So Health Care Reform Is Here: What's in It for Us?

So most of the health care reform package has passed, and we're just waiting for the Senate to pass the reconciliation fixes this week. So what's in it for us? Quite a bit, in fact. Here's a rundown from Crooks & Liars on which reforms take place starting this year.

Adult children may remain as dependents on their parents’ policy until their 27th birthday

Children under age 19 may not be excluded for pre-existing conditions

No more lifetime or annual caps on coverage

Free preventative care for all

Adults with pre-existing conditions may buy into a national high-risk pool until the exchanges come online.

While these will not be cheap, they’re still better than total exclusion and get some benefit from a wider pool of insureds.

Small businesses will be entitled to a tax credit for 2009 and 2010, which could be as much as 50% of what they pay for employees’ health insurance.

The “donut hole” closes for Medicare patients, making prescription medications more affordable for seniors.

Requirement that all insurers must post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments.

Authorizes early funding of community health centers in all 50 states (Bernie Sanders’ amendment). Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.

AND no more rescissions. Effective immediately, you can't lose your insurance because you get sick.

All of these are quite important, and some will really come into use this year as they come online. I'm especially excited about the community health clinics.

Now all the other big changes, including the creation of the insurance exchange, the individual mandate, the employer mandate, and the affordability tax credits, will come online starting in 2014.

But what happens in the mean time? And what if Republicans are serious about their threats to repeal health care reform? No matter how serious they are, it's not very likely.

Conservatives have been hinting at a campaign to repeal the newly-passed bill for weeks. But actually having to run one is their worst nightmare. They never wanted to get to this point. They know that repealing the legislation will be far more difficult than passing it was, and by now, Americans fully realize how arduous the journey to last night was. At this point, repeal is fantasy.

For starters, Republicans simply don’t have the numbers in either chamber. It’s doubtful that even Democrats who voted with them last night, would support a repeal of their President’s signature achievement. Pelosi may have allowed a few members in difficult districts to sit this one out, but she certainly wouldn’t allow them to actively undermine her. Moreover, Republicans are far short of the requisite 60 votes in the Senate. And besides, its become abundantly clear over the past year that having the votes in the Senate is a very different proposition than having the party unity to exercise them.

More significant though is the political difficulty of arguing against the benefits of the bill, especially the ones that kick in early. Republicans will have to tell people with pre-existing conditions that their new ability to access coverage will be withdrawn. They’ll have to tell young people and their parents that young folks won’t be able to stay on the family plan. They’ll have to tell Americans that they’re fighting to allow insurance companies to drop sick people from their rolls once more. Those aren’t easy fights to have. Health care reform was much easier to dog before it actually becomes law. [Emphasis mine.]

Of course Republicans can argue that they’d repeal the package but reinstate certain popular provisions, but Democrats have two easy rejoinders. First, the country can’t afford to force insurers to keep people on their rolls without also expanding the entire pool of insured people. And without the cost cutting measures, the bill is just a spending bill. Second, after years of controlling Congress and not acting on health care, Republican’s [sic] don’t have a lot of credibility on the issue.

Need I say more? They had their chance to do something, but Republicans preferred to do nothing. So I doubt voters will trust them this time when they make empty promises to "start over" after they "kill the bill" that's now becoming law.

So most likely, the Senate will soon pass the reconciliation fix this week and the whole health care reform package should become law by the end of the month. Some benefits, like the exchange, will have to wait until 2014. Meanwhile, other benefits, like the community health centers, will be seen as early as this fall. And while this final package isn't perfect (we've talked about this extensively), it looks to withstand Republican attacks and start working for those who need help the most.