A report released today by the Economic Policy Institute reinforces Michigan’s need for full implementation of federal health care reform known as the Affordable Care Act. Michigan ranks No. 1 in the number of people, nearly 1 million, who have lost employer coverage over the period 2000-01 and 2008-09.
This is bad news, both for Michigan’s health status and economy. The majority of people who lose their employer coverage are unable to afford private coverage due to cost. This has contributed to the dramatic increase in the number of uninsured.
The report should help counter the “noise” about the repeal of the Affordable Care Act that has certainly escalated over the past couple of weeks. It is important, however, to filter the “noise” for substance, or lack thereof. To date, there has been no comprehensive alternative proposed by those unhappy with the law, and the Congressional Budget Office estimates that repeal would increase the deficit by $455 billion over the period 2010 – 2019.
While the law is not perfect (and what new law is?), it has already provided critical health care benefits to thousands of Michigan residents, including children who can no longer be denied coverage due to a pre-existing or chronic condition; young adults without employer coverage who have the opportunity to remain on their parents’ employer insurance plans without being students or tax-defined dependents; adults who have gained coverage through the special program subsidized by the federal government but administered by Physician’s Health Plan for those with a pre-existing condition who had been unable to secure coverage and had been uninsured for six months (applications for this program are currently being accepted); and Medicare Part D beneficiaries who received a $250 payment to help those who had reached the “donut hole” and no longer had assistance with their drug costs.
In addition, health insurance plans can no longer cancel coverage for someone simply because they become ill and need benefits or impose lifetime limits on the amounts they will pay in benefits. There are also newly imposed restrictions on the amounts of annual benefit limits insurers can impose.
It would be devastating for those who recently gained these valuable benefits to lose them, and again become uninsured or underinsured.
Additional consumer-friendly benefits are scheduled to take effect in each of the next four years. In 2011, more than 20 new provisions will be implemented, including such policies as:
• Health plans must spend 80 percent to 85 percent (depending on their market size) of collected premiums on medical care. Failure will result in insurers having to offer rebates. Key definitions of medical care were recently adopted by the National Association of Insurance Commissioners, and submitted to the Department of Health and Human Services for approval.
• The elimination of cost sharing for Medicare beneficiaries for specific recommended preventive services.
• Required 50 percent discounts on brand name drugs for beneficiaries who have reached the Medicare Part D “donut hole” and would otherwise have no assistance with their drug costs.
• The creation of the Center for Medicare and Medicaid Innovation to test new payment and delivery approaches to reduce cost and improve quality and outcomes.
Full implementation of the Affordable Care Act will provide the opportunity for those people who lose or have lost their employer coverage to secure affordable coverage, with sliding income scale subsidies and limits on out-of-pocket costs, through the Exchanges to be implemented on Jan. 1, 2014.
Let’s not be distracted by the “noise” about repeal.
Rather, let’s focus our energies on helping policymakers, particularly the new ones, understand the law and its benefits, and determining the best way to implement the Affordable Care Act to provide affordable, quality health care for all in Michigan – our families, our friends, and our neighbors.