Health Care Reform: Support It Today Because Of What’s In It For You

Today, tomorrow and Sunday should be the final days of the push for health care reform in the US House of Representative, and know it or not you want to support H.R. 4872, the Reconciliation Act of 2010. Unless you are a hard-core conservative (more interested in handing a defeat to President Obama than in saving the lives of millions of Americans, reducing the deficit and reducing the likelihood that you, personally, will be billed into poverty by an unforeseen medical emergency) there is no reason not to support this bill.

This bill is not a government takeover of health care. There are no death panels or provisions for rationing care. In fact, when fully enacted it will prevent health insurance companies from rationing care as they do now through rescission (denying coverage when people get sick) and annual and lifetime caps on coverage.

This bill is a modest, conservative (too conservative for many liberals) reshaping of the way health insurance companies profit in the United States—and according to the non-partisan Congressional Budget Office, it reduces the federal deficit by about $130 billion in the nest 10 years and by 1.2 trillion in the second ten years. This is the biggest deficit reduction bill since the Clinton years (remember President Clinton who left a budget surplus?).

What is in the bill for you?

I hope you and everyone you know are in relatively good health. If you are, you may not be aware of the health insurance nightmare scenarios many American live through many of which are addressed by this bill. For brevity’s sake, I will not go into the tragedies that the problems so addressed inflict on families. When I tell you that within 90 days of the bills being passed those Americans who have been denied coverage because of some preexisting condition will finally get a path toward coverage, I will leave it to you to imagine what it is like to have a health condition, say type-II diabetes, and not be able to buy health insurance. Within 90 days such people will have immediate access to care through high-risk insurance pools created by the government (yes there is government involvement but only in creating the pool).

Within 180 days of the bill being signed it will be illegal for insurance companies to deny kids coverage because of their preexisting conditions. (Yes, although it is prevented for some by the Health Insurance Portability and Accountability Act of 1996 [HIPAA] many parents find that their children cannot be covered by their health insurance because the children are born with preexisting conditions) At 180 days in, children will also be allowed to stay on their parent’s health care plans until they are 26 years old. (This is a great relief to parents whose adult child cannot find a job with health care benefits.)

At this point, insurers will also be banned from imposing lifetime limits on health insurance benefits (If you don’t know someone who has hit this limit you may not have been aware it was there, and modern hi-tech procedures can run you to the limit fast.)

Insurers will also now be banned from rescinding your insurance—canceling your coverage based on some, until then, unknown technicality after you file a claim.

The next phase of reform kicks in during the next calendar year (on January 1^st). From then on insurance companies essentially will be required to spend 80 percent to 85 percent of what they take in from premiums on actual medical care, and if they don‘t spend 80 percent to 85 percent on actual medical care, they will have to refund you the difference. Also at this point, if you‘re on Medicare, you will qualify for free annual wellness visits.

After January 1^st your insurance company will no longer be able to arbitrarily raise your rates. (Even those of us covered by employer’s health insurance suffer from rate hikes as employers opt to pass on more of the cost to the employee or opt for cheaper coverage with fewer benefits.) If the insurer wants to hike your rates, they‘ll have to announce it and justify it. This justification will be reviewed and the increase can be denied it the justification doesn’t hold water.

After all of that, in 2014, it will no longer be legal for insurance companies to deny anyone coverage based on preexisting conditions, period. The prevision protecting kids with preexisting conditions that goes into effect in 180 days will be extended to everyone in 2014.

By 2014 the health insurance exchanges for people who don‘t have coverage will also be established, giving millions of people who cannot now afford health insurance affordable options. Also in 2014 insurers will be banned from imposing annual benefit limits. This is real protection against going bankrupt due to a catastrophic health emergency.

If you are complacent about this health care reform legislation, you probably have health insurance you are satisfied with, so I have not gone into the number of uninsured who will be gain coverage under this bill (about 31 million) or the number of people who die each year for lack of health insurance (about 45,000) or survival rates for children born to mothers who lacked pre-natal care (their babies are five times more likely to die). Instead I have tried to focus on the benefits you may need tomorrow if not today. (Want to be half-way through a quadruple bypass surgery when you hit your annual benefit limit? Want to see what that bill would do to your savings and home equity?)

Plus this bill, as I noted at the start, reduces the federal deficit by about $130 billion in the nest 10 years and by 1.2 trillion in the second ten years. Not bad.

Republican talking points focus on the bill’s cost ($940 billion over 10 years, it sounds like a lot but it also reduces the deficit substantially). The way the bill is being passed (through reconciliation so the Republicans can’t filibuster it, and through deem and pass in the house, to cover it in a single vote. Both of these techniques have been used again and again by Republicans.) Republicans also like to talk about the uncertainty in the CBO’s estimates. For something this big and complex, there is going to be uncertainty, but the CBO is non-partisan and provides the best unbiased estimates available. The Republican concerns about the CBO’s figures are purely political. You want to prove that to yourself? Imagine what Republicans would be saying if the CBO had found the bill cost more than expected and did not reduce the deficit. There would still be uncertainty, but I doubt you would hear about it from the Republicans.

This is not a perfect bill, but because of what it does for you, it deserves your support today. You will find examples of letters to your representatives in the post that follows.