ON MARCH 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. Since then, Blue Cross of Northeastern Pennsylvania, other health insurers and the entire health care industry have been working to implement the law's numerous provisions, many of which go into effect on Jan. 1, 2014.
Since its passage, the Affordable Care Act has been a polarizing issue among Americans. Legal challenges to the act from a number of states and small business interests resulted in the U.S. Supreme Court ruling on the constitutionality of the law in June. The court ruled that the individual mandate provision and the insurance market reforms included in the law were constitutional. The court's decision ensured that the Affordable Care Act remained a cornerstone issue in this year's presidential election.
The health care law is President Obama's signature domestic accomplishment. Now that the president has been elected to a second term, we can expect the administration to continue moving toward full implementation of the law over the next few years as designed.
Because a major campaign theme for many Republican candidates was a vow to repeal the law, many people are speculating whether there will be efforts by some members in the new Congress to propose changes to this wide-ranging reform law.
Whether or not these forces continue to collide, Blue Cross and other health insurers will remain on the path of Affordable Care Act implementation as directed under the law and by the Obama administration. That means that beginning on Jan. 1, 2014 consumers will be able to compare and purchase health insurance plans through an online exchange. Individuals with lower incomes will have access to federal subsidies to help pay for their coverage, and individuals with pre-existing medical conditions will not be denied coverage through the exchange.
We also must remain mindful that implementation of certain major provisions of the law – such as establishing health insurance exchanges and whether or not to expand Medicaid eligibility – are decisions now facing individual states.
Friday is the deadline by which states must inform the federal government if the state is prepared to administer its own health insurance exchange or work with the federal government to jointly operate an exchange. If a state is not prepared to pursue either of these paths, then the federal government will step in and administer the exchange.
States also must decide whether to expand Medicaid. In its original form, the Affordable Care Act compelled states to expand Medicaid eligibility to those individuals under the age of 65 who make less than 133 percent of the federal poverty level. The U.S. Supreme Court's decision in June, however, allows states to choose to participate in this expansion, and Pennsylvania is one of many states that has not yet made this decision.
Development of a health insurance exchange and whether or not to expand Medicaid are only two of the major health care decisions facing our commonwealth. On these and other issues, we urge our policymakers to make decisions that retain state control of our health care and health insurance markets, because our commonwealth leaders know our markets and consumers, and are in the strongest position to decide what will work best for all Pennsylvanians.
At the end of the day, it's important to realize that these measures – and the other insurance market reforms included in the Affordable Care Act – will not address the driving issue of rising health care costs. All stakeholders in the health care system must continue to work toward a unified and multi-faceted approach to addressing the rising costs of care.
For example, health insurers already are working with doctors and hospitals nationwide to implement accountable-care models and other patient-centered payment reforms that reward the quality of care a patient receives. Health insurers also are offering an array of programs that promote wellness and that help manage costly chronic conditions.
As Congress and the president continue to debate health care policy over the next few years, Blue Cross of Northeastern Pennsylvania urges lawmakers at the national level to turn attention to policies that address the long-term ability to control escalating health care costs.
Now that the 2012 elections are over, our members – and all residents of the 13 counties we serve – deserve health care policy at both the state and federal levels that works to control escalating costs through prevention, disease management and wellness; improves access to care; and rewards doctors and hospitals for keeping their patients healthy.
Beginning on Jan. 1, 2014 consumers will be able to compare and purchase health
insurance plans through an online
Kimberly J. Kockler is vice president of government affairs for Blue Cross of Northeastern Pennsylvania, based in Wilkes-Barre.