Costs of health overhaul may be felt before benefits accrue

News outlets examine how health care reform legislation will affect consumers.

The Associated Press reports: "The costs of health care reform being pushed through Congress by Democrats will be felt long before the benefits. Proposed taxes and fees on upper-income earners, insurers, even tanning parlors, take effect quickly. So would Medicare cuts. Benefits, such as subsidies for lower middle-income households, consumer protections for all, and eliminating the prescription coverage gap for seniors, come gradually. ... Congress can't abolish medical inflation, so don't hold your breath waiting for premiums to drop. For people who buy their own insurance policies — about one of every six Americans — premiums will go up. But that's for better benefits prescribed under the legislation. And about half of them would get tax credits to substantially lower their costs."

Exchanges would "be up and running in 2013 under the House bill, a year later in the Senate version." Around that time, other major changes would occur, including: "Health insurance companies would be prohibited from denying coverage to people with health problems, or charging them more. For the first time, Americans would be required to carry health insurance, either through an employer, Medicare or Medicaid, or by buying it themselves. ... Most employers would be required to offer coverage or pay a tax, under the House bill. In the Senate version, employers would get a bill if any of their workers got subsidized coverage in the exchange" (Alonso-Zaldivar, 12/23).

The Salt Lake Tribune answers readers' questions including how reform will affect dental and vision services, which will largely be based on age. "Insurance companies would be required to offer pediatric dental and vision coverage, under the House and Senate proposals. These 'essential benefits' would apply at first to plans offered through government-regulated exchanges, where people who are not covered through their jobs would buy coverage. Eventually, it would become the nationwide norm. Adults: Much to the chagrin of dentists and optometrists, the bills remain silent on the issue of dental and vision coverage for adults. Some plans are likely to offer these services but they are not required to do so. Some states may decide to pay for vision and dental for those receiving Medicaid, but the federal government won't cover that. ... [Meanwhile], Some elderly Americans could see their vision and dental benefits cost more or be dropped altogether as a result of these health reform proposals. These potential cuts would only impact seniors who have bought a Medicare Advantage plan from a private insurer" (Canham, 12/22).

Meanwhile, Reuters reports on a positive development for the elderly and disabled: "A new government insurance program that would help the elderly and disabled stay in their homes is headed for passage in the U.S. Senate's sweeping healthcare revamp despite doubts about its viability and cost. The measure has not received the intense scrutiny focused on a proposed government-run medical coverage plan, which has been jettisoned from the Senate's healthcare bill and is unlikely to be restored in final legislation. But the Community Living Assistance Services and Supports (CLASS) Act, which was championed by the late Senator Edward Kennedy, is a significant program that supporters say is long overdue and critics say could add to the federal treasury's long-term debt problems" (Smith, 12/23).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.