What is Not in the Health Care Reform Law?
Will not ration care for the elderly:
- It creates a nonprofit Patient-Centered Outcomes Research Institute charged with examining the “relative health outcomes, clinical effectiveness, and appropriateness” of different medical treatments by evaluating existing studies and conducting its own.
- The institute, governed by a 19-member board, includes patients, doctors, hospitals, drug makers, device manufacturers, insurers, payers, government officials and health experts.
- It does not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment.
- Medicare may take the institute’s research into account when deciding what procedures it will cover, so long as it is not the sole justification and the agency allows for public input.
- Many experts believe that as health costs continue to mushroom, Medicare and private payers will incorporate the institute’s work into their coverage decisions. Others say history suggests that’s unlikely.
Will not end TRICARE and force military families to buy different insurance:
Military personnel and their families can continue to get full benefits under the familiar military health plan.
Illegal immigrants will not get free health care:
- They already are barred from receiving Medicaid benefits, and the new law excludes them from receiving premium subsidies.
- They are also explicitly banned from purchasing insurance with their own funds on the exchanges created in the legislation.
- To purchase insurance through those marketplaces, one must provide proof of citizenship or legal resident status.
- Without insurance, many of them will continue to receive care in free or subsidized clinics.
- New law doesn’t change the requirement that hospitals offer emergency services to all patients, including illegal immigrants.
No federal funding for abortions:
- The law prohibits federal subsidy funds, intended to help people afford health coverage, from being used to pay for abortions except in except in cases of rape, incest or to save the life of a woman.
- Obama’s order includes a provision to ensure that insurers offering coverage through state-level insurance exchanges charge customers separate premiums to cover abortion services.
- It also revisits past decisions by Congress to bar community health centers from using federal funds to provide abortion services outside of the exceptional circumstances.
- It directs federal officials to “ensure that program administrators and recipients of federal funds are aware of and comply with the limitations on abortion services.
Not government-run health care:
- The law builds on our current system of private insurance, and drums up more business for private companies by mandating that individuals buy coverage and giving many subsidies to do so.
- There would be increased government regulation of the insurance industry, however, to require companies to cover preexisting conditions, for example.
Increased premiums:
- For most people, premiums wouldn’t change significantly.
- The Congressional Budget Office estimated that for those who get insurance through their employers, premiums would largely stay the same.
- The change in the average premium in the large group market would be between 0% and a 3% decrease, for instance, compared with where they’d be under current law in 2016.
- The average premiums for those who buy insurance on their own would go up by 10% to 13%, because the benefits would become a lot better for this market under the law, but most would receive subsidies that make their net costs for these plans substantially lower than they otherwise would be.
Download the final bill passed by House and Senate here.
Watch for updates at the White House website.
Sources:
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