This Week in Healthcare

Health Reform Implementation:  What Happens First?
Most of the new requirements and programs in HR 3590, the Patient Protection and Affordable Care Act as amended, will not take effect until 2014.  However, there are several immediate changes that you should know about, as follows:

1.  Young Adult Coverage:  Within a few months, young adults up to the age of 26 will be able to stay on their parents health plans.
2. Insurer restrictions:  Within a few months, insurers will no longer be able to drop you from coverage because of illness
3. Free preventive services:  Within six months, specific preventive services will be available through your private health plan at no charge to you.  These services include (but are not limited to) screening for colorectal cancer, breast cancer, cervical cancer, HIV, obesity, osteoporosis in adult women, lipid disorders in adults, and diabetes.  Also included are immunizations; preventive care for infants, children and adolescents; and additional preventive care and screening for women.
4. High Risk Pools:  Within 90 days, a temporary high risk pools for those who have been denied coverage due to pre-existing conditions will be established.  The new health reform law allocates $5 billion to finance the high risk pool.  The cost is expected to be less than the cost in the State’s existing high risk pool (MRMIP) and out-of-pocket expenses will be capped.  The high risk pool will be terminated in 2014 when the entire health reform bill is implemented and no individuals will be denied coverage due to pre-existing conditions.
5. Small Business Tax Credits:  Within a few months, tax credits will be available to employers with fewer than 25 employees and average annual wages less than $50,000 who cover at least 50% of the cost of health coverage for their employees.   Tax credits will cover up to 35% of the premiums paid and will increase to 50% in 2014.
6. Medicare Donut Hole for Prescription Medication:  Within a few months, the first step in reducing the cost of pharmaceuticals for seniors will be achieved through a $250 rebate for Medicare beneficiaries that reach the coverage gap.  The coverage gap will be fully eliminated by 2020.

Insurance industry agrees to fix kids coverage gap
By RICARDO ALONSO-ZALDIVAR (AP) If you can't beat them, join them.

After nearly a year battling President Barack Obama and congressional Democrats over the health care overhaul, the insurance industry says it won't block the administration's efforts to fix a potentially embarrassing glitch in the new law.

In a letter to Health and Human Services Secretary Kathleen Sebelius, the industry's top lobbyist said Monday insurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year. Quick resolution of the doubts was a win for Obama — and a sign that the industry has no stomach for another war of words with a president who deftly used double-digit rate hikes by the companies to revive his sweeping health care legislation from near collapse in Congress.

"Health plans recognize the significant hardship that a family faces when they are unable to obtain coverage for a child with a pre-existing condition," Karen Ignagni, president of America's Health Insurance Plans, said in a letter to Sebelius. Ignagni said that the industry will "fully comply" with the regulations, expected within weeks.
Read More >

Health Reform Law Could Limit Calif.'s Proposed Program Cuts
Provisions in the new national health care reform law could make it difficult for Gov. Arnold Schwarzenegger (R) to follow through on some of his proposed cuts to state health insurance programs to rein in California's mounting $20 billion budget deficit, New America Media reports.

The health care reform law includes a "maintenance of effort" provision requiring states to maintain their Medicaid and Children's Health Insurance Programs. Medi-Cal is California's Medicaid program, and Healthy Families is the state's CHIP program.

Schwarzenegger has proposed eliminating several social service programs, including Healthy Families, unless the federal government provides the state with an additional $7 billion. So far, the federal government has pledged only $3 billion.

If Schwarzenegger attempts to follow through with his proposed cuts, California would have to forgo all federal Medicaid funding, amounting to billions of dollars annually, according to Kelly Hardy, policy director for the national advocacy group Children Now.

Schwarzenegger and state lawmakers are examining the new federal law to determine what it will mean for the state financially.

At a press conference last week, Schwarzenegger said, "My concern about the federal government's health care reform is only how do we fund it, because they have shifted the funding from the federal government and ... it will cost us $3 billion more."
Read More >

KPBS interviews Sharp Healthcare CEO, Michael Murphy and Gary Rotto, Director of Health Policy for the San Diego Council of Community Clinics on the impact of health reform legislation on their industries.
Read More >

KPBS interviews business leaders Richard Ledford, owner of Ledford Enterprises, Ruben Barrales, CEO of the San Diego Regional Chamber of Commerce and Ruben Garcia, Executive Director of the Small Business Administration in San Diego on the impact of health reform legislation on small business.
Read More >

  Opinions

Don't Believe the Writedown Hype
Taken as a whole, health reform is undeniably pro business and pro jobs
By GARY LOCKE, US Commerce Secretary
President Obama began his campaign to reform the American health-care system focused on three goals: protecting Americans' choice of doctors and health plans, assuring quality and affordable health care for all Americans, and reducing costs for families and businesses.

The new comprehensive health-care legislation meets these goals, and will significantly benefit American businesses by slowing and eventually reversing the tide of crippling premium increases washing over our nation's employers.

These cost savings are real. They will grow over time. And they will make U.S. businesses more competitive.
Read More >

Thank you for subscribing to Voices for Reform. Your email will never be shared or sold to other companies. You can subscribe / unsubscribe at our newsletter page.