Mar. 23--The vast majority of Americans will see no difference in their health insurance despite the landmark health care bill passed by Congress, according to a professor at UNC-Chapel Hill.
"Fears of this have been exaggerated," said Jonathan Oberlander, an associate professor of social medicine and health policy and management. "The people who have employer-sponsored insurance -- 160 million workers -- will keep their insurance."
The state's largest health insurer, Blue Cross and Blue Shield of North Carolina, which wasn't shy about carping about provisions it disliked in the bill as it was being debated, praised it as "a step in the right direction."
Extending health insurance to millions of Americans is a historic accomplishment, said Barbara Morales Burke, vice president of health policy. But, she added, Congress still needs to address health care costs that are driving the cost of insurance higher every year.
Indeed, John Hood, head of the conservative John Locke Foundation, predicted reform will cause insurance premiums to skyrocket. "I hate the bill, so I hope it gets repealed," he said.
Adam Searing, project director of the N.C. Justice Center's Health Access Coalition, countered that the non-partisan Congressional Budget Office concluded that the changes wouldn't have an impact on the cost of policies provided by employers, which is where most North Carolinians get health insurance.
The advocacy group estimates that, by 2019, more than 1 million North Carolinians who are uninsured will have coverage. That would still leave 400,000 to 500,000 residents without health insurance.
"I think it is a fundamental improvement for everyone in North Carolina," Searing said. "It is a sea change in how we think about health insurance and health care."
Given the sweeping changes ushered in by the bill and the extreme emotions aroused by the extended political debate that surrounded it, it's no surprise that the reaction from local health care experts and providers spans the spectrum.
One thing many agree upon, however, is that the measures passed Sunday night by Congress, as well as a package of changes already in the works in the Senate, won't be the end of it. Instead, the thinking is that no matter which party is in control, Congress is likely to at least tinker with its overhaul as we get closer to 2014, which is when the bulk of the provisions are scheduled to take effect.
Some provisions will kick in immediately. Among the most important outlined by the N.C. Justice Center are:
Parents will be able to keep children on their coverage up to age 26. That's important, said Searing, because many young adults are struggling to find jobs.
A temporary high-risk pool will be created for people who are otherwise unable to purchase insurance because of pre-existing conditions. "If you have lost your job ... this is going to be a lifeline," Searing said. However, you have to be uninsured for at least six months in order to qualify.
Medicare patients who end up having to pay for prescriptions out of their own pocket under Medicare Part D can receive a $250 rebate this year.
Insurers can't put a cap on benefits over a person's lifetime.
Nonprofit hospitals, which includes almost all the hospitals in North Carolina, will face new reporting requirements and other measures. They include limits on what they can charge poor patients who lack insurance and on "aggressive collections practices." Searing said the N.C. Hospital Association has been urging its members to move in this direction.
"We do all of these things," said Becky Andrews, vice president of finance at WakeMed.
Oberlander, who is writing a book about the politics of health care changes, predicted the overhaul will grow on people.
"Medicare was passed with a lot of controversy in 1965, and I think we're seeing a similar story for this," he said.
Staff writer Sarah Avery contributed to this report.
firstname.lastname@example.org or 919-829-4877
To see more of The News & Observer, or to subscribe to the newspaper, go to http://www.newsobserver.com.
Copyright (c) 2010, The News and Observer, Raleigh, N.C.
Distributed by McClatchy-Tribune Information Services.
For reprints, email email@example.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.