National health reform is here

The new federal health insurance reform law won’t require everyone to have health insurance until 2014. That might seem like a long way off, especially when so many politicians are campaigning for state and federal offices on a pledge to repeal the “Patient Protection and Affordable Care Act.” Twenty states have even filed lawsuits to fight the law’s implementation.

Not only is Wisconsin not one of those states, it’s already way ahead of many others in putting the new federal law to work.

The law’s impact on Wisconsin to date was the topic of discussion at a Public Policy Forum luncheon in Milwaukee last week. The luncheon at the Italian Community Center featured state Secretary of Health Services Karen Timberlake’s update on the law’s impact on Wisconsin so far, as well as the perspectives of Milwaukee City Health Commissioner Bevan Baker, Froedtert Hospital President and CEO William Petasnick, Milwaukee Health Services CEO C.C. Henderson and Aurora Medical Group President Jeff Bailet.

Wisconsin is out in front of most states in expanding residents’ access to insurance, Timberlake said.

She acknowledged that while the new federal law isn’t perfect, it does offer opportunities for states to compete for billions of dollars in new federal grants to improve and expand health care services at the state and local levels. States that spend time fighting the law’s implementation will miss out on those opportunities, she noted.

She also highlighted some of Wisconsin’s health care successes: The state leads the nation in health care quality; it is No. 1 for making sure that all children, regardless of economic status, have access to health insurance; and it’s near the top in total number of people with health care coverage.

On the down side, thousands of Wisconsin residents remain uninsured, and many of those who do have insurance face double-digit insurance premium increases each year. In addition, the state shows serious health disparities among its poor and minority populations; the state ranks among the worst for having an overweight and obese population and Wisconsin is first in the nation for binge drinking.

Making Wisconsin a healthier state must involve both the public and private sectors, Timberlake said, adding: “We all need to be in this together.”

She highlighted the Affordable Care Act provisions underway in Wisconsin. They include:

• As of July 15, Wisconsin residents who haven’t been able to find health insurance because of pre-existing medical conditions can apply for coverage under an expanded version of the state’s Health Insurance Risk Sharing Pool, known as HIRSP. Coverage will begin Aug. 1. HIRSP will serve as a bridge for those with pre-existing medical conditions until 2014, when insurance companies will be prohibited from refusing to cover adults with pre-existing conditions.

• Employers that provide affordable health coverage to retirees are eligible to apply for financial assistance through the U.S. Department of Health and Human Services’ Early Retiree Reinsurance Program. Available on a first-come, first-served basis, the program is a $5 billion temporary reinsurance program for employer-based plans that cover early retirees over 55 who don’t yet qualify for health insurance through Medicare.

• About 89,000 small businesses in Wisconsin may be eligible for a new tax credit for providing health insurance to their workers.

• As of Oct. 1, funding to Community Health Centers will increase so that existing centers can serve nearly double their number of patients over the next five years; funding could also be used to build new health centers.

Meanwhile, the state Office of the Commissioner of Insurance is preparing for new consumer protections in the insurance market that will go into effect Sept. 23, such as:

• Insurance companies can no longer put lifetime limits on coverage.
• Insurance companies will be banned from dropping someone’s coverage when they get sick.
• Children with pre-existing medical conditions can no longer be denied insurance coverage.
• Adult children covered under their parents’ insurance plan will be allowed to stay covered under that plan until they turn age 26.

Froedtert Hospital’s Petasnick said the argument that the national health reform law is an act of socialism and should be repealed reminds him of the opposition to Medicare when it passed back in the 1960s. He supports the new law, even though some business leaders have criticized him for doing so.

He’s disappointed that the political debate over the law didn’t produce a healthy, bipartisan discussion over how to improve the nation’s health.

“I’m optimistic for the legislation,” Petasnick said. “We in the health care community view it as a starting point. My hope is it will be a starting point in the dialog for how we can achieve a healthier community.”