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Linda Bergthold

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Health Reform's Second Anniversary

Posted: 03/22/2012 7:40 pm

This Friday, March 23rd, marks the second year anniversary of the passage of the Affordable Care Act -- a.k.a. "health reform." If you are like most people, you may have some misconceptions about what has or has not happened in the past two years. A Kaiser Family Foundation poll last year about this time found that two-thirds of those polled could identify the key elements of reform -- an individual mandate to require everyone to purchase insurance; a subsidy to be made available for those who can't afford insurance; a requirement that insurance companies stop denying children coverage because of pre-existing conditions. But fewer than half knew that there were no death panels, or that undocumented people could not buy insurance through the exchange. Those answers have not changed a great deal in the past year. There is still a lot of confusion about the law. And while the law's overall unfavorability rating is about the same as the favorability -- 40 percent -- support for specific provisions of the law is in the 60s or higher (like the idea of tax credits for small business or subsidies for people to help them afford insurance).

Here are a few simple questions to test your knowledge. TRUE or FALSE?

1) The U.S. Supreme Court has ruled that the Affordable Care Act is unconstitutional.

2) Health care costs have gone up because of health reform.

3) Preventive benefits no longer require co-pays or deductibles.

4) The state health care exchanges are not going to be implemented.

5) Insurance companies can no longer deny coverage to children because of pre-existing conditions.

And the ANSWERS are?

1. FALSE -- The U.S. Supreme Court has not yet taken any action on health reform. The Court will indeed rule on the constitutionality of the individual mandate in health reform this year, and potentially even on the constitutionality of the law itself, but most legal analysts believe that even if the individual mandate itself is struck down, the rest of the law will stand. In addition, even without a mandate, there are ways to encourage the healthy uninsured to sign up for coverage so that plans don't end up with only sick people.

2. MOSTLY FALSE -- If health care costs have gone up this year, it is not due to health reform (because it has not been implemented), but perhaps due to insurance companies wanting to raise their prices while they can before the full power of the law kicks in. Health care costs in the Medicare program have actually decreased slightly in the past year. And in the Medicare Advantage plans, premiums have decreased up to 4 percent for 2012. Despite the claim that health reform "robs" Medicare of $500 million, the law actually requires insurance companies to submit bids to participate in Medicare Advantage, saving Medicare $500 million that can be used to help subsidize the coverage of the uninsured. Benefits for Medicare beneficiaries are not diminished; in fact, there are more benefits for them than ever. The prescription drug "doughnut hole" has been reduced and will be eliminated by 2020; new preventive benefits are now included without co-pays; and seniors are offered all kinds of discounts and free benefits like memberships in fitness centers.

3. MOSTLY TRUE -- Even though health reform is not fully implemented, there are a number of benefits that have already been put into place. Many preventive benefits, including colonoscopies, mammograms, immunizations for kids, contraception devices, etc. have already been included in health plans, although for many plans these requirements to provide preventive benefits will not be fully implemented until 2014 or after.

4. FALSE -- The main element of health reform -- the state insurance exchange where you will be able to choose a health plan from many options -- has not even been implemented yet and won't be until at least 2014. And even if your state refuses to implement an exchange for political reasons, the federal government will still make an exchange available to you, with financial subsidies if you cannot afford the coverage. This will be a boon to individuals and people who work for businesses that do not offer coverage, because it is expensive and often impossible to get coverage if you are in those categories.


5. TRUE - Although insurance companies can still deny coverage until 2014 to adults with pre-existing conditions, children have been protected since Sept. 23, 2010. For parents of kids with serious disease, this part of the law has been an enormous relief.

In the next weeks and months you will hear a lot about health reform, primarily because it is an election year and politicians want to scare you about it, and also because the U.S. Supreme Court will rule on the constitutionality of the law this year. Lies such as "you will have to pay a new tax on the sale of your house to support health reform" or "health reform will tell your doctor what treatments you can have" have been circulating for several years and are false. Stay informed and try to check the accuracy of the many false claims that will be made about "obamacare" this year. Places you can look for information including the White House's health care reform site or Factcheck.org which continually updates its health reform site, paying particular attention to what the political candidates say. Politifact rates various claims about health reform with "true," "mostly true" and even "pants on fire."

If you do not stay alert, you may find there IS no health reform on this anniversary next year.

 

Follow Linda Bergthold on Twitter: www.twitter.com/lab08

This Friday, March 23rd, marks the second year anniversary of the passage of the Affordable Care Act -- a.k.a. "health reform." If you are like most people, you may have some misconceptions about wha...
This Friday, March 23rd, marks the second year anniversary of the passage of the Affordable Care Act -- a.k.a. "health reform." If you are like most people, you may have some misconceptions about wha...
 
 
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HUFFPOST SUPER USER
fb0252
02:15 PM on 03/23/2012
Obama care provides free health care for those unable to afford health insurance and the rest of us pay. It's another welfare program for minorities. Anybody with a objectivism and reasoning ability understands that. they get the benefit, our premiums go up to pay for it. that's all it is, was and ever will be.
01:35 PM on 03/23/2012
Remember the Obama campaign against Hillary where his chief criticisms of Hillarycare were mandated health insurance for all Americans and that negotiations for Hillarycare were carried out in secret? Thankfully, he didn't make THOSE mistakes.
researcher
researcher
12:40 PM on 03/23/2012
We are the only industrialized nation without a universal or national health care system.

That should tell everyone in the world about the mentality of americans.

Unchecked capitalism will create such a culture of selfishness and greed.

And if anyone thinks charity can make up the difference they are on something and it is not rational thinking or intelligence.
HUFFPOST SUPER USER
Awake-and-Sing
named after a great play written by Clifford Odets
12:24 PM on 03/23/2012
"most legal analysts believe that even if the individual mandate itself is struck down, the rest of the law will stand"
----------------

While I predict the law will be upheld and with a 7-2 vote from a corporatist Supreme Court, the scenario of upholding the consumer regulations that forbid denying coverage for pre-existing conditions and denying the ability to rescind policies after the fact, but not allowing the mandate that keeps corporate profits rolling, it is corporations themselves that would be begging for the passage of Medicare for All.

One other thing about this bill that is not understood. States can go farther than what the bill establishes federally. Oregon and Illinois are likely to have public health insurance options on their state's coming exchanges. Vermont is even going for single-payer health care.

The Democrats are likely to win back hundreds of state legislative seats this year. So progressives should be inquiring at the state level where their candidates stand on adding public options to their state's exchanges or even going for the Vermont approach.
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HUFFPOST SUPER USER
Bart DePalma
Bart DePalma
11:44 AM on 03/23/2012
2. MOSTLY FALSE -- If health care costs have gone up this year, it is not due to health reform (because it has not been implemented), but perhaps due to insurance companies wanting to raise their prices while they can before the full power of the law kicks in...

3. MOSTLY TRUE -- Even though health reform is not fully implemented, there are a number of benefits that have already been put into place."

And health insurance inflation has spiked from 2.5% in 2010 to 9% in 2011 largely to pay for just theorist wave of mandates.

"5. TRUE - Although insurance companies can still deny coverage until 2014 to adults with pre-existing conditions, children have been protected since Sept. 23, 2010. For parents of kids with serious disease, this part of the law has been an enormous relief."

Actually, most insurers have dropped individual health insurance coverage for children because of this mandate and parents need to be part of group health plans to get coverage for their kids. Group coverage always covered per existing conditions. Thus, there is no benefit from this mandate, only fewer options for parents.
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11:31 AM on 03/23/2012
The anniversary is actually Saturday.
11:21 AM on 03/23/2012
The Canada Health Act sets out the primary objective of Canadian healthcare policy which is to "protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to healthcare without financial or other barriers."
One page document.
Federal funding to provinces is based on adherence to these principles.
All citizens covered. Doctors may opt out but none do. Fee for service like Medicare. A list of essential services covered is established by provinces. Fees are negotiated with doctors every 4 years. Many private clinics and labs also provide services then bill the healthcare system.
Hospital costs are included. Hospitals are non-profit but compete for funding based on outcomes and areas of specialization.
Per capita healthcare costs are 30% less in Canada than in US.
11:17 AM on 03/23/2012
Oh no, madam. We understand perfectly. We understand that instead of a Public Option, as most people in America wanted, the Congress and the White House have colluded with the Medical Cartels to enshrine monopoly into law, forcing us all to buy insurance from companies that should not exist, but for covering certain 'optional' procedures and treatments.

These companies' sole function is making obscene profit from human suffering, misery and death. They are a blight. A cancer. The most profane of obscenities.

People like you have cemented their undeserved power, and now you have the supercilious audacity to believe that we don't like it because we're all just too simple to understand? Insulting.

Yes, this "reform" does some good things. But much like religion, what little good it does, is VASTLY outweighed by the damage it will do, and will only exist until the bribers...erm...I mean lobbyists start waiving cash and "gifts" around in front of our hopelessly corrupt politicians. This says nothing of the stupidity of having what protections it DOES provide not take effect until 2014, allowing for these demons squatting on America's chest a good, long chance to gouge and claw at us some more.

But clearly, we just need this explained to us properly so that our objections and dislike will magically vanish. That way, you all can finally get back to the very important business of merging corporate and state interests...
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01:18 PM on 03/23/2012
Spot-on response.
HUFFPOST SUPER USER
wakeupyouall
11:09 AM on 03/23/2012
We should have just put in medicare for all in place but why didn't that happen because we had to compromise.Repub who want to privatise the whole thing so their buddies can make billions in bonuses. And which In the end as in all capitalistic systrem you end up with a few monopolies that fix the prices The health of the nation should not be trusted to greedy psyopaths. Medicare has been highly sucessfull. Has a great track record. .Don't let the repubs scare you with there lies Look at how other countries do it. They have better out comes than we do.
10:39 AM on 03/23/2012
If you haven't actually read the legislation enacted in the middle of the night, by self-serving, non-participating legislators (and all their political supporters) - then you're acting/responding/functioning only on gossip and slanted reporting.
If you are dependent on gov't, you gain (personally) - if you're independent of gov't, you lose.
In the end, there is no free ride & all costs of gov't increase - and control for gov't increases.
Bigger gov't (159 "new" agencies for PPACA) costs more - and taxpayer citizens pay for freeloaders.
Trick it up all you want - but, it's more gov't control, more costs, less benefits - - everything else is just politicized fiction.
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HUFFPOST SUPER USER
Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
10:07 AM on 03/23/2012
Isn't the "individual mandate" just a healthcare tax with an exemption for everyone who buys insurance so the public doesn't have to pay for their emergency room visits? With that spin it's hard to rule it unconstitutional.
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HUFFPOST SUPER USER
Luis Angel Rosa
09:58 AM on 03/23/2012
Happy Birthday to the Affordable Care Act.
Long may it live.
Health Reform will continue to save this country billions of dollars.
Conservative Republicans have to stop thinking this is another hand-out or government intrusion.
With preventive health care we will help people stay healthy thus save money!
Why do you think poor woman and children receive free milk, cheese and other foods with the WIC Program and Prenatal care?
By eating healthy during their pregnancy, Healthier babies are being born,
With a lot less postnatal care,
Millions of dollars saved with healthy children.
People have to stop and think.
Health Care will benefit us all,
By everyone being able to see a Doctor or Dentist at least twice a year,
Doctors can help keep people healthy and out of expensive long term medical trouble.
By losing weight, Stop their smoking,
Even learning if they have diabetes and detect early signs of cancers.
PREVENTION IS THE ANSWER.
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09:29 AM on 03/23/2012
My health insurance is like an airman's parachute: it's there for an emergency but if I get to use it, it's only because the plane is going down in flames.

My insurance benefits have slowly eroded over the years with increasing deductibles and co-pays while the cost to have this benefit has risen to hundreds of dollars per month. Sure it covers my annual physical at 100%. That's when the doctor gives me 10 minutes to look in my ears, tap my knees and asks me to turn my head and cough. If I get sick during the rest of the year I get to pay out of my pocket until I reach the $4,000 deductible/co-pay, then the insurance company generosity kicks in.

The individual mandate is being touted as a line in the sand that "freedom loving people" won't tolerate. Well, instead we have the "freedom" to pay for our medical care until it hurts.
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08:38 AM on 03/23/2012
This 2,000-page monstrosity of a law is an unmitigated disaster and will continue to be for years to come, assuming SCOUS does not strike it down.

Shame on Congress and the Administration for NOT establishing a public option for this Country.
HUFFPOST SUPER USER
wakeupyouall
11:12 AM on 03/23/2012
What do you mean by public option. And I think each state can establish a public option. I think vermant is doing single payer. This bill lets each state discide. Maybe the governors of the red states will opt out if they stick to the reduced government policies?????
07:49 AM on 03/23/2012
How about the tax that kicks in when I sell my house in 2013? Is it true that there will be a 4% tax to help pay for the healthcare...yup...there sure is...but continue to point out the "highlights" of this bill where Obama paid off the healthcare providers, increased our costs and failed to calculate the cost it was going to have on all of us...This is a failure and if it was so great, where was Obama speaking about it on the anniversary...silly Left, when you wake up from your Obama dream, your America will be unrecognizable...Obama is a failure and he must go away in November.
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HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
11:13 AM on 03/23/2012
You are another example of why I wrote this piece. Perhaps you didn't read the last section where I point out that there is NO sales tax on your house because of health reform? You can check out a number of sites, but politifact has a clear "pants on fire" rebuttal of this.
HUFFPOST SUPER USER
wakeupyouall
11:16 AM on 03/23/2012
The dems and the obama wanted single payer Some blue dogs and repub are the ones that want health care to be privatised. The bill we got was a bad compromise Elect more Dems and we can fix it., We never did have an honest dialogue because the right wing Faux news started yelling death panels remember. It completely shut down any honest discussion.