During his weekend address, President Barack Obama said that health reform is already delivering “real benefits” to the American people. On Monday, Health and Human Services Secretary Kathleen Sebelius built on this theme in a letter to Democratic and Republicans congressional leader detailing the Obama administration’s early progress in moving forward with health reform implementation.
These developments have led bloggers to examine both the rule-making process and the bureaucratic efforts to fill in the blanks.
The Wonk Room’s Igor Volsky calls attention to Sebelius’ letter touting the administration’s accomplishments in implementing the early provisions of the health reform law ahead of schedule. And it seems the progress she mentions regarding state high risk insurance pools, a reinsurance program for early retirees and efforts to allow children to stay on their parents insurance until age 26 are only the beginning. He lists what the near-term calendar looks like and focuses on the policy and political dynamics in play as the next implementation save-the-date approaches: June 1 is when HHS will receive uniform definitions from the National Association of Insurance Commissioners about medical loss ratio definitions.
But InsureBlog’s Bob Vineyard takes exception with Sebelius’ glow of success. “The ink is hardly dry on the law and already Washington is trying to figure out what the law means, and how it will impact health insurance policyholders. In fact, they are making up rules as they go along.” He goes on to explore – with specific examples and scenarios — how the process may have negative impacts on the individual major medical market.
Critical Condition’s Avik Roy revisits a continuing question – “Will any of us be able to keep our current plans?” He draws on recent writings to build his answer. “The pages of National Review and NRO are no strangers to debunkings of the president’s promise that ‘if you like your health-care plan, you will be able to keep your health-care plan. Period. No one will take it away, no matter what.’ (If you really need proof, check out Deroy Murdock, Jim Geraghty, Stephen Spruiell, and Yuval Levin on the subject.) But, believe it or not, the truth may be even worse. Depending, once again, upon the regulatory divinations of HHS bureaucrats, it may turn out that no one with private insurance can keep his or her preexisting plan.”
And, writing for The Foundry, David Weinberger, with a touch of self-congratulation, points to the wisdom of those who didn’t believe the Obama promise in the first place. As proof, he cites recent news “that AT&T, Verizon, John Deere and others may well drop the health care coverage they now offer their employees. Obamacare makes it much cheaper for these companies to dump their workers into the government-controlled health exchanges and pay a penalty for NOT insuring them.” And he adds, “Congress could have dramatically expanded health insurance without incentivizing employers to end their current health care coverage.”
Meanwhile, in the National Journal’s Health Care Expert Blog, Marilyn Werber Serafini moves beyond the most immediate implementation issues to pose another question. “What is the most effective use of new health care reform money to promote prevention and wellness?” She also mentions that, by September, health plans will be required by the law to cover preventive services. The experts responded with very different views. American College of Cardiology CEO Jack Lewin wrote that “if we used the prevention and wellness money to create an additional institute, the National Institute for Keeping People Healthy, dedicated to keeping people healthy even with the presence of a chronic disease, we could reduce the amount of health care dollars spent on end of life care by reducing chronic disease.” But the National Center for Policy Analysis’ John Goodman says “It is too bad that the new health reform law will require all insurance to cover preventive services with no cost sharing. This is the exact opposite of sound policy. With few exceptions (e.g., childhood immunizations), third party insurance should not pay for these services at all. Instead, patients should make their own decisions….”
On a lighter note, and because it is never too early to start a summer reading list, Wright On Health’s Brad Wright offers his picks for health policy’s great reads. They include Jonathan Cohn’s book “Sick,” “How Doctors Think” by Jerome Groopman and “Pathologies of Power” by Paul Farmer.