Health Reform

                Second only to the election of President Obama, the Health Reform Bill recently signed into law on March 23, 2010 has been one of the most historic moments in United States history.  With its’ wide spread fame came mixed emotions; Many people are angry, some are afraid of rocking the boat, others are happy about the passage of the reform bill and still others don’t really know much about it or care.

The five promises made by President Obama about the bill- That more Americans will receive insurance coverage; The Insurance market will become more competitive; More accountability preventing insurance industry abuses and denial of care; Non-discrimination of pre-existing condition individuals and the Federal Deficit being reduced by $100 billion in the first ten years and $1 trillion within the second decade- have many of us confused.  How is the United State Government planning on keeping these promises?  Let us explore:

                The Federal Government is implementing a non-discrimination act, effectively giving individuals with pre-existing conditions- Whether they be physical, mental, claims experience, genetic information or disability- more options for care.  Regulations to cap premium costs will, in effect, lower health insurance costs for all markets making it much more accessible.  Insurance companies may no longer establish rules relating to insurance coverage based on total hourly or annual salary.  The Obama Administration has abolished a lot of roadblocks to accessing health insurance, thus upping the number of insureable individuals in the United States.

                The law stipulates that each State is to ensure participation by Health Insurance issuers in competition in the Health Insurance market within that State.  State programs will be set up to access information on affordable Health Insurance, including a website as a single database to compare coverage, cost and the issuers’ regulations for coverage.  With Health insurance more accessible, the market is going to become larger and with a larger market, more risk.  Health Insurance providers are going to be vying for every person they can get to adjust to the cost, thus creating greater competition, keeping costs low and, hopefully, quality of coverage high. 

                In order for Insurance companies to be able to do business, they must meet all regulations set up by the Federal Government.  Annual audits of claims data will be done to ensure this, however if they fail to do so, they may incur penalties per failure until the regulations are met.  When met, the quality and value of the companies’ plans will be evaluated and published through the States media.   All alternative payees, such as clearinghouses and Billing agents will be required to register through Medicaid, thus making it easier to track the insurance industries data.  Payments made to entities outside of the United States are now prohibited to ensure data is accessible.

                Fees will be imposed on various sectors of the health industry, intended to recapture some of the benefits they get as more Americans purchase health insurance. These include:  a fee on branded prescription drug pharmaceutical companies in proportion to their federal sales; an excise tax on medical devices; an annual fee on health insurance companies and an excise tax on indoor tanning services.  The bill enforces and closes loopholes in the tax code. These measures include: expanding corporate information reporting requirements; closing the loophole that allows certain byproducts of paper production to be eligible for tax credit and helping prevent tax shelters by clarifying the definition of when activities have true “economic substance” beyond evading taxes.  The bill also will require individuals with high un-earned income- such as dividends, interest, annuities, rents and royalties- to pay a 3.8 percentage for Medicare Hospital Insurance.

                 Another common question that is asked about the new Health Reform Law is, if it is so good for out country, why is it going to take three to five years to implement many of the new regulations?  In order to ensure proper transition from the old way to the new, smaller steps need to be taken in intervals of weeks, months, even a few years.  Insurance providers, law makers, care providers and those who supply medical supplies need time to implement and adjust to these changes in order to keep providing accurate, high quality care.

                  Imagine, if you will, your employers changing several major company policies, or even all of them.  Would your employer expect you to adapt and know the new rules right away? No, because it would effect production and accuracy.  Your employeer would implement the new policies over a period of weeks or months, providing trianing on them and making sure the employee’s understand what is being changed, how it effects their job and whats expected of them.

                    We want to know how it is going to work?  We have to make it work.  As a community, we know what works for us and what does not.  As a community, we know what needs improving and what needs to stay the same.  We have to find ways to make it work for us.  That is our responsibility.