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Wendell Potter

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One Year Later: Health Care Reform a Law Worth Keeping

Posted: 03/24/11 09:45 AM ET

Is the health care reform law a good deal for Americans or is it so badly flawed that Congress should repeal it? Now that the measure is one year old -- President Obama signed the Patient Protection and Affordable Care Act to law on March 23, 2010 -- I humbly suggest we attempt an unbiased assessment of what the law really means to us and where we need to go from here.

To do that in a meaningful way, we must remind ourselves why reform was necessary in the first place. I believe the heated rhetoric we've been exposed to since the reform debate began has obscured the harsh realities of a health care system that failed to meet the needs of an ever-growing number of Americans.

Among them: seven-year-old Thomas Wilkes of Littleton, Colo., who was born with severe hemophilia. You would never know it to meet Thomas because he looks and acts like any other little boy his age, but to stay alive, he needs expensive treatments that over time will cost hundreds of thousands of dollars. Thomas's parents were terrified before the law was passed because the family's health insurance policy had a $1 million lifetime cap. Thanks to a provision in the law that makes lifetime caps a thing of the past, they can sleep easier at night.

Another person who faced the real possibility of not being able to pay for needed medical care is Robin Beaton of Waxahachie, Texas. Her insurance company notified her the day before a scheduled mastectomy two years ago that it was canceling her coverage. Why? Because Robin had forgotten to note when she applied for insurance that she had previously been treated for acne.

So Beaton - who told her story to a congressional committee -- was a victim not only of breast cancer but of "rescission," a once-prevalent practice in the insurance industry. The congressional panel - the House Energy and Commerce Committee -- discovered that just three insurers had rescinded the policies of 20,000 people over the course of a five-year period, confirming for lawmakers that the practice was widespread and growing. By rescinding those 20,000 policies, the three companies avoided paying for more than $300 million worth of medical care, much of it for critically ill people. Thanks to the Affordable Care Act, Beaton and the rest of us will no longer have to worry that our insurance policies will be canceled when we need them most because of innocent omissions on applications.

That same congressional committee discovered during another investigation that the four largest U.S. insurance companies had refused to sell coverage to more than 600,000 people with pre-existing conditions over a three-year period. Thanks to the Affordable Care Act, insurers can no longer deny coverage to children with pre-existing conditions. The law will apply to all of us by 2014.

In addition, young people who have not been able to find jobs that offer health care benefits can now stay on their parents' policies until they are 26. Young adults, many of whom haven't been able to find jobs or who work for firms that don't provide coverage comprise the largest portion of the nearly 51 million Americans who are uninsured.

The new law also eliminates copayments for preventive services and requires insurers to establish appeals procedures for denied coverage or claims. And the law has additionally begun to close the infamous "doughnut hole" in the Medicare prescription drug program. Medicare beneficiaries are also now getting better coverage for preventive care. And small-business owners who provide benefits to their employees are being helped by tax credits available for the first time.

Another important provision of the new law requires insurers to spend most of what we pay them in premiums on medical care. In 1993, insurers on average were spending 95 percent of our premiums paying medical claims. That average has dropped steadily ever since. In many cases, especially in the individual and small-group markets, insurers have been spending as little as 50 percent on medical care. The law requires insurers to spend at least 80 percent (85 percent in the large-group market) on health care services or quality improvement activities. Those that don't will have to pay rebates to their policyholders.

Other helpful parts of the law will be phased in. By 2014, for example, states will have to set up health insurance exchanges, which should help control costs. Between 2000 and 2010, American families saw annual premiums increase 114 percent on average from $6,438 to $13,770, according to the Kaiser Family Foundation. While employers often still pay the lion's share of health insurance premiums, workers are seeing their portion increase every year. During the last decade, worker contributions to health care premiums increased 147 percent. The exchanges, if implemented as Congress intended, should bring down the cost of premiums by fostering competition among insurers. The exchanges will also require insurers to provide data that will enable us to make apples-to-apples comparisons among various benefit plans.

Even after the law is fully implemented, there will be much to do. While an estimated 30 million Americans will be brought into coverage, more than 20 million others will still be uninsured. There's also still work to be done on addressing the underlying costs of health care in the United States.

But the Affordable Care Act is a start. Let's consider it just that -- a start -- and an important one on our shared journey toward a health care system that works better for all of us. If we stop to think for a moment about what needed to be fixed, about why the health care system in the world's richest country was failing an ever-growing number of Americans, I believe we will want to continue the journey.

 
 
 

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This user has chosen to opt out of the Badges program
03:02 AM on 03/27/2011
although it's complicated, the health care law is a step forward. i hope we all realize that in 2012.
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warloch2
Spraying cold reality from the hose of truth.
09:06 AM on 03/25/2011
How are these things good?

Since Jan. 1, 2011, you cannot use your flex-account at work or health savings account to purchase over-the-counter medicines?

In 2018, if your health insurance is “too good” or considered a “Cadillac” plan, then you will incur a new 40 percent tax on your health plan?

Obamacare has 21 new or higher taxes in it, totaling over $500 billion in increased taxes going to the government over 10 years?

In 2014, individuals and families that do not purchase “qualifying” -- as defined by federal bureaucrats -- health insurance will be forced to pay a yearly tax penalty?

7 tax hikes in Obamacare directly break President Obama’s “firm pledge” not to raise any form of taxes on individuals making less than $200,000 per year and families making less than $250,000 per year?

In 2013, those Americans facing the highest medical bills and the least ability to pay for them will find their ability to deduct medical expenses is further limited (medical expenses must be reduced by 10 percent of income under Obamacare, rather than current law’s 7.5 percent)

Beginning in 2014, businesses with over 50 employees will be forced to offer health coverage for everyone, or pay a hefty tax for each employee?

In 2013, Obamacare caps the amount families can put in their flexible savings accounts at $2500? These are accounts used for a myriad of health expenses including paying upwards of $14,000 in tuition to special needs schools for some parents?
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08:50 AM on 04/05/2011
when you get to kolob, send me some jesus-jammies, okay?
08:00 AM on 03/25/2011
Health Insurance Premiums Up 131% in Last Ten Years

Today, the average cost of a family health insurance offered by an employer is $13,375. That's up 131% over the last decade—a period in which inflation rose only 28%. And one estimate says that if costs continue on their current trajectory, premiums will go up another 166% in the decade ahead.

The data was collected by the Kaiser Family Foundation and comes via USA Today:
Since 1999, health insurance premiums for families rose 131%, the report found, far more than the general rate of inflation, which increased 28% over the same period. Overall, health care in the United States is expected to cost $2.6 trillion this year, or 17% of the nation's economy, according to the non-partisan Congressional Budget Office.

Read more: http://money.blogs.time.com/2009/09/16/health-insurance-premiums-up-131-in-last-ten-years/#ixzz1HM8mQk8C

So, health insurance rates have been increasing long before Obama became president. My brother is a small business owner who provides health insurance and is pleased to have the financial assistance from the ACA.
HUFFPOST SUPER USER
dogdiva
07:51 AM on 03/25/2011
There's no mention of the not so effective high risk insurance the government made available. There's good reason there isn't. Very few are signing up for it. I heard Congressman Weiner say "It's pretty expensive". Well, "pretty expensive" turns out to be up to $1500 a month. Gee, I wonder what constitutes "ruinously expensive"??? Of course you have to be uninsured for 6 months to get on it...not a problem if you have serious health problems. It's not like you could rack up hundreds of thousands of medical bills if you had heart failure during the 6 months you were uninsured.

I guess it accomplished the important thing...improving health care for those who already have insurance, social security, or are young enough to probably not need it. The important thing was that they gave goodies right away to the 'haves'. Some of the 'have nots' will get help in 3 years to buy insurance they still can't afford. Smart move though. By that time they will be firmly entrenched in the underclass and you won't really have to do anything.
HUFFPOST SUPER USER
Elyriaohio
Stop the Monarchy
05:47 AM on 03/25/2011
Over ONE-MILLION children under the age of 26 are NOW covered under their parents plans. Our daughter who is in college and has to have an expensive prescription is one of them. THANK YOU!
07:36 AM on 03/25/2011
hm... I never knew a 25 year old was a "child".
HUFFPOST SUPER USER
Elyriaohio
Stop the Monarchy
07:16 AM on 03/26/2011
If you had a daughter, wouldn't she be your child? If you don't care about people, just say so.
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Left of Right
Want to default your country? Default your job!
01:06 AM on 03/25/2011
God bless you Mr. Potter for your courage and support on the health care matter. For anyone that does not know what I am talking about, do a search on "PBS + Wendell Potter" for 1.

My fear is that there is a very good chance our Republican SCOTUS and the tea-party tribe taking over the country will defeat it and we will be worse off than ever before. The hundreds of millions that the wealthy corportations/republicans put into creating all the misinformation and town-hall travesties is only going to increase.
12:30 AM on 03/25/2011
Can someone out there please explain to me why Congressman Weiner wants a waiver from Obamcare for NYC and why over 1000 waivers have already been approved???
11:59 PM on 03/24/2011
boy, this is a compelling argument
09:34 PM on 03/24/2011
Healthcare will result in higher taxes, higher debt, rationing, an lone healthcare czar accountable to no one, crushing burdens on small businesses, senior citizens losing their Medicare plans, higher premiums, and a potentially unconstitutional mandate.

All of this to redistrubute wealth and manufacture identical social and economic outcomes for everyone! I will never cease to be amazed by the complete insanity and lack of practicality.
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HST
Conservatism = selfishness
10:50 PM on 03/24/2011
I keep hearing about higher premiums from the conservatives like they were no increases before the law was passed.

What a laugh!

Blue Shield cancels insurance rate increase
The healthcare premium increase, averaging 6.5% and going as high as 18%, would have been the third in recent months by the insurer, which had faced pressure from state officials and consumers.
March 16, 2011|By Duke Helfand, Los Angeles TimesBlue Shield of California's decision to cancel a big rate hike for nearly 200,000 people followed mounting pressure from the public and political leaders. But an unforeseen factor may have made the retreat easier for the company to accept: It's paying out less for medical claims than it had anticipated.

And it's not just Blue Shield. Major insurers including WellPoint Inc. and Aetna Inc. also say that medical spending has been lower than projected recently, saving the companies millions of dollars in payouts.

http://articles.latimes.com/2011/mar/16/business/la-fi-blue-shield-20110317

Reality-1 Conservatives-0
HUFFPOST SUPER USER
lipps
Capitalist Pig Taxpayer
10:58 PM on 03/24/2011
Reality is that the increases occured because the free markets looked foward to trends in the future and they were right. That is why the cost increased before the law was passed. The markets knew how damaging this legislation was going to be.
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Left of Right
Want to default your country? Default your job!
01:15 AM on 03/25/2011
Great Post! Thank you for spending that time on this data. Baby step by baby step eventually our voices of common sense will be heard over the spell of misinformation!

#410
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MadAs
Tuned-in science editor
12:46 AM on 03/25/2011
Hey ol' thetruthmustbetold buddy...

No disrespect but your truth = the blah-blah you hear on FOX.

That does not speak much to the credibility of your comment here, but then nor does a gremlin dressed up as a human evoke much more than a laugh at best.
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HUFFPOST COMMUNITY MODERATOR
efffox
The truth is NOT halfway between right and wrong
08:53 PM on 03/24/2011
States with worst health-care systems:

39 Texas
40 Arkansas
41 Kentucky
42 West Virginia
43 Georgia
44 Tennessee
45 Nevada
46 South Carolina
47 Louisiana
48 Alabama
49 Oklahoma
50 Mississippi

Notice what these states all have in common? They're all CONSERVATIVE states. It just proves that conservatives are BAD for America!!
09:14 PM on 03/24/2011
Doesn't prove a thing. Think hard, just for a moment. What else do these states have in common? Poor people with unhealthy life styles. And what do you mean by "worst health-care systems" Please elucidate.
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HUFFPOST COMMUNITY MODERATOR
efffox
The truth is NOT halfway between right and wrong
09:31 PM on 03/24/2011
Oh dear, your state must be on this list. But to answer your question, access to health care, quality of coverage, costs and preventability of hospital admissions, how the poor and uninsured fare under a state's particular system, and the general healthiness of people's lives.

Wake up!!
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HUFFPOST SUPER USER
bigmadd
Retired Teamster & Vet USN
10:13 PM on 03/24/2011
So why are there so many poor people in those states? Could it be the same reason as the bad heath care?
Bernique
Solar is clean, cheap and plentiful
06:41 PM on 03/24/2011
Thank you, Wendell Potter. Someday you will have statues erected in your image, all over the land! Or avenues named after you. I'm serious.

And ObamaCare will be revered, not ridiculed.
05:26 PM on 03/24/2011
"While employers often still pay the lion's share of health insurance premiums, workers are seeing their portion increase every year."
Yes, workers are seeing their portion increase every year - on average, it's proportional to the increase that employers see.
HUFFPOST SUPER USER
samtee
Shankapotomus.
05:15 PM on 03/24/2011
LOL this is getting too crazy

http://www.politico.com/news/stories/0311/51840.html
04:45 PM on 03/24/2011
From the House of Representatives discussions with Dr. Berwick:
the $575 billion it requires in Medicare reductions will make it hard for seniors to find doctors and other providers.

"Medicare actuaries predict that because of the cuts in the Democrats’ health care law, 725 hospitals, 2,352 nursing homes and 1,587 home-health agencies will become unprofitable,"

'Unprofitable' means they will close their doors. These folks cannot afford to subsidize health care, are they supposed to pay every patient they see five bucks? Not likely.
Butquestioning
Searching for truth
05:11 PM on 03/24/2011
The reduction in Medicare payments is designed to find the abuses and stop the payments to those that are trying to cheat the system. The numbers you show are really out of line with the reality of the cuts unless all these have been filing unwarranted claims...
07:32 PM on 03/24/2011
To piggy back on your point, there are doctors out there who are trying to cheat the system. Just two days ago an individual offered my dad medical care from a clinic in Beverly Hills, she also stated that the doctor would get (through his medicare) my father a medical bed and an electric wheel chair he does not need.
09:17 PM on 03/24/2011
Too bad our current administration has not done a better job in stopping Medicare abuse. What in the world makes you think they will improve their performance? Note that these data came from Medicare actuaries. These are government figures and government projections.
04:13 PM on 03/24/2011
Wendell, you are truly an American hero. We need more of you, and we need more citizens to see past the hate filled, emotional rhetoric that has been driving the discussion of health care in the US. Life and death are serious issues that deserve our best, our noblest, and our most humane attention.

The is not and should no be any option to 'kick the can' down the road. The human agenda is the most critical agenda on our plate.