Could You Pass a Health Care Reform Pop Quiz?

I made it a point to tune in to all sorts of talk radio, TV and Internet broadcasts in recent weeks to gather as much information regarding the implications of the newly passed health care reform bill as I could. But I’m pretty much convinced that in spite of all that listening and reading I’ve been doing, I couldn’t pass a pop quiz on what it all means for those of us lucky enough to be employed and have access to employer-sponsored health insurance.

How about you? Have you read the 2,000+ page law? Do you know anyone who has?

Quick – list five points about the health care reform bill that you know for sure will affect you directly. Five too many? How about three? Yeah. Neither could I.

The miasma of information mixed with politics and rhetoric fatigue has made making sense of it all quite a slog. I think some folks just quit trying to keep up.

But one broadcast caught my hopeful interest over the weekend because it was so straightforward. It was an interview that NPR’s Scott Simon did with Jonathan Oberlander, who teaches health care politics at the University of North Carolina Chapel Hill. I’m happy to report that I was actually able to follow and retain some of what was said. Read on for a round-up of 10 points I gathered from this conversation, most of which, (to the best of my knowledge) is accurate. At least for now:

  • A few provisions in the health care reform bill go into effect in a matter of a few months, such as barring insurance companies from dropping children with preexisting conditions.
  • People with pre-existing medical conditions will no longer be walking a tightrope without a net – they will be eligible for a federally funded high-risk insurance program.
  • Some provisions won't go into effect for four years or even longer, such as expansion of insurance coverage.
  • There are two main ways that the legislation will expand access to health insurance; the first is to broaden eligibility for Medicaid, which will add an estimated 16 million Americans to the program beginning in 2014.
  • The second is the creation of “health insurance exchanges,” which will be run at the state level and “are sort of regulated marketplaces where the uninsured and small businesses would shop for health insurance,” according to Oberlander. The exchanges will start running in 2014.
  • Employees who already have access to health insurance through their workplaces are not at risk to lose coverage due to their employers seeking to reduce costs so they can cover more people (such as part time employees and adult children up to the age of 26) Oberlander says.
  • One drawback with the legislation in its current form is that while people currently enrolled in employer-sponsored health insurance programs are not likely to lose their coverage, they will not have access to the new health insurance exchanges unless they work for very small companies. This means that they won't have the option to comparison shop and choose from the new plans.
  • Insurance companies might come out the big winners, which is why the insurance industry has supported reform for the most part. Why? “Their major business is in employer-sponsored health insurance coverage. And a decade ago, 69% of American companies provided health insurance to their workers. Now, it's only 60%. So, from their financial perspective, they really need to stabilize this market and the prospect of the government subsidizing coverage for 32 million Americans is a good one for them,” says Oberlander.
  • But, on the other hand, life as they have known it will not be the same for insurers: there’s going to be a LOT of regulation and a lot of change. Private health insurance companies will no longer be able to deny coverage to sick people and they won’t be able to charge astronomically higher premiums due to preexisting conditions.
  • Oberlander also says that drug companies have something to celebrate in the passage of the reform bill. The well-financed drug makers got onboard with reform early because they figured they stood to gain a broader base of consumers in the long run.

This may not have explained it all, but it’s my best shot at summarizing a document that’s longer than War and Peace in a blog.(Read the text of the Senate bill and the changes passed by the House.)

What facts have you gleaned from the hype on how the new health care plan will affect employers and employees with existing coverage? What steps is your organization taking to prepare for various implementation stages of the plan?