Change coming: Forum explains new health care legislation

About 30 people turned out to a public forum Wednesday at Mercy Health Center to hear more details on federal health care reform legislation signed into law earlier this year by President Barack Obama.

Keynote speaker at the forum was Mercy Regional Director of Revenue Management and Reimbursement Karen Endicott-Coyan, who presented details on both the Patient Protection and Affordable Care Act signed into law on March 23, and the Health Care and Education Reconciliation Act of 2010, signed into law March 30. This is an amendment to the Patient Protection legislation.

Endicott-Coyan, who has read the entire health care bill, outlined its key components for attendees.

Mercy Health Center President and CEO Reta Baker introduced Endicott-Coyan and said there are currently "more questions than answers" regarding the controversial bills.

"Unfortunately, there are a lot more questions than answers at this point in time," she said.

Endicott-Coyan said it gives "a lot of power" to insurance commissioners in each state and U.S. Secretary of Health and Human Services Kathleen Sebelius.

Implementation of the law will be ongoing for many years. Its provisions will present many challenges and changes through 2019, and "no one will be untouched," Endicott-Coyan said. The law also created 159 new health care boards and commissions.

The law could change in the future, depending on the outcome of the Nov. 2 general election, Endicott-Coyan said.

"If the Democrats win, then health care reform will continue to roll on as it is," she said. "If the Republicans win, there will be some changes."

According to Endicott-Coyan's presentation, some overall key provisions of the health care bill include providing coverage to 32 million uninsured people by 2019, changes in insurance rules, building on existing employer and government-sponsored insurance programs, higher Medicare taxes for the wealthy, new taxes on expensive health insurance, fees to drug manufacturers and health insurers, taxes on medical devices which increase costs for hospitals and consumers, and financial penalties for people without health insurance.

The bill will also cost $940 billion over the next 10 years, she said.

Some provisions effective in 2010 include: young adults on parents' health plans, prohibition against dropping coverage, elimination of cost-sharing for preventive care, small business tax credits, interim high-risk pools, and a state option to expand Medicaid eligibility.

There are other provisions in the law slated to become effective in 2011, but "these could change tomorrow," as there is currently no regulation to implement thoese provisions, Endicott-Coyan said. Some of these include expanding preventive services, increasing training support for primary care, nursing and public health, a medical loss ratio, establishment of physician value-based purchasing and a national strategy to improve health care quality.

Several other specific health-related provisions are expected to be phased in and take hold each year through 2014, but are also not currently regulated.

These include subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, establishing health insurance exchanges and support for medical research. The cost of these provisions is offset by a variety of taxes, fees and cost-saving measures.

The bill also states that by 2014, every American will be required to have health insurance or receive a penalty of $95 or 1 percent of taxable income, and those penalties increase after that year.

As for the future, Endicott-Coyan said "health care reform is here."

"Some changes will take effect quickly, some over many, many years," she said. "Our (Mercy) mission will continue."

Mercy organized the forum following a suggestion from Jamie Armstrong, a local financial advisor and member of Mercy's advisory board, who said she had heard increasing concerns from her clients on the impact of the health care reform on their retirement and investment strategies.

"The public needs to be well informed and to plan appropriately about these changes and how it impacts their lives," she said.