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Health Reform at Six Months: What Changes Are Taking Effect?

September 22, 2010 at 4:34 PM EDT
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Health correspondent Betty Ann Bowser looks at the impact of the health reform bill President Obama signed into law six months ago, what changes are set to take effect this week and how some Americans are already using the law's provisions to improve their health care.
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GWEN IFILL: The health care reform law reached a kind of anniversary today. Six months since President Obama signed it into law, big new changes are set to take effect. Health correspondent Betty Ann Bowser has the story.

U.S. PRESIDENT BARACK OBAMA: Hello, hello, hello!

CROWD: Hello.

BARACK OBAMA: Good to see you guys.

BETTY ANN BOWSER: The president marked the occasion in a northern Virginia neighborhood today, his goal, to sell the six-month-old law to voters six weeks before the midterm elections.

BARACK OBAMA: What we realized was we had to take some steps to start dealing with these underlying chronic problems that have confronted our economy for a very long time. And health care was one of those issues that we could no longer ignore.

So it was bankrupting families, companies, and our government. So we said we had to take this on.

BETTY ANN BOWSER: At the same time, Mr. Obama acknowledged many Americans still don’t like or don’t understand the new law, and he said he’s partly to blame.

BARACK OBAMA: Sometimes, I fault myself for not having been able to make the case more clearly to the country. We spend — each of us who have health insurance, spend about a thousand dollars of our premiums on somebody else’s care.

BETTY ANN BOWSER: In fact, the latest round of polling underscores that health care reform has yet to win strong support. A new Associated Press survey found 40 percent disapproved, while 30 percent approved. The rest had no opinion.

The effects of those flagging poll numbers have been showing up on the campaign trail. Democrats who voted for reform now face voters unhappy with the changes. Republicans, in turn, have pressed the issue and even talk of repealing the reforms if they take back control of Congress.

REP. JOHN BOEHNER (R-OH), House minority leader: In my opinion, Obamacare will ruin the best health care system in the country — in the world, and it will bankrupt our country.

BETTY ANN BOWSER: In the meantime, most of the major provisions, like coverage for millions of the uninsured, don’t kick into gear until 2014.

But several key reforms focused on the insurance industry take effect tomorrow. As of Thursday, providers will have to stop imposing lifetime caps on coverage. They will be barred from canceling insurance for people who become sick, and from denying coverage to children with preexisting conditions. In addition, young people will be able to stay on their parents’ insurance policies until the age of 26.

The president was also joined today by people who said they will benefit from changes like those. Across the country, the debate continues between those who welcome the new law and those who warn of what’s to come.

Seven-year-old Thomas Wilkes of Englewood, Colorado, will no longer have caps put on his coverage. He’s one of 20,000 Americans the White House says will be helped by the new ban. While he looks perfectly healthy, Thomas need intravenous medications every day to treat severe hemophilia, a deadly blood-clotting disorder.

NATHAN WILKES, father: Most of the cost of our care is in the medication, and this is medication that he needs to survive and live a happy life, a productive life. Without it, he would — he would — he would risk complications of bleeding in his joints, severe arthritis. He would basically become disabled before he’s a teenager.

BETTY ANN BOWSER: Dad Nathan Wilkes says the injections are over $1,000 a day. Without them, he could develop a bleed in some part of his body that could be fatal.

NATHAN WILKES: His cost, depending on the year, could be anywhere from half-a-million to a million dollars a year.

BETTY ANN BOWSER: Thomas has reached the maximum lifetime caps on two different insurance policies, so, at one point, Nathan and his wife, Sonji, were desperate.

NATHAN WILKES: We had social workers saying, well, just get a divorce, because, if you get a divorce, and if your wife doesn’t work, the kids can go on Medicaid, and get coverage that way. And we weren’t about to get a divorce just for the sake of insurance coverage. So, we — I had to quit my job.

BETTY ANN BOWSER: Wilkes finally started his own company and bought a policy that covers Thomas and the rest of the family with a $6 million lifetime cap. Even that will eventually run out, so the Wilkes family is pleased that the new rule will give them more security.

KAREN POLLITZ There will be some important protections that will affect some people very directly.

BETTY ANN BOWSER: Karen Pollitz heads the new Office of Consumer Information and Insurance Oversight for the federal government. She acknowledges that it will take time for the impact of these provisions to be felt by many who will be affected.

KAREN POLLITZ, director, Office of Consumer Information and Insurance Oversight: The protections will roll in as your insurance policy renews or as you buy a new policy.

We are giving people better protection. You know, it’s like putting stronger seat belts in cars or better air bags. You know, we may not use them. We may not all get in the high-speed crashes, but that’s what they’re there for. And I think we all feel a little better knowing that that protection is solid.

MAN: I would like to see you before you see the specialist.

BETTY ANN BOWSER: The White House also says there are other less-well-advertised benefits kicking in that will require insurance companies to pay for a long list of preventative services at 100 percent, including childhood vaccines, mammograms, and yearly checkups.

Insurance companies and other critics of the new law say this provision and others like it will drive up the cost of health insurance even higher.

ED HAISLMAIER, Heritage Foundation: It certainly will increase the cost of health insurance, yes.

BETTY ANN BOWSER: Ed Haislmaier of conservative Heritage Foundation says the increases are to be expected.

ED HAISLMAIER: My gosh, this is more micromanaging and more regulatory than anything I have ever seen any state do when it comes to mandated health insurance benefits. You simply cannot require health insurance to pay for more things and not have the cost go up above and beyond what it is. I mean, it’s just simple. It’s not even economics. It’s mathematics.

BETTY ANN BOWSER: Bethesda, Maryland, small business man Jordan Resnick has seen the math, and he doesn’t like it.

JORDAN RESNICK, small business owner: I think it’s highway robbery.

BETTY ANN BOWSER: Premiums for his family and three full-time employees have gone up more than 50 percent in five years. So, he’s had to drop paying for coverage altogether.

JORDAN RESNICK: The money’s got to come from somewhere, and it’s either going to come from salary or it’s going to come from benefit. So now, instead of us being able to match or give a percentage, we have just elected to say, if you want it, you can pay for it yourself through payroll. We’re just not able to give it anymore and still be able to pay a competitive wage.

BETTY ANN BOWSER: Resnick says he’s not convinced another provision, a tax credit for small businesses, included in the law will help his bottom line.

JORDAN RESNICK: I just hope Congress did the right thing with this bill and did provide some provisions that can help people like me be able to, one, stay in business, and, two, be able to make sure that our employees know that, when they walk out the door that, if something happens, they’re covered.

BETTY ANN BOWSER: Some families are already enthused about another new rule, the one that would guarantee coverage for more than two million young adults under age 26 who can stay on their parents’ plan now.

SUE SNIVELY, mother: This is what I should have done with you when you were little.

BETTY ANN BOWSER: For 22-year-old Tom Purser, who has epilepsy, and his mother, Sue Snively, it’s a big relief.

SUE SNIVELY: Having a kid with these kind of — this kind of health condition over the past several years, and him not being a full-time college student a lot of that time, was going to really make a big difference for us, because it gives us several more years. He’s 22.

We now have, you know, three more full years where he will be able to be covered under my insurance. And that means he can take his time and do school in a way that will hopefully work for him. So, it’s very significant for us.

BETTY ANN BOWSER: Before the new regulation, Purser had to be a full-time student to stay on his mom’s policy. But the threat of seizures has made it hard for Purser to go to college full-time.

TOM PURSER, student: I ended up missing a lot of classes. And then, of course, there were the times when I had seizures in school. And the fact that, you know, I’m insured now, even though I’m not a full-time student, is just awesome for me, because I can take my time, and I can be a student, but not be nothing but a student.

BETTY ANN BOWSER: While the new law will help young adults like Purser and help kids who were previously denied coverage on their parents’ plans, big insurance companies in four states announced in recent days they will no longer sell new separate insurance policies to cover children.

WOMAN: OK. You feeling better?

BETTY ANN BOWSER: Earlier this year, industry leaders had indicated they would comply with portions of the law that relate to children’s coverage, a point Obama administration officials made this week.

But a spokesman for America’s Health Insurance Plans told the NewsHour: “The final regulations that were issued went beyond what was originally discussed and what the industry agreed to.”

BARACK OBAMA: We have got to make the system work better for consumers.

BETTY ANN BOWSER: While the Obama administration and the insurance companies are haggling over implementation of the law, the bigger fight could come next year, if Republicans win control of Congress.