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Health Reform's Second Anniversary

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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.

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