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ETpro's avatar

Healthcare Reform Passes, how much difference will it make immediately after being signed into law?

Asked by ETpro (34428points) March 22nd, 2010

It is interesting that many of the same people who were yesterday telling us that if Obamacare passed, the sky would fall, the massive caldera that forms Yellowstone National Park would have its next super-eruption and cause a nuclear winter to kill all life in America and the Soviet flag would immediately be hoisted over the White House now are writing that nothing will change for years to come, it doesn’t do enough soon enough.

Why do you think they would change their tune so abruptly and discordantly? If, yesterday, it really was going the end all medical care and cause the Soviet Flag to be flown over the White House, how could it today be going to do nothing at all for years?

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26 Answers

Qingu's avatar

• For people under 26 it will make an immediate difference. The bill lets such people maintain coverage under their parents’ plan.

• For people with pre-existing conditions, the bill sets up a high-risk insurance pool, and (I believe) soon after outlaws insurance companies from denying you coverage.

• Many of the bills more substantial changes don’t go into effect until 2014. Even then, for many people—i.e. people who already have insurance through their employers—it won’t make much difference at all. It may help to contain costs, but probably not by much.

• For people with individual health insurance it will make it easier to buy insurance and cheaper through the exchanges.

• For the rest of people, i.e. people without insurance, who can’t afford it or who are too sick to get it, the bill will make a huge difference. It will give them money to afford coverage and force insurance companies to not screw them over.

More details here (NYT).

Dr_C's avatar

the 10 immediate changes enacted as of the bill’s passage are as follows:

* Prohibit pre-existing condition exclusions for children in all new plans;

* Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;

* Prohibit dropping people from coverage when they get sick in all individual plans;

* Lower seniors’ prescription drug prices by beginning to close the donut hole;

* Offer tax credits to small businesses to purchase coverage;

* Eliminate lifetime limits and restrictive annual limits on benefits in all plans;

* Require plans to cover an enrollee’s dependent children until age 26;

* Require new plans to cover preventive services and immunizations without cost-sharing;

* Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions;

* Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs.

By enacting these provisions right away, and others over time, we will be able to lower costs for everyone and give all Americans and small businesses more control over their health care choices.

casheroo's avatar

What about people on state insurance already? (sorry if a link covers it, I can’t look right now)

Ron_C's avatar

The above answers are excellent. Funny I didn’t see any government take overs or death panels. I guess it won’t matter because the republicans said that this is the end of the world anyway.

Qingu's avatar

@Ron_C, you know that Republicans are going to take credit for there not being death panels. “If we Republicans didn’t speak out so strongly against death panels and rationing, they would still be in the bill!”

Ron_C's avatar

Seriously? There were never death panels in any bill. There was the opportunity for people to talk about end of life issues that would be paid by insurance. That was removed. Now you have to figure it out for yourself. We just went through that with my father. It would have been nice if we could have had a third party to help us through it but that was labeled as a death panel. I dare any politician to take credit for that omission when I am present.

Grisaille's avatar

@Qingu “If we Republicans didn’t speak out so strongly against death panels and rationing, *it would** be in the bill!”

Slight difference.

Variation of this.

Qingu's avatar

@Ron_C, remember how Republicans took credit for all the stimulus bill projects they demonized and voted against?

phillis's avatar

With 16 million people now meeting the eligibility requirements for medicaid because of this bill, how in the hell are those offices going to operate? Hve any of you huys ever gone to a medicaid office to apply? It’s an all day nightmare! Though I agree that HR is a good thing with a little bad thrown in, the hidden costs are enormous. More people have to be hired to process the paperwork, more machines to process the paperwork, and probably new buildings built to house medicaid offices, at least here in Georgia. And, more doctors and nurses need to be hired. That’s just scary.

I have looked and looked, but I need a little help. Whatever happened to the idea they were trying to pass that this insurance would not pay for annual screenings? Cancers are only caught successfully with early detection. What happens to those who cannot afford screenings, then go on to devlop full-blown cancer, driving up the medical costs?

lilikoi's avatar

Nobody mentioned the fact that you are required by law to buy health insurance and if you don’t you’re fined 2.5% of your income?

And the control the DOE now has over student loans?

And that FFEL loans have been killed, with the money saved going to fund the health care reform?

Read the whole bill here.

It’s pretty lame that it is easier to find legislation on someone’s privately owned site rather than on the government’s own site, btw.

jaytkay's avatar

Every bill introduced into Congress is at Thomas.gov

Here is yesterday’s
http://thomas.gov/cgi-bin/query/z?c111:H.R.4872:

ETpro's avatar

@casheroo This bill doesn’t force anyone who currently has health insurance they like to change it. The only impact is will have is to prohibit the most egregious practices that insurers have practiced in the past.

@phillis I haven’t signed up for Medicaid but I have for Medicare. It was a total breze. I was sure it was going to be an all-day beuracratic exercise but was pleasantly surprised by the cherful attitude of the lady who waited on me and the little time it took. The CBO scored the bills cost, and that did include looking at personel additions required to make it work.

@lilikoi Better stop getting what you think is news from Fox. The penalty fine was dropped. The DOE is taking control of student loans to eliminate egregious, expensive practices banks had developed for them. About FFELP Loan subsidies, CBS news comments, “Democrats could score a clear political victory by passing reforms that would help the thousands of students across the country who last week protested rising higher education costs.”

rottenit's avatar

I think the concept of “health care reform” got a bad named during the begining, with the “death panels”, etc. the Hyperble over took the whole theme. Im just happy they cut some of th back room deals out and tried to execute this with some crediablity. This is not going to efect people for a couple of years. And dont mind paying more $$ into SS, we have friends that dd not hae coverage but will under this plan, they work hard justdont have jobs good enough to get coverage.

ETpro's avatar

@rottenit Thanks. I wished for a lot better. I’d love to have seen them start off talking about Medicare for All who want to buy in instead of a “Public Option”. THey could have allowed anyone who couldn;t get private insurance or afford it to buy into Medicare at a price appropriate for their age, and make just enough profit on it to make sure Medicare stays solvent for seniors without needing a huge cash infusion in the future.

The wording, “public option” gave the disinformation crowd perfect ammunition to distort what it was about. The government is going to make my healthcare optional? It’ll be public, meaning some bureaucrat in Washington gets to decide if I live or die? It wasn’t that at all, but the wording played right into Republican spin-masters’ hands.

Like Republicans, I would liked to have seen reasonable tort reform so long as real malpractice still got compensated. I would have liked to see competition across state lines so long as an insurance commission was established to make sure the companies don’t buy out some state’s legislature, set up laws that allow legalized extortion, and then just offer policies under that state’s laws.

Oh well. Next year, we can take up fixing some things that are wrong.

phillis's avatar

@ETpro Thank you for that. Do you know what happened to annual screenings? Are we still to pay for them, or did that get changed? I had a hard time keeping up with the loose ends on this bill.

ETpro's avatar

@phillis Preventative care coverage added to Medicare. Whoopee!

phillis's avatar

Damn, that is seriously THE best news I have heard in awhile. Thank you, my friend! You made my day :)

rottenit's avatar

@ETpro The medicare for all plan scares the hell out of me, currently how medicare reimburses doctors is pretty screwed up. I have a friend who is a psychatrist, according to him if a patient comes in, gets diagnosed with deperession and then a perscription is ordered for medication, family practice/internal medicine docs get more money from medicare than he does. Which seems silly based on the fact he is the mental health specialist.

There are other cases where certian specialties are reimbsed 33% of standard rates, on some procedures it is possible to loose money with medicare patients, im not talking just proft but it does not cover the basic costs of the procedure.

ETpro's avatar

@rottenit I am on Medicare and like it. But I agree it needs fixing and it does carry a cost. Most of the medicare population simply would not be able to purchase private insurance at any price. They might say preexisting condition, but the bottom line is it’s an unprofitable group to insure. That is why Medicare was set up, and why it is costly. If young people were part of the group as well, the overall cost per person would be far lower than Medicare now and also far lower than private health insurance. Medicare administrative costs are far lower than for-profit insurance administrative costs.

Most of the developed world has either some form of Universal Medicare (single payer government provided insurance with private doctors and providers) or socialized medicine as in the UK, (Single payer with doctors working for and in goverment hospitals). Both models deliver far better healthcare outcomes art a drastically lower price. The US spends 17% of its Gross Domestic Product on healthcare and ranks #37 in the world in outcomes, just behind Costa Rica and ahead of Slovenia.

So this isn;t something that has to be left to guesswork or personal opinion. We can look at each system where it is employed and see which works best. The #1 system in outcomes is a Medicare for all (Single Payer) system.

rottenit's avatar

@ETPro I am saying that medicare does not provide good coverage to patients, what scares me is the reimbursment system for physicians under medicare, its kind of screwed up (im refrencing my psych example from before). It just seems like without fair reimbursment for providers we might either end up with lower quality providers or too many providers flocking into “better reimbursed” specialties (some of the latter is allready goigng on with the way things are now tho.) We have some of the top talent and hospitals in the world.

I am also alittle skeptical of the “outcome” model of healthcare performance, some specialties will naturally have lower good outcome rates, some stuff wont be cured. Its just life, I guess alot of how I feel about reform is tanted by my natural distrust for goverment. The one thing I will say is Obama and the dems bought alot of credit with me when they dropped some of the “bribe” deals that went along wth peoples votes on this. This could be a good step towards something better, I am very dissappointed that they did not couple this with more legal reforms (malpractice, etc.) I think we have a signifigant amount of waste with alot of the “cover your ass” documentation and procedures that are ordered.

At the very least alot of people who need coverage are going to get it. I’m still trying to figure out how thats bad if we can save $$ in the process with this plan.

ETpro's avatar

@rottenit They made some tweaks to the reimbursement system to try to even thoing out for the small town providers who had been getting hosed. It still needs changes and improvements. But I have no doubt they will come. One thing we seniors have is a voice in government because we vote. Almost all of us do. And if my doctor doesn’t want to accpet my Medicare any longer, that is definitely going to come to the attention of my congressman and senators.

The outcome thing will take work to perfect, but it needed doing. I know of doctors who want to see Medicare patients every month just for borderline BP treatment that is under control. They won’t give them a refil. Only a month’s supply so they can bill Medicare every month for something that should require 2 visits a year.

Dr_Dredd's avatar

@ETpro It isn’t just the small town providers who are getting hosed. It’s anyone doing primary care. We don’t get reimbursed for filling out forms, coordinating care, and spending time on the phone trying to keep people out of hospitals and nursing homes. If that isn’t changed, I predict more and more primary care providers retiring early and medical students not choosing it to begin with.

I think that’s the reason why doctors won’t give refills and want to see patients for blood pressure control. Volume is the only way to make enough to cover the overhead for many practices.

ETpro's avatar

@Dr_Dredd Noted. THere is a whole lot that still needs fixing.

Dr_Dredd's avatar

@ETpro No argument there!

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