Healthcare Reform – Is it Just Politics?

Healthcare Reform is it Just Politics?

Summary: Healthcare reform is it just politics? With 2014 rapidly approaching and the most significant year in terms of Healthcare Reform, many provisions/mandates have been delayed. Is Healthcare Reform just a way of pitting Democrats and Republicans against one another?

Well, it looks like we are about to have another political battle over Healthcare Reform a.k.a. Obamacare. Many issues are about to become topics of debate.

Debt ceiling – the United States is approaching another debt ceiling in November 2013. What this means is that our ability to acquire additional funding through borrowing is going to again reach a cap. The last time this happened, our US credit rating was downgraded for the first time in many years and substantially impairs our ability to borrow from other countries at least at an interest rate that is plausible. What will be the outcome? Will the debt ceiling be raised? Will our ability to borrow funds be frozen/cut-off? Should we not concentrate on paying off the debt we already owe before trying to incur additional?

Threat to shutdown the government – one of the most serious items on the table is the threat to shut down the government at least temporarily while negotiations are made on the debt ceiling and healthcare reform. Are these idle threats or do you think this is a possibility? Do you think the government should even be able to make such threats? Will it actually be a bargaining chip?

Healthcare Reform – Healthcare Reform in general is a subject for debate on the political front. The Democrats are pushing for the law in its entirety to continue to as proposed. The Republicans on the other hand are seeking to either delay the remainder of the law provisions to be either delayed or repealed.

• Beginning in October 2013, healthcare exchanges are scheduled to begin open enrollment for the year beginning January 1, 2014.

  

  With this initiative, both federal and state run exchanges must be ready to go in terms of all computer systems integrated while protecting individual’s financial and health information to allow applications to be completed, transmitted, approved, and implemented through electronic means. Right now, there is a scramble especially in terms of the complex technological changes. Do you think the exchanges will be ready to go as of October 1? We are about 6 weeks out.

 

• Employer mandates – These are provisions which require employers to provide health insurance coverage for their employees. As originally, written, employers with less than 50 employees had until 2015 to comply with the coverage options. Recently, the employer mandate for those who had more than 50 employees was delayed from becoming effective in 2014 to 2015. Companies who choose not to comply with these mandates will face substantial penalties. Do you think these mandates will be delayed even further? Do you think they should be “mandates”? Do you think the penalties are too severe? Should companies with greater than 50 employees be treated any differently than those with less?

 

• Individual mandates – The other side of the coin to employer mandates is individual mandates. These are provisions within

  

  Healthcare Reform which require Americans (with few exceptions) to carry health insurance coverage. Those opting not to be insured will also be faced with a penalty. However, the penalty is minimal as compared to the employer mandates. There has been some talk of delaying this mandate as well. This mandate seems to coincide with the employer mandates. If employers aren’t forced to cover their employees, does forcing the affected individuals to purchase through the exchanges seem like a viable solution? Or do you think the individual mandate should be delayed and/or repealed? Do you think Americans should be required to carry insurance? If so, do you think the penalties are steep enough to encourage coverage or do you think many will opt for the penalty? Do you think we should have to include our financial records in order to participate in the exchanges? Do you agree in a “level playing field” in terms of health insurance premiums? Should the healthier individuals have to subsidize those who are less healthy? Should there be healthcare incentives to the healthier individuals?

 

• Out of pocket caps – This provision was to become effective in 2014 but as with the employer mandate has been delayed until 2015. This provision basically puts a cap on things such as deductibles and co-pays. The out of pocket limits slated for 2014 were $6350 for individuals and $12,700 for families. With the delay until 2015 these limits may change. What are your thoughts on the delay? Do you think it is good or bad?

About BHM Healthcare Solutions – www.dev.dev.bhmpc.com

BHM is a healthcare management consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services ranging including managed care consulting, strategic planning and organizational analysis, accreditation consulting, healthcare financial analysis, physician advisor/peer review, and organizational development.

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