NY Times: Health Care Changes Wouldn’t Have Big Effect for Many

Armstead

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Fri Dec-25-09 11:26 PM
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NY Times: Health Care Changes Wouldn’t Have Big Effect for Many

Edited on Fri Dec-25-09 11:32 PM by Armstead

This is a reasonably balanced article from the NY Times about the changes you can or can't expect from the health care reform bill.

Worth reading wherever you stand on the issue.

(My own take it that it reinforces my view that the is some things that are helpful for some, but it is missing important changes in this bill, including control of rates.)

http://www.nytimes.com/2009/12/25/health/policy/25employer.html?_r=2&pagewanted=1&src=twt&twt=nytimes&adxnnlx=1261749788-qxs5xBcSKHcrvWLwwyEXHw

Health Care Changes Wouldn’t Have Big Effect for Many

Excerpts:

Now that the Senate has caught up with the House by passing a sweeping health care bill, lawmakers are on the verge of extending coverage to the tens of millions of Americans who have no health insurance.

But what about the roughly 160 million workers and their dependents who already have health insurance through an employer? For many people, the result of the long, angry health care debate in Washington may be little more than more of the same.

As President Obama once promised, “If you like your health plan, you can keep your health plan.”
That may be true even if you don’t like your health plan. And no one seems to agree on whether the legislation will do much to reduce workers’ continually rising out-of-pocket costs.

True, there is an important advantage for the working insured: more peace of mind for people who are worried about being laid off or would like to change jobs.

Of course, with more security will come more obligation. Congress seems likely to impose an individual mandate that will require people to be insured or face a financial penalty.

The other proposed changes for employer-provided coverage seem aimed mainly at workers whose benefits are either very generous or exceedingly skimpy.

On the generous end, about a fifth of employers now offer health plans that could be affected by a new 40 percent excise tax in the Senate bill on so-called Cadillac policies, according to an estimate by Mercer, a benefits consulting firm. That tax, to be imposed on annual premiums that exceeded $23,000 for family coverage, would go into effect in 2013. For example, if an insurer, or a self-insured employer, offers a plan costing $25,000, it must pay a 40 percent tax on the $2,000 that is above the threshold, or $800.

If the excise tax survives the House-Senate negotiations, it is hard to predict how employers will respond. But almost two-thirds of the employers Mercer recently surveyed said they were likely to reduce employee benefits rather than pay the tax.

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The public policy goal of the tax, in theory, is to have everyone spend less on medical care, even if it means using it less. “We know people will use less care under such plans,” said Paul Ginsburg, president of the Center for Studying Health System Change, a nonpartisan group.

What is not so clear, Mr. Ginsburg said, is whether people will make — or be able to make — rational choices between treatments that are not particularly effective and treatments that may help them from becoming sicker later.

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People working for small businesses — an estimated 40 percent of the private labor force — could see their coverage affected. And if their employer decided to use one of the new insurance exchanges, workers might have a much broader choice of plans than they do now.

The premiums a small-business employee are charged could also change, especially if that company’s work force is particularly young and healthy. Those people could wind up paying more, Mr. Ginsburg said, because the legislation tries to spread the risk of covering employees with expensive medical conditions by setting new rules over how insurers can determine premiums.

The real unknown, of course, is whether any final legislation will accelerate the rise in premiums or slow it. At least one impartial analysis, by the nonpartisan Congressional Budget Office, concluded that the legislation was not going to have much of an effect on the cost of premiums either way.

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NY Times: Health Care Changes Wouldn’t Have Big Effect for Many

A Bill Well Worth Passing