universal health care in the U.S.
Changes introduced (or to be introduced
the 2009 health care reform law
We have extracted the following information from a variety of websites that we believe are reliable. However, we have no guarantee of the accuracy of the data. Do not make personal decisions based on the following information without first checking any applicable statements in detail.
Changes due to the Patient Protection and Affordable Care Act:
At the time that the act was signed into law by President Obama, health insurance in the U.S. does not fare well when compared to other developed nations. Tens of millions of Americans are uninsured and tens of millions more are underinsured. A much lower percentage of Americans were pleased with their insurance plans when compared to the citizens of other developed countries. Life expectancy and general health of Americans is poorer than in other developed countries. Persons with pre-existing conditions often cannot obtain insurance. Health insurance companies often cancelled the plans of subscriber when they ran into health problems. Many plans had maximum life-time limits. To add insult to injury, the cost per capita of health care in the U.S. was much higher than in other developed countries. Over Republican opposition, an Affordable Care Act was passed in 2009.
Surveys show that opposition to the Act remains high. However, when they are asked about specific features of the plan, they are in general agreement.
The following changes have either already taken effect, or will do so by 2014. Most of the following were taken from an article in The Huffington Post supplemented by other information sources: 2
- Children with pre-existing conditions cannot be denied health insurance. (This same provision will apply to adults in 2014).
- Small businesses -- those with fewer than 50 employees -- will get tax credits that will cover up to 50% of employee health insurance premiums. This is a major development, because according to the U.S. Census Bureau, only 11% of businesses have more than 20 employees. 3
- A deficiency in Medicare drug coverage -- called the "donut hole" will be fixed. It has placed severe limits on prescription medication coverage over $2,700 per year. As of 2012, 50% of the "hole" will be filled.
- Young adults will be continued to be covered under their parent's health insurance until they reach the the age of 26. This is extremely important to college and university students.
- Lifetime caps -- the maximum amount that an insurance company will pay over the lifetime of their policy holders -- will be relaxed in 2010 and banned in 2014.
- A high-risk pool will be established to cover adults with pre-existing conditions.
- New insurance plans will have to cover regular checkups and other preventative care without requiring the payment of co-pays. This will be extended to all plans by 2018.
- If you or anyone covered by your insurance plan gets sick, the insurance company cannot terminate your policy. This will make a profound change to the insurance industry. Previously, they had no motivation to care about their customers' health. If a customer was in poor health and became ill, the company could simply decide to unilaterally cancel their policy. Now the companies will find that advocating good living practices, exercise and improving their clients' eating habits will increase their profits and save them money.
- Insurance companies will have to reveal how much they spend on overhead/administrative costs.
- New plans will have to include an appeals process to dispute coverage determination and claims.
- In the middle of 2010, a 10% tax will be imposed on indoor tanning services. This will offset some of the health-care costs of skin cancer caused by these services.
- Health insurance fraud and waste will be reduced through new screening processes and increased penalties.
- Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients.
- Decisions on health care are made by the individual and her/his doctor, not the insurance company.
- Non-profit health insurers -- like Blue Cross and Blue Shield -- will be required to maintain their medical loss ratio at 85% or more in order to take advantage of IRS tax benefits. This value is the percentage of their income that they spend on prodecures.
- Chain restaurants with more than 20 locations and vending machines carrying convenience foods will have to display nutrition information prominently. Michelle Obama has been promoting children's health. In mid-2010-MAR, she told a meeting of the Grocery Manufacturers Association about their sales of junk food she said: "We need you not to just tweak around the edges but entirely rethink the products you are offering, the information that you provide about these products, and how you market those products to our children." 3
- A temporary program will be established for companies that provide health benefits for early retirees -- those retiring at ages 55 to 64.
- The Secretary of Health and Human Services will establish a web site to help people and small businesses find affordable health insurance options.
- A two-year fund of up to $1 billion is being established to encourage investment in new therapies for the prevention and treatment of diseases.
- Insurance companies will not be able to increase rates without justification.
- Hundreds of community health centers will be built or improved.
- Taxpayers will receive tax credits starting in 2014 to help them afford insurance premiums.
- Insurance companies will not be able to charge women more than men, starting in 2014.
- State-based marketplaces will be created where people can easily compare and shop for insurance, beginning in 2014.
- People who lose their jobs will still continue their insurance.
- People will not be forced into bankruptcy because of medical bills.
- People who already have insurance will be able to keep it.
- People who cannot afford to buy insurance will receive a government subsidy to help them pay insurance premiums.
- Medicaid will be expanded for handicapped and lower income people.
Objections to the Affordable Care Act:
There has been a massive amount of misinformation and disinformation circulated about this Act, typically from religious and social conservatives:
- Some commentators have stated that it will increase the deficit. In reality it is revenue neutral.
- Some have stated that it will create "death panels" who will decide who and when sick people will be deemed no longer worthy to live, and will be murdered. This is nonsense and is derived upon misrepresentation of a clause that provides for individuals to discuss with their doctors about end of life issues. So, for example, a person might ask that if they are terminally ill, in intractable pain, and their quality of life is nil, they might be able to specify that their life not be needlessly extended through extreme medical procedures; they would be allowed to die a natural death. The initiative and decisions remain under control of the individual. In spite of "death panels" being non-existent, they are still regarded as a real threat by a surprisingly large percentage of the American people.
- There is a mandated requirement that everyone purchase healhcare insurance. Some people object to this, describing it as socialized medicine. But it is just like vehicle drivers being mandated to purchase car insurance and a driver's license. Anyway, the only method bt which a health insurnace can work without ruining the economy is to have the vast majority of people covered.
- Some have maintained that the Affordable Care Act includes funding of abortions by the federal government. Again, this is without validity and yet is firmly believed by many Americans.
Support for the Affordable Care Act:
Support mainly comes from secularists and religious liberals/progressives. Typical is the response of the Rev. Peter Morales on 2012-JUN-28:
"As president of the Unitarian Universalist Association, I applaud the Supreme Court's decision to uphold the Patient Protection and Affordable Care Act. For more than 50 years, the UUA has called for health care reform, as it speaks to the protection and inclusion of some of our most vulnerable populations, including women, children, elders, and those with chronic illnesses.
To take steps toward providing basic care for all is a moral and spiritual imperative, and it is encouraging to see our Supreme Court justices consider the better health of the millions of Americans who benefit from the provisions of the ACA. We are thankful for their thoughtful work.
Unitarian Universalists hold among our principles the affirmation of the inherent worth and dignity of every person. As people of faith, our principles call us to speak up for those who have been silenced, forgotten, or pushed aside in our society. Today, I am proud to say that we and our allies in social justice have been heard. Health care is not a luxury; it is a fundamental human right. And while we celebrate today's decision, we also will continue to advocate for this fundamental human right until it is available to all who seek it." 5
- David Cecere, "New study finds 45,000 deaths annually linked to lack of health coverage," Harvard Science, 2009-SEP-17, at: http://www.harvardscience.harvard.edu/
- Jeremy Binckes and Nick Wing, ""Health Reform Bill Summary: The Top 18 Immediate Effects http://www.huffingtonpost.com/
Katherine Goldstein, "Calorie Count Disclosure And The Health Care Bill: Will This Lead To A Food Revolution?," Huffington Post, 2010-MAR-23, at: http://www.huffingtonpost.com/
- "Statistics about Business Size (including Small Business)
from the U.S. Census Bureau," U.S. Census Bureau, at: http://www.census.gov/
- From the Unitarian Universalist Association (UUA) mailing list for 2012-JUN-18
Copyright © 2010 to 2012 by Ontario Consultants on Religious Tolerance
Originally posted: 2010-MAR-22
Latest update: 2012-JUL-27
Author: B.A. Robinson