What Happens Now?

Most of the reform changes do not begin until 2014, and 2016 will roll around before all reforms are fully implemented. But there are some things that begin right away or by next year. Here are some of the things we will see in the next two years.

Starting in Calendar Year 2010

• Small business tax credits of up to 35% of premiums -- increasing to 50% in 2014
  
• Re-insurance program for early retirees (aged 55-64) to lessen health care costs -- effective 90 days after enactment
  
• Bans rescissions by health plans -- effective 6 months after enactment
  
• Bans denial of coverage to children for pre-existing conditions -- effective 6 months after enactment
  
• Bans lifetime caps on coverage -- effective 6 months after enactment
  
• Restricts annual caps on coverage -- effective 6 months after enactment
  
• No cost sharing (co-payments) on preventative care for new group or individual plans -- effective 6 months after enactment
  
• Interim high-risk pool to cover people with pre-existing conditions
  
• Allow children to remain on their parents health care plan until their 26th birthday
  
• Increased funding for community health centers
• Medicare: $250 rebate to beneficiaries who hit the Part D "doughnut hole" -- closes doughnut hole by 2020
  

Starting in Calendar Year 2011

• Require individual plans to spend at least 80% of premium dollars on medical services
  
• Require group plans to spend at least 85% of premium dollars on medical services
  
• Medicare: 50% discount on brand name drugs for beneficiaries who hit the Part D "doughnut hole"
  
• Medicare: Eliminates co-payments for preventative services
  
• Medicare: Increases payments to primary care physicians

Source: http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf

Americans Win!!!

This is a great and historic day for America! While the Senate health care reform bill has its flaws, it also has great "bones." By that, I mean it has a great structure that will serve America for many decades. It will:

• set minimal standards for health insurance
  • guarantee coverage
    
  • eliminate recision
• create health insurance marketplaces where consumers can easily compare and contrast plans from different insurers
  
• help those with low- and middle-incomes purchase health insurance
  • provide tax subsidies that to people with incomes less than 400% of FPL
    
  • limit out-of-pocket costs for people with incomes less than 400% of FPL
• help small businesses provide health insurance to their employees
  
• start controlling health care costs
  • eliminate overpayments for Medicare Advantage plans
    
  • establish a strong Independent Medicare Advisory Panel to recommend cost saving measures
    
  • test potential cost-saving changes such as bundled payments
    

I don't think that Jonathan Chaitt is too far off when her writes that, "[h]istorians will see this health care bill as a masterfully crafted piece of legislation."

It is Time to Pass Health Care Reform

"We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine... It is time to pass health care reform for America"

...

"I believe in an America in which we don’t just look out for ourselves, that we don’t just tell people you’re on your own, that we are proud of our individualism, we are proud of our liberty, but we also have a sense of neighborliness and a sense of community ... and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck and give them a pathway to success and give them a ladder into the middle class. "

Health Reform By the Numbers

Health Care Opposition Zeitgeist

(via Nate Silver) This wordle represents the responses from people who opposed health care reform in the recent Gallop poll. According to these responses, people's biggest complaint (or worry) is government. Presumably the looming government takeover of health care, or as I often see it expressed, the government takeover of one-sixth of the economy.

Incidentally, that is not a view I share.

source: http://www.wordle.net/show/wrdl/1783870/healthcarebad and http://www.fivethirtyeight.com/2010/03/two-pictures-tell-story-on-health-care.html

A few points about the health care reform "takeover"

• It is a "takeover" that will spend nearly $1 trillion over the next 10 years. That is a lot of money, but it accounts for less than 4% of expected health care spending for the next decade.
• It is a "takeover" that protects health insurance companies, provides incentives to small businesses to remain or start offering group health benefits, and helps the 50+ percent of the population enrolled in group coverage to remain in that group coverage.
• It is a "takeover" that strengthens Medicare financing by reducing Medicare advantage over-payments, increasing payments to primary care physicians to promote health, reduces payments to specialists to reduce overuse, and helps the 15% of the population in Medicare to remain in Medicare.
• It is a “takeover” that directly affects about 10-15% of the population by financially helping them purchase health insurance from private companies to obtain services from private enterprise providers.