Yeah, I know - you're not happy about health reform legislation. You feel like it was shoved down our throats. No, it's not fair. But it is reality, so we can either keep complaining or we can try to put some lipstick on this pig and make the best of it.
Reading through the legislation, I think we have a lot to be thankful for - it could've been a lot worse. We've fought for years against a single-payer health plan, and that's not what this is - even though a number of people who think we should scrap the bill and start from scratch don't believe it goes too far; they think it didn't go far enough.
The new legislation doesn't include a public plan option - another bullet dodged. Instead, there are other measures that should create competition among health plans and "keep insurance companies honest" as President Obama likes to say. These include nonprofit co-op plans that compete on a level playing field with other private plan options, multi-state plans, and the ability to purchase plans across state lines.
The legislation also creates unprecedented access to information. New Web portals provide residents with uniform information, including tax credit calculators to help people determine if they're eligible for a public program like Medicaid. Since one-third of the uninsured fall in this category, that should help get more people covered.
Restaurants with more than 20 outlets also will have to put calorie counts on their menus - an idea modeled after rules New York adopted two years ago. For diners at fast food chains, ignorance will no longer be an excuse.
And while I've repeatedly heard the bill does nothing to reduce the cost of care, I'm not sure I agree with this. It may not do enough, but there are elements that should help reduce utilization. For example, there's a huge emphasis on preventive care. All group and individual plans will be required to cover preventive care on a first-dollar basis with no cost-sharing. That's a good thing - an ounce of prevention is much less expensive than a pound of cure. There's also expanded preventive care for Medicare beneficiaries and at-risk populations.
Another potential cost-saver is the predictable growth of consumer-directed health plans like health savings accounts. Coverage for over-the-counter drugs is going away, but that's the biggest hit that HSAs take. The penalty for non-eligible expenses will increase from 10 percent to 20 percent, which should make employers more comfortable with contributing to their employees' accounts, and most HSA plans will meet the standards for creditable coverage. To the extent that consumer-directed plans really do have the ability to curb utilization and influence behavior, which we've been saying for years, then the growth of these types plans is encouraging.
And finally, pre-x is going away. This is long overdue. Of course, as we all know, you can't require carriers to cover everyone unless you also require everyone to purchase coverage - the only way to make guaranteed-issue plans affordable is by covering both the sick people and the healthy people. And this bill does that - unless, of course, the Republican attorneys general who are suing the government are successful in their attempt to eliminate the mandated coverage requirement. That, I believe, would be a huge mistake because it would remove the biggest cost-controlling measure in the legislation.
So health reform is now the law of the land. No, the bill isn't perfect, but it is what it is, and for those of us who would like to continue in the business, there's still an opportunity - agents and brokers are specifically included in the legislation. The quicker we can get through our denial, anger, and depression, the quicker we can move on to acceptance and, ultimately, hope.
