Eve of change

Eve of change

Many still skittish on health care

August 16th, 2010 by Emily Bregel in Health

Allison Peters has deep misgivings about health care reform and its potential impact on spending - both the government's and her own.

But her overriding feeling is one of uncertainty.

"Obviously there's more to it that none of us know and probably won't know until it happens," said Peters, a former social worker and a stay-at-home mom in Chattanooga. "I think even the politicians don't understand every little thing of it."

She's not alone. Five months after the landmark health care reform bill passed Congress, insurers, medical providers and residents are bracing for changes. But confusion reigns a month before some key components go into effect, according to Chattanooga residents and recent polls.

The most recent weekly Rasmussen Reports opinion poll shows that 55 percent of Americans favor repealing the health care bill and only 38 percent support it.

But monthly telephone surveys from the Kaiser Family Foundation - a health care nonprofit that supported the reform - found support remaining stable. The Kaiser survey showed opposition dropping 6 percentage points from June to July, to 35 percent.




* Up to 4 million small businesses are eligible for tax credits to help them provide insurance to workers. (Already in effect).

* Medicare enrollees who hit the "doughnut hole" - a gap in Medicare prescription drug coverage - will receive a $250 rebate. (Started in June.)

* Young adults up to age 26 can stay on their parents' plan, unless they are offered insurance at work. (For new health plans that start after Sept. 23.)

* Insurers no longer can impose lifetime dollar limits on essential benefits. (For new health plans that start after Sept. 23.)

* Starting in 2014, if your employer doesn't offer insurance, you will be able to buy insurance directly through an exchange, an insurance marketplace where individuals and small businesses can buy health plans that must meet certain cost and benefits standards.

Source: Healthcare.gov

The contradictory results largely come from how survey questions are phrased and details such as whether President Barack Obama's name is used, Kaiser spokeswoman Claudia Deane said.

She said there has been no clear majority for or against the overall reform package, but there's a clear partisan divide: Most Democrats support reform, and most Republicans reject it.

"What you'll find is basically a pretty divided public on this law," she said. "That was true before passage, and that's been true since passage."

Some polls find misconceptions about reform. A Kaiser survey found that more than 40 percent of Americans believe that "death panels" will make end-of-life decisions for families, which is untrue.

In a July poll, Harris Interactive found that 36 percent of respondents believe that the so-called "public option" - a government health plan to compete with private plans - is included in reform. That provision was removed from the legislation.


Some of the easier-to-sell parts of reform are the first to take effect.

Checks for $250 are in the mail for seniors who are hitting Medicare's prescription drug coverage gap, known as the "doughnut hole." The White House says 4 million seniors will benefit.

For new health plans starting on or after Sept. 23, young adults up to age 26 can stay on their parents' health plans if they can't get insurance at work. Some insurers already have complied with this rule.

People who have been uninsured for at least six months because of a pre-existing medical condition will be guaranteed a place in state high-risk health insurance plans. That lasts until 2014, when insurers no longer can deny coverage based on health status.

Tennessee's high-risk insurance pool, AccessTN, will run parallel to whatever federal plan is set up. Georgia officials are leaving it up to the federal government to bring a high-risk plan to the state.

For Chattanooga resident Denise Drake, a Cigna Healthcare employee, health care reform was long overdue.

"People are dying from things that could have been prevented," Drake said. "It's our duty to help people, as citizens."

But Peters worries that reform will raise insurance premiums and balloon national health care expenditures.

"I worry about how it's going to affect our paychecks," she said.

Deane said polls show broad, bipartisan support for some parts of the reform law, such as the small business tax credit.

Other, more controversial pieces, such as one requiring people to buy insurance or be fined, won't go into effect until 2014.

Earlier this month, 71 percent of Missouri voters favored a state measure to bar the government from enforcing mandatory coverage, The Associated Press reported.

St. Elmo resident Rodney Johnson, who works in customer service at a local paper company, said he strongly supports getting coverage for the uninsured, whose medical expenses often get passed along to other payers.

"It's not free care. It's getting paid for either by the state or by people like me who are actually paying premiums," he said.

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