Tag Archives: Obama

Your Health Bill Questions Answered : NPR


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Now that the big health bill is law, people have more questions than ever. How will it affect their families and their health care? NPR’s health policy correspondent, Julie Rovner, explains some of the key provisions in the new law.

My son is going to turn 23 in June. Under the new health bill, he can stay on our plan until he’s 26, but I’ve heard this doesn’t go into effect for six months. Do we have to enroll him in alternative insurance in those intervening months, or will he be allowed to stay on that plan continuously? — Patricia Fontana of Berkley, Calif.

This is a provision that doesn’t take effect for six months, and actually, most people won’t have a chance to enroll their children in their plans until their next open season. For some people, it won’t be until next January.

So, yes, you’re going to have to find other insurance. For those with employer-provided insurance, under COBRA they can pay to add their young adult children to their plan, but this can be very expensive. For healthy young people, you can probably find some cheaper insurance for them in the intervening months, and that’s what most people are going to have to do.

This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance though a temporary subsidized high-risk pool. Can you explain the high-risk pool? If I am eligible, will my husband and daughter be covered, too? — Sarah Tamor of Santa Monica, Calif.

A national high-risk pool is supposed to start in 90 days to cover those who have been uninsured for six months and have pre-existing conditions. There’s $5 billion to help subsidize it, but the premiums could still be pretty high, as they are in most of the state high-risk pools that exist. And the premiums can vary by age — older people can be charged four times as much as younger people.

You have to have been uninsured for six months in order to be eligible. I don’t think your husband and daughter will be allowed to join unless they are also high-risk, and they probably wouldn’t want to because premiums will be high.

Insurance companies won’t have to insure those with pre-existing conditions until 2014, so a national high-risk pool will be there in the interim.

It looks like with the new law, we could find a policy in the risk pool right away if we were uninsured for six months, but if we have insurance — even if it is inadequate — we can’t change until 2014, when the [restrictions on] adult pre-existing conditions go away. Are these really our only options? — Audrey Hagan of Jackson, Wyo.

I’m afraid so. In this new interim risk pool that we were just talking about, you need to be uninsured for six months, and premiums are likely to be high. These are for people who have no other options. The idea is to give people something in the interim. But this couple has insurance, even though they write that it’s inadequate.

This high-risk pool is really for those who have nothing and want something to tide them over until 2014, when insurers can’t turn them away for pre-existing conditions.

I am a small-business owner, and every year my premium has gone up by at least 20 percent. Will the new health care law help keep the cost of health insurance down? — Katherine MacColl, Conway, Mass.

That is certainly the hope. It’s doubtful anyone really thinks this new law will bring premiums down. The idea is that it will stop premiums from going up as fast.

There is a large effort in this bill to protect small businesses. There is a tax break that goes into effect right away that will be from 35 percent of the premium up to 50 percent of the premium. There will be these new exchanges that will begin in 2014 that will hopefully help create competition that will help keep premiums lower, if not low. That will help small businesses, again.

There are a lot of things in this law that hopefully will create changes in the way health care is delivered and paid for that will help stem the growth of health care costs. But no one is suggesting this is the magic bullet.

How does the new law affect people who have insurance through the TriCare program? That’s the private insurance plan for Defense Department workers and military families.

It turns out that people with TriCare won’t be affected by the new law, and that’s both good and bad.

It’s good in that if you have TriCare, it means that you won’t have to go out and buy any other insurance. TriCare is sufficient to cover the individual mandate that you have insurance.

It’s bad if you have an adult child who’s 24 or 25 — you won’t be able to keep them on your TriCare, because TriCare only covers dependents up to age 23. A lot of people are upset by that, and there’s already been a bill introduced in the House that would allow people on TriCare to keep their dependents on TriCare until age 26.

I’m a medical student. I’ve heard from some doctors that reimbursements will decline. For those of us who have the choice of going into primary care or specializing, what will the economic incentives be? — Josh Roarke of Alexandria, Va.

In fact, there are incentives in this law to enlarge the pool of primary care doctors. One big one, which was added very late, is that they are going to increase payments for Medicaid primary care doctors to what Medicare pays. That will be a big increase.

There is increased loan forgiveness — up to $50,000 — for primary care doctors who join the National Health Service Corps. They go off and practice in underserved areas.

There’s going to be more primary care residency slots, and there will be other inducements for primary care doctors. As I mentioned earlier, there will be changes in the way doctors are paid and health care is organized, so those will be other kinds of longer term changes in the medical system that are supposed to encourage doctors to become primary care doctors. On the other hand, there’s not that much to be done about the fact that medical school is very expensive and that specialists will still be paid more than primary care doctors.

When will the “Cadillac” plan taxes come into play, and who will they affect? How do you know if you have a plan considered to be “Cadillac”? — Lisa Kantrowitz of Malvern, Pa.

The tax applies to very high-end plans, and it doesn’t take effect until the year 2018. Your plan has to be worth more than $10,200 for a single person and $27,500 for family coverage — that includes both what you and your employer pay if it’s employer provided insurance. Those plans can be worth more if you’re a retiree or in a high-risk profession, like a police officer or firefighter. Dental and vision coverage don’t count toward those totals.

How will the health care law be enforced? Who’s determining the rules and regulations, and who’ll be helping them with their specific cases?

The Department of Health and Human Services, with assistance from the Department of Labor, will be largely responsible for enforcement. But people are correct when they say that the Internal Revenue Service will play a role in this, because you will have to declare on your income taxes whether or not you have health insurance — that’s the individual mandate. If you don’t have insurance, that’s how you’ll pay the penalty that will be required — with your taxes.

via Your Health Bill Questions Answered : NPR.


Immediate Effects Of Health Reform Bill


Most of the consumer benefits will not kick in until 2014 but changes that will occur this year includes:

Dependent children can remain on their parents’ health insurance plans until age 26.

Senior citizens will get more help paying for drugs in Medicare.

People with health problems that left them uninsurable can qualify for coverage through a federal program.

Tax credits will be given to small businesses that offer health insurance to their workers

Children will be able to get insurance-even if they have pre-existing conditions

 All new insurance plans must offer and cover preventative care

Anyone Remember What’s In The Health Care Bill? : NPR


 by Julie Rovner

March 9, 2010

Since the Senate passed its version of a health overhaul on Christmas Eve, most of the debate has focused on the politics of the effort. By now, many people have forgotten — if they ever knew — what the bill would actually do.

So here’s a short refresher.

According to the Congressional Budget Office, the Senate-passed bill would expand coverage to roughly 30 million of the 46 million people in the U.S. who lack health insurance. Most of the remaining uninsured would be undocumented immigrants, who would be ineligible for benefits under the bill.

Insurance Mandates

One of the most popular things the bill would do is ban insurance companies from excluding people or raising their rates, because they have what’s known as a pre-existing medical condition.

What’s that? Here’s how California Democratic Rep. George Miller described his: “I sit here with two artificial hips, a little bit of arthritis, and I have a kidney stone. I’m dead in that insurance market if I have to switch policies or switch companies.”

But in exchange for getting insurance companies to agree to accept everyone, the insurance companies need more healthy people to be covered to help spread the risk. So the bill does something that’s a lot more controversial: It requires everyone to have insurance.

That’s something many Republicans used to support, but don’t now. “Never has the federal government said any American had to buy anything. Now, [you] have to buy insurance. If you don’t buy insurance, pay the IRS more money,” said Sen. Charles Grassley (R-IA) during the Senate’s floor debate in November.

Grassley is correct in that the mandate would be enforced at tax time. If you can’t prove you’re covered, you’ll pay a penalty.

Helping Hand

But help will be available. If you’re poor, you’ll get health insurance for free through the Medicaid program. For the first time, able-bodied adults who are simply low-income would become eligible for Medicaid.

Middle-class people who have to buy their own policies would get government subsidies. And small businesses would get tax credits to encourage them to help pay for insurance for their workers.

Those who have to buy their own health insurance get another leg up — a new marketplace called an exchange. There they could pool their buying power and compare their options.

At the same time, said Senate Finance Committee Chairman Max Baucus (D-MT), “exchanges will make it easier for consumers to choose the most efficient plans. And that will reduce their costs and put pressure on insurance companies to offer lower-cost, higher-quality plans.”

Another cost-cutting aspect of the bill is a new focus on paying doctors, hospitals and other health care professionals.

“We … believe that there should be incentives to provide care based upon best practices, not based upon simply procedures being reimbursed,” House Majority Leader Steny Hoyer (D-MD) said at the White House health meeting last month. In other words, the new payment system would be based on how health care professionals do their jobs, rather than just how many tests they order or exams they perform.

Political Deal-Making

But politics has had a lot to do with getting the bill this far. Now House Democrats are being asked to cast a vote for the bill the Senate passed Christmas Eve. And, at least initially, they’ll have to approve that Senate bill with no changes.

That means, as Sen. Lamar Alexander (R-TN) reminded everyone at last month’s meeting, “It still has the sweetheart deals in it. … I mean, what’s fair about taxpayers in Louisiana paying less than taxpayers in Tennessee? And what’s fair about protecting seniors in Florida and not protecting seniors in California and Illinois and Wyoming?”

Alexander was referring to several deals cut by Senate Majority Leader Harry Reid to win the 60 Democratic votes needed to get the bill passed by the Senate.

Of course, here’s where this process gets even more complicated. Those so-called sweetheart deals are expected to be cancelled in a second bill. That so-called fix bill will carry the compromises now being made between the Senate and the House. That bill is also likely to alter the way the health care program is paid for.

But that second bill is still being drafted, and House Democrats are skittish about its ultimate prospects. Don’t expect a House vote on the Senate bill until they get some assurances about what that second bill will do — and that the Senate can actually pass it.

via Anyone Remember What’s In The Health Care Bill? : NPR.

Health Care Summit: Significant and Pointless


       All week President Obama and members of his administration repeatedly denounced pundit claims that the healthcare summit was an act of political theatre.  Neither side of the aisle wanted to imply that the summit had any real chance at producing a significant breakthrough in the healthcare debate.  In fact, Congressional Democrats came into the meeting having already threatened to expedite the bill through the legislative process, ironically, called ‘reconciliation’.  Congressional Republicans, prior to the assembly, planted their feet firmly into poll tested talking points and took every chance they could to mock the Presidents sincerity and willingness to act bipartisan.

As for the meeting itself? 

Well, it was too boring to be called political theatre and too theatrical to bring about any reconciliation.  There are two issues that immediately come to mind when attempting to define the reasoning behind this summits failure. The first, is that it was simply too late in coming.  Had President Obama come out immediately announced the meeting in early 2009 and challenged the two parties to discuss their differences face to face and in front of television cameras, then maybe he could have silenced much of the resistance and maintained control of the debate.  This actually brings to view the inexperience of President Obama, who deserves to take full responsibility for this disappointment.  President Obama promised to make his administration the most transparent in history only to turn around and hold closed-door meetings on healthcare reform with members of his own party long before meeting the brick wall known as the Republican Party.  This gave both instant legitimacy to Republican talking points and easy fodder to establish lasting distrust of President Obama’s agenda.  This, along with the lack of unity within the Democratic Party itself on this issue, allowed the republicans to keep the focus on bashing Obama’s proposal’s and fanning the flames of distrust that President Obama himself ignited.  Therefore, long before the summit was even announced, pundits were able to pump their rhetoric into the cynical minds of conservatives, loyal Republican Party constituents, and disillusioned moderate Democrats.  In other words, after a year of debate, minds were simply already made up and no amount of nationally televised discussion, even if it had been substantial, would have changed them. 

…and that brings me to my second point. 

President Obama challenged the Republicans to present their alternatives in front of the cameras because he viewed much of their rhetoric to be melodramatic and thought he could prove the Republicans were indeed just the party of ‘NO!’.  The Republican point of view was that this meeting of minds was just another slip up by the President and considered the offer to meet publically as a win-win scenario for their party.  If they showed up and engaged the President and Democratic Party than they could squash the partisan label that the Democrats had been trying to place on them.  Or they could walk away, regardless of how the debate went, declaring that it was the Democrats who continued to play partisan games because they refused to take the presented Republican concerns into account.

 Although both parties utilized the media’s presence with emotionally charged tales of constituent despair, it was the Republicans who maximized the attention and at times appeared to treat the event as a kind of massive campaign event.  The healthcare debate is so hot right now that Republicans knew it was not in their interest to present any in-depth, unified alternative to the Democrats plan, but instead cite polls showing the unpopularity of “Obamacare” and use the media stage to continue to present themselves as the voice of the American people. 

For the American people, the healthcare summit was really a bittersweet moment. 

I praise President Obama for orchestrating, and the representatives of both parties for participating, in a delightfully transparent view of the legislative process.  But I can’t help but feel that the conduct of our elected officials in this conference was bad for Republicans, worse for Democrats, and demoralizing for the American people.

Image Source: Reuters