A number of political commentators have expressed concern about the timetable for implementing health care reforms, particularly as it relates to Democratic prospects in the upcoming midterm elections. So far, Politico‘s Carrie Budoff Brown has the best summary of the timetable for the proposed Senate compromise health care reform bill. Here’s a much-abbreviated summary of Brown’s rundown on “immediate benefits” of ‘The Patient Protection and Affordable Care Act,’ which kick in the first year after enactment:
Access to Affordable Coverage for the Uninsured with Pre-existing Conditions…
Closing the Coverage Gap in the Medicare (Part D) Drug Benefit… reduce the size of the “donut hole” by raising the ceiling on the initial coverage period by $500 in 2010…also guarantee 50 percent price discounts on brand-name drugs and biologics purchased by low and middle-income beneficiaries in the coverage gap.
Small Business Tax Credits…Tax credits of up to 50 percent of premiums will be available to firms that choose to offer coverage.
Extension of Dependent Coverage for Young Adults…until age 26.
Free Prevention Benefits…exempt these benefits from deductibles and other cost-sharing requirements in public and private insurance coverage.
No Arbitrary Limits on Coverage…prohibit insurers from imposing lifetime limits on benefits and will restrict the use of annual limits.
Protection from Rescissions of Existing Coverage
Prohibits Discrimination Based on Salary
Health Insurance Consumer Information…provide assistance to States…to assist individuals with the filing of complaints and appeals, enrollment in a health plan…
Clear Summaries, Without the Fine Print
It’s encouraging that the key element of no denying coverage for prior conditions kicks in during the first year. That alone is a significant selling point. The problematic Senators (Lieberman, Nelson, Landrieau and Snowe) will have to think twice about the costs of casting a vote that may kill that important reform for consumers. The other measures are gravy, thin gravy in some cases, but selling points nonetheless.
Now for the tough sell, according to Brown:
The Senate bill pushes back implementation of major parts of the reform to 2014 — a change from 2013 under the Finance Committee bill…This is bad news for lawmakers who will need to explain to constituents why the elements that have attracted the most attention — the public plan, the Medicaid expansion and the insurance exchanges — won’t be available for four years.
Presumably, the timetable for these these delayed reforms is negotiable in myriad combinations with other proposed modifications to come in horse-trading during the weeks ahead. The challenge is to devise face-saving options for Nelson, Lieberman and/or Snowe, and maybe Landrieu — which don’t significantly undermine the substance of Reid’s proposals. Quite a hat trick, that.
The extension of coverage for dependents is not “thin gravy.” In this job market, lots of young adults have a hard time getting coverage.
This assessment confirms that those currently covered will very little that affects them in 2010 or 2012 because the big ticket items that would make a difference to them don’t kick in for years — and may never kick in if the effects of the bill are viewed very negatively by many voters and the Democrats lose control of the House, Senate, or Presidency.