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How Will Healthcare
Reform Affect Your Life?
(Part 1 of 3)
Posted to Kansas City Star/Midwest Voices, April 28, 2010

Healthcare Reform Column

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There's been a lot of talk, on both sides of the debate, about the healthcare reform package either resulting in dire personal consequences, or solving all or your healthcare problems. The truth is, for the average healthcare consumer, it's neither, despite all the rhetoric. So, what's the reality? What's in it for you, how will it affect your life?

If you need a quick bullet-point summary of who is affected and how, here it is (see Parts 2 and 3 for details and when they take effect):

Parents get their kids covered until age 26, and an end to pre-existing condition restrictions.

—Those in chronic ill health get big-time help: eventually no more pre-existing condition restrictions, and a transitional program for them in the meantime.

Low- and middle-income uninsured will get subsidies to buy insurance through exchanges, or through Medicaid.

Seniors get help with Medicare drug coverage, eventually closing the so-called "donut hole," and getting a $250 rebate in the meantime. But those seniors who get additional benefits by paying for Medicare Advantage programs will likely see some insurers either drop those programs or cut benefits.

High-income earners (those making more than $200,000 a year) will pay more in a number of ways. Direct taxes include: a Medicare Payroll tax on both earned and investment income.

Other tax changes include a new limit on FSA's (Flexible Spending Accounts) and a higher threshold on using medical deductions, as well as a new tax on high-end "Cadillac" insurance plans.

—Those who currently choose not to insure themselves may end up paying for insurance they don't really feel they need.

Small business owners will get tax credits to help buy insurance for their employees, but will not be required to do so (if smaller than 50 employees).

Large businesses and corporations, (those with 50 employees or more), and health insurers, will face a variety of new restrictions, regulations, penalties and taxes. In the end, the effect on corporations will affect consumers. There is debate as to what that effect will be, including claims of job losses vs. job creation, higher costs/lower costs, higher or lower quality of care, availability of care, and so on.

From a cursory point of view, not taking into account all the unknowns and unintended consequences, there is little new benefit to the average consumer, and no harm I can see. No one will lose their doctor, get more limited healthcare choices or get poorer care. The positive theory is that it will help society as a whole, because the general health of our population will increase. Costs shared by all will be reduced, such as emergency room care for the sick and indigent, and lost productivity due to lack of preventive care.

It remains to be seen if this will really "save" our healthcare system, in the sense of lowering the spiraling costs for businesses and consumers. For some, the most important perspective is that it fulfills a moral imperative, ending the contradiction of the richest nation on earth being lower on the scale than many developed nations on some standards of healthcare such as life expectancy and infant mortality.

As far as that "average consumer" goes, I'll use myself as an example of what to expect. I get my insurance through my employer and am in fairly good health. For me, for now, nothing really changes. I get to keep my current plan, I don't think my rates are not going to be increased (though I'll see for sure once the renewal period comes this Fall), and I will not pay more in taxes or fees (unless I suddenly get rich).

One benefit for me—sort of—will be that I will no longer have to co-pay for preventive care visits to the doctor or for certain (approved) preventive care services such as annual check-ups, healthy child visits, breast cancer screenings for women and immunizations. Here’s the catch: it only goes into effect for "new" plans. I get that only if I switch to a new job/plan, or if my company's plan changes enough to be considered "new." If I stay in current job and plan, I don't get free preventive care until 2018, when all plans must have it.

Enough about me, let's pick some other "typical" people and see how it affects them. Go to Part 2 and 3 for details for specific groups of people:

Continue to Part 2 of 3