10 Facts About Health Care Reform

It can be tough to find straight-forward, honest reporting in today’s heated political world, especially when it comes to hot-button issues like the recently enacted health care reform. Stories that big generate so much coverage that it’s hard to keep it straight. Who’s lying? Who’s telling the truth? Who’s just crazy? Here are ten facts — actual, black and white facts — about health care reform to get you started on the road to truth. This reportage comes from FactCheck.org, a nonpartisan, nonprofit project from the University of Pennsylvania’s Annenberg Public Policy Center, and PolitiFact.com, a Pulitzer Prize-winning fact-checking group at the St. Petersburg Times.

1. Health care reform does not mean a “government take-over.” This is one of the trickiest misconceptions about the reform bill. The new law does not place hospitals or doctors under government control, nor does it mean the government will cover all costs. Major things like Medicare, Medicaid, and the insurance you get from your employer won’t change. What’s happening is that the government is creating private exchanges to help people compare prices on insurance policies, and its offering subsidies for poorer families to help them buy insurance. That’s it.

2. Your premium will probably stay the same. For people in the individual market, who do not get their insurance from an employer, the cost of premiums might rise or fall depending on what level of coverage they choose; for example, the greater access to coverage might lead to a bigger plan being purchased. But most Americans get their insurance through an employer, and for those people, the Congressional Budget Office estimates that the cost of premiums will hold steady, and mightt decline by a small amount (up to 3 percent).

3. Most abortions will not be federally subsidized. The new law says that a woman receiving federal subsidy money must use her private money to pay for an abortion unless it’s in an instance of rape, incest, or to save the mother’s life. Neither side of the debate is thrilled with the set-up — one group claims that denying funds for a legal medical service is wrong, while the other points out that it’s only elective, non-life-threatening abortions that aren’t federally funded — but the truth of the matter is that the number of abortions would likely stay level.

4. Illegal immigrants aren’t covered. Congressman Joe Wilson became briefly famous for shouting “You lie!” during a joint session of Congress in which President Obama said that health care reforms wouldn’t cover illegal immigrants. But the president’s statement is true: Only legal immigrants will be eligible for the federal subsidies being offered. Anyone here illegally isn’t eligible.

5. You have to have health care. By 2014, everyone must have health care coverage or pay a fine. For many workers who receive coverage through their employers, nothing will change, but for others, they will need to purchase insurance from private companies. However, subsidies will be available for lower income families to help them afford the insurance. Those who don’t have it will pay a fine of $95 in 2014 that will rise to up to 2.6 percent of income by 2016.

6. Pre-existing conditions are a thing of the past. Starting immediately, children under 19 can’t be denied health coverage because of a pre-existing condition, and by 2014, no adults can be denied coverage for their pre-existing conditions. Additionally, children can remain dependents on their parents’ plan until they turn 27.

7. Rescissions are also gone. A rescission is the legal unwinding of a contract, and in health care contexts, it means cancellation of coverage. However, from now on, people with insurance won’t lose their coverage because they get sick.

8. Regulation of insurance companies will increase. For instance, preventive care must now be offered to all.

9. Medicare patients will see some price reductions. The so-called “doughnut hole” is a gap in prescription medication costs for seniors, and the health care reforms address that by offering a $250 rebate to help people on Medicare pay for prescription drugs. In 2011, those on Medicare will be able to receive a 50 percent discount on brand-name drugs to help lower their expenses.

10. Congress has to abide by the reforms. Despite claims by opponents, members of Congress must obtain insurance like the rest of us. The new law includes a Republican amendment that members of Congress take themselves out of the Federal Employees Health Benefits Plan and purchase coverage from private exchanges in 2014.

Filed under: Healthcare Administration

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