What Does Federal Health Reform mean for Cincinnati?
June 2010
The 2010 national healthcare reform is the most sweeping change to the American healthcare system since the introduction of Medicare in 1965 and aims to succeed in two major areas: increasing access to insurance for millions of Americans and containing healthcare costs.
After a long and often contentious debate, President Obama signed the two healthcare acts, the Patient Protection and Affordable Care Act and Health Care and Education Affordability Reconciliation Act, into law on March 23, affecting millions of Americans. Here are some highlights.
In the long run this will save the taxpayers millions of dollars by better management and prevention of chronic conditions, such as diabetes or coronary disease, that often land people in emergency rooms—the most expensive setting to provide treatment. For Cincinnati, this means in 2014 an estimated 40,000 more Cincinnatians will be insured, including roughly 16,000 current Cincinnati Health Department (CHD) patients. Our primary care centers are at full capacity and on pace to conduct 115,000 patient visits in 2010 (113,500 in 2009). If implemented as planned, Health Reform means millions of additional dollars coming to the CHD enabling us to expand services and improve the health of our citizenry.
What does this reform mean for you? The Affordable Care Act does not force people to change insurance providers. Individuals satisfied with their insurance can keep their current plans and stay with a plan even if they switch jobs because of increased insurance portability.
However, under the new law insurance companies can no longer place lifetime limits on coverage or drop coverage for those with certain pre-existing illnesses or conditions. Beginning in September 2010, children under age 19 with pre-existing conditions cannot be denied coverage, and this is extended to adults in 2014. Another immediate aspect of healthcare reform is coverage for young adults who will be able to stay on their parents’ plans until age 26.
In order to increase the number of insured Americans, Medicaid benefits will be extended to those making below 133 percent of the Federal Poverty Level ($29,327 income for a family of four). Financial assistance will be available for those making 133 to 400 percent of the Federal Poverty Level (up to $88,000 income for a family of four). Tax penalties will exist for non-coverage for individuals and employers with more than 50 employees.
The prescription drug “doughnut hole” for Medicare patients will be closed. Medicare covers prescription costs below $3,000 and offers assistance over $6,000. This year, $250 rebate checks will be mailed to affected Medicare recipients.The doughnut hole will continue to be phased out and eliminated completely by 2020.
In efforts to decrease the number of preventable conditions, Medicare and Medicaid will cover preventive services. Health Reform will also offer funding for research on health disparities, epidemiology, lab capacity grants and funding for mid-career training to increase the public health workforce.
With legislation of this magnitude and scope, many details regarding implementation have not yet been fully determined and will continue to be finalized over the coming months. This legislation is good news for the City and the citizens we serve and presents an exciting time for the healthcare providers. The CHD will continue to follow the implementation of the legislation in order to maximize opportunities to improve the health and wellness of Cincinnatians.
