) and helps many people afford coverage.

FACT #2: Health reform is a good deal for states.

Opponents like to say that health reform will burden state budgets.  That’s false.

From 2014 through 2022, the federal government will pay 93 percent of the cost of health reform’s Medicaid expansion, which will enable Medicaid to cover an estimated 17 million more low-income adults and children than it does today, most of whom are now uninsured.

The expansion’s cost to states over this period will be $73 billion — just 2.8 percent more than what they would have spent on Medicaid without health reform.

Health reform will also save states billions of dollars each year in costs for providing mental health care and other health care services to the uninsured.  An analysis by the Kaiser Commission on Medicaid and the Uninsured found that many estimates of state Medicaid costs under health reform don’t adequately take these savings into account, which could be quite substantial. In fact, analysts from the Urban Institute suggest that the savings could more than offset the state costs of expanding Medicaid.

FACT #3: Health reform’s Independent Payment Advisory Board can’t ration health care.

Critics charge that the Independent Payment Advisory Board (IPAB) — a presidentially appointed commission that health reform created to help slow the growth of Medicare costs — will ration health care for seniors, but that’s false.

Health reform specifically prohibits the board from slowing costs by rationing health care, raising Medicare’s premiums or cost sharing, cutting benefits, or restricting eligibility.  It must focus exclusively on proposals that achieve savings in paying for and delivering health care services.

If Congress repeals IPAB, Medicare beneficiaries likely would face far worse alternatives.  Congress would likely consider blunt proposals that generate federal savings simply by shifting significant costs to beneficiaries, such as sharply increasing premiums and raising the eligibility age.

Happy Birthday Health Reform, Part 2: A Look Ahead

March 26, 2012 at 11:54 am

Part 1 of this series looked at some of the benefits that the Affordable Care Act — that is, health reform — has delivered in just its first two years.  But some of the law’s most dramatic improvements to both the health care system and the lives of tens of millions of people lie ahead.

  1. Health coverage for tens of millions of the uninsured.

    Thirty-three million uninsured people will have health coverage by 2022 because of health reform, according to the Congressional Budget Office (see chart).   Research studies consistently show that having health insurance enables people to get more health care services and improves their health.

  2. More affordable insurance for those who already have it.

    Starting in 2014, many people who now struggle to afford health insurance will get help paying for premiums and out-of-pocket costs (like co-payments for doctor visits).  This help will come in the form of tax credits and help with cost-sharing for private coverage that people buy through the new health insurance marketplaces, called exchanges, that health reform will establish for each state.

    Many states are forging ahead with setting up their exchanges and are well-positioned to have their exchanges operating by the January 1, 2014 target launch date.

  3. More protections for consumers.

    Health reform has already banned some of insurance companies’ worst practices.  But, more protections are on the way.

    Starting in 2014, it will bar insurance companies from denying coverage to anyone with pre-existing health conditions (the law’s current ban applies only to children).  This means that people who previously couldn’t buy health insurance at any price because they had cancer or had had a relatively common procedure such as a c-section will be able to buy insurance and get the care they need.

    Insurers also won’t be able to charge higher premiums to women or sicker people and will face restrictions on their ability to charge older people more.

  4. Steps to begin slowing the growth in health care costs across the economy.

    Rising health care costs are putting pressure on the budgets of families and businesses, as well as public programs like Medicare and Medicaid.  Health reform makes important progress in this critical area by significantly improving Medicare’s long-term financial outlook and taking a number of steps to lower costs and improve the quality of care by beginning to change the way providers deliver health care.

Happy Birthday Health Reform, Part 1: A Look Back

March 23, 2012 at 3:39 pm

Two years ago today, President Obama signed the Affordable Care Act — health reform — into law.  Millions of Americans already are experiencing the benefits, and other important parts of the law are starting to move forward.  This series of posts will look at what health reform has accomplished and what it will accomplish over the next few years, as well as certain issues related to health reform.

First, a look back at health reform’s achievements in its first two years:

  1. Prescription drugs are more affordable for 5.1 million seniors and people with disabilities.
    Health reform has begun to close the “doughnut hole,” the gap in Medicare prescription drug coverage that many seniors experienced once their annual drug costs exceeded $2,840.  Before health reform, seniors had no additional coverage until their costs hit $6,448.

    Last year, seniors received a 50 percent discount on brand-name drugs and a 7 percent discount on generic prescription drugs while they were in the coverage gap.  This year, the generic discount jumps to 14 percent.

    5.1 million Medicare beneficiaries have saved more than $3.2 billion as a result of these changes, according to the Department of Health and Human Services (HHS).   The law will close the entire doughnut hole by 2020.

  2. Two and a half million young adults have gained health insurance.
    Health reform requires insurers and employers that offer dependent coverage to allow parents to include children up to age 26 on their insurance plans.  As a result, 2.5 million more young adults had health insurance in June 2011 than in September 2010, according to HHS.

    In the past, most insurance companies dropped children once they turned 19 or a few years later if they were students.  That’s one reason why nearly a third of all young adults lacked insurance in 2010 — a larger share than any other age group.

  3. Tens of millions of Americans are getting free preventive care.
    Insurance companies now have to cover preventive care services at no charge, and Medicare provides preventive services for free now, too.  As a result, nearly 87 million Americans received a free preventive health care service last year, according to HHS:  54 million through private insurance and 32.5 million through Medicare.

    Preventive care includes screenings for chronic illnesses like diabetes and cancer, routine vaccines for adults and children, and other recommended care for kids, such as regular doctor visits.

    Better access to preventive care will help millions of families with their budgets and likely produce other benefits, such as fewer unnecessary deaths from disease, less spending on costly and avoidable illnesses, and a healthier population overall.

  4. Insurance companies can no longer deny coverage to sick children.
    Health reform bars insurance companies from denying coverage to children with pre-existing health conditions like cancer, autism, or diabetes.  As a result, for the first time in most states, families with children with serious illnesses, chronic conditions, or special health care needs can buy coverage for their children in the individual health insurance market.

    This rule will apply to adults, too, starting in 2014.

  5. Insurance companies can no longer cut off care for people who need expensive medical care.
    Health reform bars insurers from imposing “lifetime limits” on benefits.  Now, people who get cancer or another illness that requires expensive treatments won’t have to worry that their benefits will run out or that expensive treatments will push them into bankruptcy — or worse, that coverage limits will prevent them from getting lifesaving care.

    HHS estimates that before health reform, 105 million Americans had insurance plans with lifetime limits.

Next up: a look ahead at some of health reform’s major benefits that are still in the works.