Wednesday, May 25, 2011

What is Happening With Health Care Reform?

Health Care Reform Forum at Cleveland State University

Clarity is one of the last word most people would use to describe our healthcare system. I had the opportunity to attend the National Health Care Forum: The Ohio Story, held at Cleveland State University on May 17th, the purpose of the forum, was to provide the public with information about healthcare reform. The forum gave a view of healthcare reform and how it specifically pertains to the state of Ohio.

Four speakers, all healthcare reform specialists in different capacities gave brief presentation on how the Affordable Care Act (healthcare reform) will impact the purchasing of healthcare, access and coverage issues of Ohioans in the coming years. Steve Millard, president and Executive Director of the Council of Smaller Enterprises, Lee Kamps, an independent health insurance broker, Kathleen Gmeiner, Project Director at Universal Health Care Action Network (UHCAN) Ohio and Carrie Haughawout, Assistant Director for Health Policy at the Ohio Department of Insurance all gave presentations. There were also two personal narratives by healthcare consumers who have both been affected by the aspects of healthcare reform that have already occurred.

Each speaker highlighted various aspects of the reform: Carrie Haughawout, discussed the various aspects of the act that have been implemented, what remains to be implemented, as well as describing the possible plans that consumers will purchase (a website that serves as a marketplace, often referred to as the Exchange) and the state of health insurance in 2014, when most of the reform will have been fully implemented. Lee Kamps, explained that healthcare reform is not a panacea for all the problems within the industry. He explained that the market will stay competitive because individuals will be able to purchase new policies if they are dissatisfied with one they have purchased or their employer has provided to them. In addition, he anticipates many large insurance companies will merge. He also felt supplemental (small plans that are meant to fill a gap in coverage) plans would become more prevalent and profitable.

Kathleen Gmeiner, described potential problems, the need of the federal government to create independent entities to oversee the Exchange (such as the state government) and the need of the federal government to set minimum qualifications for participation. She indicated that there was a need to provide mandated minimum qualifications to prevent inexpensive plans that provide minimal coverage. Steve Millard described the changes and what small business owners can expect with healthcare reform.

It was clear that healthcare reform if it is successfully implemented will provide better care for more people. A few examples key examples of how healthcare reform will benefit the uninsured, those who are under insured, and those with barriers to obtaining coverage are as follows:
  • Insurance companies must spend 80 to 85% (depending on size of company) of income on care.
  • No lifetime caps on healthcare reimbursements
  • Not sudden or unexplained cancellation in coverage
  • Must provide coverage even those children with pre-existing conditions
  • Improvements in coverage of those considered “High Risk”
  • Coverage of a myriad of preventive health services for those on Medicaid.
  • Improved prescription coverage for those receiving Medicaid.
One of the most unique features of the forum was that it was non-partisan and appropriate for uniformed and well informed audience members. I was pretty much a novice to the subject myself, only hearing snippiest on the news about the act itself. I had heard far more personal opinion about the act than about the content of the new legislation. The forum allowed me to gain a rudimentary understanding of the current and coming changes, as well as supplied me with oodles of helpful information; I spent much of the following day at work reading up on the Affordable Care Act. I listed the resources given and highly suggest reviewing some of them as well as attending the remaining two forums that focus on economic impact as well how employment will be affected.

Below are the date, time and location of the remaining two forums.
National Healthcare Reform Begins, The Economic Impact on Northeast Ohio
Thursday, June 2, 2011 and Monday, June 20, 2011
4:00-6:00 p.m.
1717 Euclid Avenue
Maxine Goodman Levin College of Urban Affairs
Glickman-Miller Hall, Roberta Steinbacher Atrium
Cleveland State University

Other places to get additional resources:
  • Ohio Consumer for Health Coverage (OCHC)--Report to the Community on the Implementation of the Patient Protection and Affordable Care Act in Ohio.
  • Consumers Union, publisher of consumer reports, The Affordable Care Act: The First Year Discover What The new Law means For You And Your Family.
  • Council of Smaller Enterprises (COSE), Health Care Reform Game-Plan (pertinent for small business owners).
  • Universal Healthcare Action Network, UHCAN Ohio’s Helpline (614) 456-0060x 233 or e-mailmgreenham (at) uchanohio (dot) org.
Types of calls UHCAN accepts include:
  • Uninsured caller who do not qualify for Medicaid and cannot explore the option of private insurance
  • Low to moderate income level callers who want more information on affordable healthcare options and need help with navigation.
  • Caller who do not qualify for Medicaid that need prescription assistance.
  • Caller who do not qualify for Medicaid that have current outstanding medical bills.
  • General Healthcare questions or concerns.
As mentioned before the forum also included two personal narratives from consumers affected by the new legislation. I thought it worthwhile to give a brief synopsis of the two stories shared, as one highlights positive change and the other describes a tragic situation reminiscent of pre-healthcare reform. After the introductions were made two narratives were shared. One was a middle aged mother talking about her sense of relief knowing her adult daughter could stay on her insurance plan until she was 26. The daughter recently graduated college, but could only find part-time jobs and did not have access to her own coverage. This was compared to the mother's own experience of not having health insurance until she was in her early 40s.

The second story is shared by a gentleman in his late 30s with three small children and a wife. He describes a tragic story that provided the audience a chilling account of his struggles. He is dying of terminal brain cancer, and found out shortly after starting a new job. At the time of the discovery, he and his family were covered by COBBRA (an interim/temporary insurance policy). Without treatment he had 3 to 6 months to live; with treatment, he could potential live well over a year. His illness necessitates that he not have a lapse in coverage. While healthcare reform will make it possible for people deemed “high risk” to receive healthcare for pre-existing conditions the recipient must be uninsured for six months, time the speaker does not have to give. He did eventually find coverage but was devastated by the amount of time he had to dedicate to procuring insurance.

All forums are archived at the Cleveland State site. Carrie Haughawout of the Ohio Department of Insurance provided her contact information and encouraged people to provide her with questions and feed back in regards to Healthcare reform. NEOCH is currently surveying homeless people about their experiences with the health care system. NEOCH staff plan on sending Ms. Haughawout the result of our homeless healthcare survey to keep this state office abreast of the challenges homeless people face when accessing healthcare.

by Holly Lyon
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