Who’s saying what about reform? (via BenefitsPro)

There are a lot of players in the reform game—and politicians aren’t the only ones. From consumers to employers, read what groups really think about health reform, how it affects them and what’s next.

Who’s saying what about reform?


Public opinion has been mixed about the Patient Protection and Affordable Care Act. Though the public is mainly split down the middle regarding the 5-4 decision to uphold the law, a slim majority wants part or all of the law repealed, according to a USA Today/ Gallup poll taken after the ruling.

The percentage who favored the law was under 40 percent (at 37 percent), and 44 percent said they didn’t favor the law.

And though the law has divided the nation, it’s ultimately really confused them, too. Many had considered the law to be so convoluted—and pieced out to occur over such a long timeline—that there’s been a considerable level of ambivalence over it, says Danielle Kunkle, a Medicare adviser at Boomer Benefits in Fort Worth, Texas.

A Harris poll conducted in the spring confirmed Americans remained largely confused about health reform. When asked about six important elements of the PPACA, large numbers of people (from 37 percent to 66 percent) weren’t sure if the provisions were even part of the bill.

Regardless, there’s been positive numbers coming out regarding how health reform is affecting Americans.

For example, more than 3.1 million Americans ages 19 through 25 are now covered by their parents’ medical insurance policies due to the law’s young adult coverage provision, up from 2.5 million in December.

“This policy doesn’t just give young adults and their families peace of mind, it also gives them freedom,” HHS Secretary Kathleen Sebelius has said. “It means that as they begin their careers, they will be free to make choices based on what they want to do, not on where they can get health insurance.”

Sebelius also recently announced that 12.8 million Americans will benefit from $1.1 billion in rebates from insurance companies this summer, because of the law’s 80/20 rule. These rebates will be an average of $151 for each family covered by a policy.

But there’s also some bad news: Doctors warn that consumers will suffer because there won’t be enough doctors to handle all the new patients under health reform. And health insurers have warned the law may result in higher costs for patients.

Who’s saying what about reform?


Those in the medical profession haven’t been excited about the Patient Protection and Affordable Care Act. That’s because, according to the Doctor Patient Medical Association, doctors say that it will have little impact on patients’ access to medical care and only create bureaucratic hoops.

“Doctors on the frontlines clearly understand what Washington does not,” says Kathryn Serkes, DPMA Chairman. “Government-mandated ‘coverage’ is not the same thing as actual medical care. We’ll still have millions who need medical care.”

About three out of four doctors say that the individual insurance mandate does not improve access to actual medical care. One family doctor surveyed commented, “The major problem is the politicians equating health insurance with health care.”

“Doctors think that the individual insurance mandate and the massive expansion of Medicaid in PPACA are the government version of bait-and-switch tactics—promising something that you know you can’t deliver,” Serkes says.

“What PPACA does is increase patients’ access to a piece of paper—that says they are ‘covered’ by insurance or ‘enrolled’ in Medicaid or Medicare,” she says. “But paper promises don’t translate to actual medical care when doctors can’t afford to see patients at the lowball payments, and patients have to jump through bureaucratic hoops set up by the government.”

Another survey of U.S. primary care physicians by MDLinx taken following the Supreme Court ruling confirmed the same findings. It found most doctors don’t believe the law will achieve its objective of 100 percent health care coverage for Americans.

And, for the most part, doctors fear there won’t be sufficient numbers of primary care providers to meet the increased demand of new patients.


For insurers, health reform, in some ways, was happening regardless of the ruling. In June, prior to the ruling, insurance giants UnitedHealth Group, Humana and Aetna said they would keep the popular provision that allows kids 26 and younger to stay on their parents’ health insurance plans—and some other popular parts of Obama’s health overhaul—even if the Supreme Court killed the law.

After the Supreme Court ruled the law constitutional, insurers expressed their willingness to comply and work with the law, but most carriers said it doesn’t change their business strategy and commitment to consumers. Many also said the PPACA falls short of fixing the flaws of the country’s health care system—and work still needs to be done.

“We are prepared for the changes ahead and will continue to fully comply with the requirements of the Affordable Care Act,” Aetna said. “At the same time, we know that much more must be done to fix the problems that remain in our health care system. We believe there is still time—if people can come together in a bipartisan way—to improve quality and affordability. That security is what Americans want and need.”

Other carriers questioned the “affordable” part of the PPACA, saying the law doesn’t address the key problems of cost and affordability.

“The health care reform law falls short in controlling the underlying cause of our nation’s health care crisis: costs that are too high and rising too fast,” Humana said in a statement. “Affordable and stable coverage must be our top priority. “Several significant reforms will take effect in 2014 such as guaranteed coverage, rating restrictions and exchanges. Humana believes there must be a gradual transition to new rating and benefit requirements, which threaten to undermine the goals of access and affordability. And, costs will jump unfairly for small businesses and many seniors, unless something is done about the health care law’s premium tax.”

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About thebenefitblog

Eric is a Producer at Lockton Insurance Brokers, Inc., the world’s largest privately held commercial broker. Eric has over 23 years of experience in the insurance industry and has spent the last 11 years with Lockton. Eric specializes in Health & Welfare Benefits, Retirement Planning, and Executive Benefits. Eric's clients utilize his expertise in the areas of Plan Due Diligence, Transaction Structure, Fiduciary Oversight, Investment Design, Compliance and Vendor negotiation to improve the operational & financial outcome for each client. The Benefit Blog is a place to share that expertise and industry news.
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