Health care policy experts discuss reform law

People attending a town-hall meeting Monday night agreed the country needed health care reform, but they weren't convinced the nation got the reforms it needed.

Health care policy experts Ryan Barker and Thomas McAuliffe of the Missouri Foundation for Health talked with about 25 small-business owners, health care workers and senior citizens who came with questions about how federal health care reform will affect them.

Barker and McAuliffe discussed several of the provisions of the 2,700-page law, including its mandate that all people purchase health insurance.

That provision faces more than 20 challenges in federal court, including one filed by Missouri Lt. Gov. Peter Kinder, a Cape Girardeau Republican.

Despite the outcome of those cases, McAuliffe said many of the other provisions of the law aren't likely to go away because the private health care market is already accepting them. Those provisions include allowing children to stay on their parents' insurance until age 26 and preventing insurance companies from dropping coverage due to illnesses or setting lifetime limits on coverage, and requiring them to cover 100 percent of preventive care costs.

The federal reform law calls for states to establish health insurance exchanges in which small businesses and people who aren't offered insurance by their employer may purchase coverage. Setting up the exchanges is left up to the states but must be done by Jan. 1, 2014. In this year's legislative session, House Bill 609, sponsored by Rep. Chris Molendorp, R-Belton, would have set up an insurance exchange for Missouri. The bill passed the House unanimously but did not come up for a vote in the Senate after some senators threatened to filibuster it, Barker said.

It is possible that the legislature will take up the measure next year, the governor could establish the exchange through an executive order or the federal government will set it up for the state if it chooses not act, Barker said.

Private insurance companies like the concept of health insurance exchanges because it gives them access to 32 million more potential customers, McAuliffe said.

The exchange will change the way insurance companies figure their rates, Barker said. Companies will no longer be able to charge customers more based on gender or occupation. They may still charge higher rates based on age but only up to three times as much, he said.

mmiller@semissourian.com

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