Public Radio Commentary
By Sandy Courtnage
July 27, 2010

Health Insurance Reform by the Numbers

Health care reform was signed into law earlier this year, and the legislation tackles many aspects of health care delivery and insurance coverage in our country. It is safe to say, I believe, that many people on all sides of the debate were not satisfied with the end result. In our own organization we have heard that the law doesn’t accomplish enough or that it does too much, that implementation costs need to be carefully scrutinized, and that what is included in the law doesn’t get implemented quickly enough.

In all of these beliefs are elements of confusion about what is in the bill and when it will be implemented. It is true, that some parts of the new law will not be implemented for years, while others are already in effect.

The new law provides at least four immediate benefits to Montanans who have insurance: these are worth outlining:

First, the law bans lifetime caps on insurance coverage and heavily regulates annual limits until the year 2014 when lifetime caps will be prohibited.

Second, the law prohibits health insurance plans from denying coverage to children with pre-existing conditions.

Third, the law requires new plans to cover preventative services at no cost to consumers;

And finally, it bans insurance companies from dropping people’s coverage when they get sick.

If you are a small business owner with fewer than 25 full-time employees with an average wage of less than $50,000, you can apply for a tax credit starting this year for up to 35 percent of the cost of your health insurance premiums. This provision is designed to help small business owners who are finding it increasingly difficult, if not impossible, to provide health insurance for their employees.

If you are a senior on Medicare, the new law eliminates co-payments for preventative services starting next year and begins to close the Medicare Part D prescription drug coverage gap-the so-called “donut hole.” This year seniors who fall into the donut hole will receive a $250 rebate. Beginning next year, drugs for seniors in the same situation will be eligible for a 50 percent discount. The funding gap is expected to disappear completely by the year 2020.

If you are a young adult, you can stay on your parents’ policy until your 26th birthday.

If you live in a rural community, you should see increased funding for Community Health Centers to serve additional patients as well as funding an increase in primary care doctors, nurses and other public health professionals in underserved areas.

Finally, there is one additional benefit that already is in place and available as of July 1 of this year. Montana has established a new high-risk pool to provide immediate access to insurance for people who are uninsured because of a pre-existing condition. This high-risk pool will continue until the year 2014, when discrimination against people with pre-existing conditions will be banned. If you fall into this category, please contact the State Auditor’s Office for more qualifications details and for information on how to apply. Enrollment in the federal Affordable Care Plan is limited and offered on a first come basis.

If you look at health insurance reform by the numbers, it is clear to us that there are many benefits to Montana that will ensure healthier Montanans. As outlined, this law addresses many of the needs specific to states with a rural character such as ours, which tend to be underserved and overcharged.

For the Montana Farmers Union, I’m Sandy Courtnage. Thanks for listening.