US health reform faces big test with implementation
* Public verdict on reform hinges on execution of plan
* Republicans vow repeal of reform
* State high-risk pools key early test of reform
By Donna Smith
WASHINGTON, March 29 (Reuters) - Democrats are pushing to shore up support for the U.S. healthcare overhaul signed into law by President Barack Obama, but the final public verdict will largely depend on how smoothly it is put into effect.
Some of the biggest changes to the $2.5 trillion healthcare system are put off until 2014, but a number of benefits are slated to go into effect this year.
"The experience of people with reform will make more difference in long-term support than anything else," said David Kendall of Third Way, a centrist think tank.
The healthcare overhaul is a huge victory for Obama heading into the midterm congressional elections in November as his fellow Democrats try to hold on to their majorities in the House and Senate.
But polling data show the public is skeptical of the coming changes even though many agree the system as it stood cost too much and left too many people without coverage.
Republicans have vowed to work to repeal the law, arguing it gives the government too big a role in healthcare and that it will bankrupt the country.
In a memo to Republicans in the U.S. House of Representatives last week, House Minority Leader John Boehner said they would "fight to repeal this government takeover of health care so we can start over on common-sense reforms that lower costs for families and small businesses."
SMOOTH IMPLEMENTATION
Democrats and advocacy groups have begun public information campaigns to counter Republican criticisms and to try to improve the public perception over the next few months.
"In order to win the public sympathy and win public support they are going to not only want the implementation to be smooth but also for the public to recognize the benefits coming out of health reform," said Eric Zimmerman, a specialist in Medicare law with McDermott Will and Emery LLP. "It's going to be a challenge."
Within months, young adults up to the age of 26 will be able to stay on their parents' health plans, insurers will no longer be able to drop people from coverage when they get sick, and new policies will be required to provide preventive services free.
Restrictions will be placed on annual and lifetime coverage caps, and many small businesses will be able to tap into new tax credits to help pay for their employees' health coverage.
One of the most challenging provisions for federal and state regulators to implement may be the new high-risk pools for people with pre-existing conditions who have been denied coverage.
The law provides $5 billion to finance these temporary pools that are to be established within the next three months. The pools expire in 2014 when the state insurance exchanges, where individuals and small businesses can shop for policies, are up and running.
Some 35 states already have some sort of high-risk pools, but they function with varying degrees of success, analysts said. The trick going forward is providing coverage for people and getting an affordable premium, they said.
"There is definitely concern about the states and some states will do a better job than others," said Richard Kirsch, of Health Care for America Now, a liberal advocacy group.
"Some states have more experience, some states have more competent administrations, and some of us also worry that there may be times that for political considerations governors are not interested in doing as well," he added.
CHALLENGES AHEAD
More than a dozen states have challenged the law on constitutional grounds arguing the federal government has no authority to require people to purchase health insurance.
Democrats argue the case is without merit, but if opponents succeed in striking down the coverage mandate, it would "blow a gaping hole in the whole framework of reform," said Zimmerman.
Longer term, signing up 32 million uninsured people for new coverage will be a challenge, says Ron Pollack, who heads Families USA. The advocacy group is undertaking a public education campaign to sort fact from fiction, he said.
"Now that we've got legislation passed so that people can learn how it will affect their lives, I think the popularity of it is going to soar," Pollack said.
Pollack's group is also spearheading an effort with other public interest and business groups to make sure enrollment for government insurance subsidies that go into effect in 2014 and the expanded Medicaid program for the poor goes smoothly.
That effort includes America's Health Insurance Plans, the insurance industry group that fought the overhaul.
The new enterprise call "Enroll America" is a broad collaborative effort to help create a system that will make it easy for people to enroll in new program benefits, he said. (Editing by Eric Beech)
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Ramming a healthcare bill the American people clearly did not want is certainly reason enough to REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
However, we the American people must remember the PROCESS that was used to ram it into law against our will. To pass this law, the Congress and Administration had to use countless, secret back room deal that rewarded the constituents of one Congressmen to buy his vote while the rest of the American people paid for it. The Administration and Congress used every legislative trick they could find to ram this bill into law against the will of the American people. The American people demanded TRANSPARENCY and BI-PARTISANSHIP instead we got SECRECY and complete PARTISANSHIP. The PROCESS used to ram this bill into law is a complete affront to our system of government. The American people cannot stand by and let this Congress and this Administration destroy our system of government because they think the process matters. This abusive process should scare us all and that is why we must REMEMBER IN NOVEMBER…VOTE THEM OUT!!! The time has come to take our government back.
Congress and this Administration have put the country on a course of reckless government spending that has mortgaged the future of all Americans especially future generations. The only way to fix this long term structural problem is to create a pro-growth atmosphere for business. To do this we must reduce taxes NOW. How many different taxes does a business or individual pay on a regular basis? We must eliminate number and complexity of all these taxes and reduce the tax burden. REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
We also need to eliminate much of the complexity of government regulation. How many different regulations does a business have to try to comply with? How many forms does a business fill out to comply with government regulations? All of that effort has a cost and the cost is very high. That inhibits growth and jobs. REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
How many government programs to help the poor and others are so riddled with paperwork and regulation that much of the money spent on them actually goes to pay for the paperwork and regulations. We need to greatly reduce the number and complexity of government programs and eliminate the ineffective ones. REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
Most of all we need to eliminate the dirty backroom politics and deal making. A law should be for one purpose without unrelated “pork” included to buy votes in the Congress. All bills and meetings should be held and debated with complete transparency. REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
Obama does not think the American people are competent enough to manage their own affairs so he wants government to do it for us. REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
We are witnessing the greatest intrusion into the private lives of individuals and business in history. It is time to take our government and Country back. REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
REMEMBER IN NOVEMBER…VOTE THEM OUT!!!
Is this journalistic hyperbole? If not please explain the circumstances under which insurers have been dropping people from coverage when they get sick
This causes more problems though than just the cost of things versus their intrinsic value. Those of us who are not in positions where we can raise our prices (our pay) in accordance with the increase in cost of living are left on the slippery slope towards poverty, ultimately pushing us toward the social programs. If you look at the data for poverty and income, the percentage of people in poverty today compared to in 1975 is roughly the same, however while average earnings have increased only 20% the increase in the “poverty threshold” (or the earnings below which one must make in order to claim impoverishment) has increased 26%, meaning that even though the dollar doesn’t stretch as far, more people would be in poverty by the standards of 1975 than by today’s standards.
Furthermore, for businesses the cost of production becomes much cheaper in places where pay is less, but because the good is sold here in the US, it is given a fictitious value based on US consumer prices, not a value based on the price of production. The more production moves to cheaper countries, the more people requiring social programs for survival because they cannot find work. One might be inclined to be angry with corporate America for abandoning the people, but the nature of business requires profits, and it has become impossible for producers of many goods to maintain American cost of living, though they should have an obligation to maintain fair pricing in order to help reverse this ever increasing cycle of devaluation of the dollar. Also we have the profiteers, or those (even in middle class) who buy stock in these companies and want them to make a profit–in other words, we are holding ourselves to these terms.
Then there are the people employed by the government, who are all salaried earners with pensions, which basically amounts to another form of social benefit. They work twenty years, and they get annual retirement payments by us, the taxpayer, unitl death. Considering the fact that more people are employed by hte government than by private industry, and we come to understand that the government will not be decreasing in size because that’s half the nation who all want to keep their jobs and their retirement packages at the taxpayer’s expense (yes, they are taxpayers as well). This law calls for more government employees, which means more people making median salaries with benefits packages and the right to collect medicare and social security on top…
The way this reform is written will only cause things to get worse from here. Until people start looking at the whole picture, instead of one small segment, and seeing the ways in which everything correlates, we will not be able to find a reasonable solution to anything. We need fiscal responsibility. And we need it now.
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