Alabama and health care reform

By By Bob Martin, The Alabama Scene
Under the new health care reform legislation 666,000 individuals in Alabama who do not have insurance and 188,000 residents who have non-group insurance will be able to get affordable health coverage.
Moreover, the reform creates immediate options for people who can’t get insurance today.
Eleven percent of people in Alabama have diabetes and 33 percent have high blood pressure - conditions that could deny them health insurance coverage. The new bill will establish a high-risk pool to enable these people to find an affordable health plan.
It provides insurance for free preventive services. Nearly 40 percent of Alabama residents have not had a colorectal cancer screening, and 23 percent of women over 50 have not had a mammogram in the past two years.
Health insurance reform will ensure that people can access preventive services for free through their health plans.
For those on Medicare the legislation reduces overpayments to private plans, begins to fill the costly gap for seniors in the prescription drug “doughnut hole,” covers such preventive procedures as a colonoscopy at 100 percent, and provides free annual wellness visits. A downside for those earning over $85,000 a year in after tax income is they will pay higher Part B premiums.
A boon for small businesses
While small businesses make up 70 percent of Alabama’s businesses, only 48 percent of them offered health coverage benefits in 2008. Nearly 50,000 small businesses in Alabama could be helped by a small businesses tax credit proposal that makes premiums more affordable.
Not only that, but the major benefit to small business owners will be the ability to attract more and better employees by being able to provide health benefits. And by 2017 small businesses will be able to purchase insurance for employees through new insurance marketplaces.
Very small companies (10 or fewer employees) which have an average wage of $25,000 or less will receive a $35,000 tax credit immediately and a larger credit starting in 2014.
Businesses with 25 or fewer employees with an average wage $50,000 or less qualify for a smaller tax credit. You don’t get a tax credit if you have more than 25 employees. Also, any employee who earns more than $80,000 a year will be excluded from the credit. Fifty employees is the maximum number a company can have without providing benefits and paying a penalty if they don’t.
People with pre-existing conditions
In 2007 36 percent of Americans were turned down or charged higher premiums because of pre-existing conditions. Now they will be able to get coverage from any insurer and will pay the same as anyone else in their age group. Insurers will be barred from denying coverage to children for pre-existing conditions this year and everyone else in 2014.
Insurers will be forbidden from placing annual or lifetime limits on coverage and regulations will limit a patient’s out-of-pocket expenses. Insurers will also be barred from removing coverage when a person becomes ill.
In 2018 so-called Cadillac policies (those that cost $27,500 for family coverage or $10,200 for single coverage) will be subject to a 40 percent excise tax and in 2020; the prescription drug coverage gap will be totally eliminated.
It is not a “cure all the ills” plan and won’t be free. “Of course we’ll fuss with it. But we at least have something to fuss about,” Karen Pollitz, director of Georgetown University’s Health Policy Institute, told Time. And many of the battles that took place in Congress over the past two years are being replicated in statehouses across the nation. At latest count, legislators in 39 states, including Alabama, are engaging in what I believe is a futile effort by introducing bills that would exempt their states from the legislation.
Our entire Congressional delegation vocally opposed and voted against the bill. Perhaps I am missing something and am probably in the minority, but what this health bill will do for millions of Alabamians, help small businesses, and reduce the nation’s deficit by $124 billion over the next decade, I do not understand how our senators and representatives could have refused to support it. The number 666,000 sticks in my mind. Perhaps it should be etched permanently into the conscious of each one of them.
Bob Martin is editor and publisher of The Montgomery Independent. Email him at: bob@montgomeryindependent.com