COLUMBIA – With the historic passage of health-care reform legislation by the U.S. House of Representatives on Sunday, Columbia residents began asking Monday about its impact.
Although the bill still must be signed by President Obama, and reconciled in the U.S. Senate, some relevant numbers have been calculated.
Missouri's 9th Congressional District, which includes Columbia, could see the following outcome, according to a report compiled by the U.S. House Committee on Energy and Commerce:
- 36,000 uninsured residents could get coverage;
- Up to 61,000 young adults could be covered under their parents’ insurance policies;
- 96,000 residents with pre-existing conditions will be guaranteed the option of insurance coverage;
- Medicare will be improved for up to 105,000 recipients;
- Tax credits and other assistance will be given to up to 185,000 families and 15,500 small businesses to make coverage more affordable;
- Health insurance coverage will improve for 428,000 residents; and
- Uncompensated hospital and other health care provider costs will be reduced by $79 million annually.
If enacted, some portions — such as allowing individuals to be covered under their parents' health care plan until age 26 — could take place within the next six months.
But many of the changes — including universal coverage and small-business insurance pools — won't be in full effect until 2014.
Mike Paden, associate vice president of employee benefits for MU, said his office is in the process of evaluating the new legislation.
He said he expects it could take some time to process the 2,000-page document. As legislation is compared to current MU benefits, he said, appropriate changes will be made.
Kris Hagglund, associate dean of health professions at MU, suggested that the bill, when enacted, may improve the position of health-care providers.
The influx of nearly 30 million people getting insurance by 2014 might allow providers to receive payment for services previously written off as charity care.
"Many providers now provide care for free for the uninsured," Hagglund said. "Now they'll have an increased number of patients who will be insured, and they (health care providers) will get paid for services.
Another issue is the ratio of health-care providers to those demanding it. There will be a growing disparity between the number of providers and their patients, he said.
The best way to address it is to prepare more students to graduate in health-care professions.
The Caring for Missourians Initiative has been a collaborative effort among two- and four-year public schools to provide state funding to increase the number of graduating health care professionals.
It will increase the number of health-care professionals entering the Missouri market in the next few years, he said, but it was part of the federal stimulus package and may not be renewed.
"Right now, we don't have an adequate number of primary-care providers to meet the demand," he said. "Any initiative to increase general providers and specialty providers is important and will be meaningful."
The legislation could shift the cost burden from one group to another, said Brant Butler, director of the Missouri Insurance Coalition.
"Some will be winners and some will be losers," Butler said. "I don't know who will be winners, but young people will definitely be losers."
He said covering pre-existing conditions and doing away with traditional rating systems will defer high insurance costs to the young.
"If a 25-year-old and a 65-year-old are rated the same, or not rated at all, it means that the 65-year-old will be using more money from the insurance company but the 25-year-old will be paying more to foot the bill," he said.
By 2014, insurance providers will be prohibited from denying individuals with pre-existing conditions health care coverage. While it will benefit some of the 36,000 uninsured residents in Missouri, it could become costly for Missouri insurance companies.
Even when the choice becomes an ultimatum between choosing to buy health insurance or pay an annual penalty fee, Butler said young people could opt to pay the penalty rather than purchase a policy.
"Young people can't really do anything to prepare now," Butler said. "They can either buy insurance now and save money in case they're injured, or they can buy it later. Either way, costs for the young could go up."