Health reform inches ahead
The massive overhaul of the U.S. heath care and insurance system will require years of fine tuning. President Obama recently described the pace of reform in terms that farmers can appreciate.
"Can you imagine if some of these reporters were working on a farm?" he asked. "They planted some seeds, they came out the next day, they looked and nothing's happened. There's no crop. They're going to starve. It's a disaster.
"So, before we find out if people like reform, we should wait to see what happens when we put it into place."
Much of its success will hinge upon final regulations, definition of terms, and effective implementation.
"It will take years for health care providers, insurers, and local communities to adapt to a complex array of new expectations, incentives, and resources," says Tim Size, executive director, Rural Wisconsin Health Cooperative, Sauk City.
The following reforms will impact farm families most directly in 2010.
- Small business owners will be eligible for a tax credit to help cover the cost of insurance for their employees. The credit covers up to 35% of premium costs.
- Insurance companies will be mandated to sell coverage to uninsured children with preexisting conditions.
- Uninsured adults with preexisting conditions will be able to obtain coverage through a new program that will expire once insurance exchanges begin in 2014.
- Insurance companies will be barred from dropping people from coverage because they become ill.
- Insurance companies no longer will be able to place lifetime coverage limits or restrictive annual limits.
- All new insurance plans will be required to offer preventive care free from co-pays or deductibles.
- Dependent children will remain on their parents' insurance plan until age 26.
- The Medicare prescription drug coverage gap (doughnut hole) will begin closing, with a $250 rebate this year.
- Insurers will report how much they spend on medical care vs. administrative costs. Other features, including the individual insurance mandate, will be phased in during 2014. Health care tax credits will be available.
Medicare reimbursement is key to rural hospitals, and the law may create greater equity. Critical access hospitals will retain current Medicare reimbursements.
About 16,000 more primary care doctors are needed in the U.S., and the law will increase the shortfall. The law offers incentives and loan forgiveness programs to physicians who serve rural areas.
As reforms unfold, consumers are being warned about health care scams and advised to contact state insurance officials.
As President Obama cautions, "This reform is not going to solve every problem with our health system. What this reform represents is basically a middle-of-the-road solution to a very serious problem."
Size agrees. "Don't underestimate the importance of unintended consequences," he says. "It will take at least 20 years to digest this much change."