Health Care Reform: A Mini-Series

Since September, I've been working as an independent contractor for the Colorado Division of Insurance to help determine how the State of Colorado must amend current statutes and regulations to comply with federal health care reform. It seems to me that there is quite a bit of confusion about health care reform and what it means for the future of health insurance and health care in America. Over the next few weeks, I'm going to attempt to shed some light on this important issue for the average person. I'll work through the issues both topically and chronologically, in terms of what measures will take effect first.

As you may know, several requirements are currently in effect, as of September 23, 2010. These include:

• Prohibition of Preexisting Condition Exclusions for those under the Age of 19; 
• Extension of Dependent Health Insurance Coverage to Age 26;
• Prohibition on Lifetime and Annual Limits;
• Prohibition on Rescissions;
• Prohibition of Discrimination based on Salary; 
• Standardized Appeals Process (internal and external reviews);
• Patient Protections (including coverage of Emergency Services); 
• Reviews and measures to ensure consumers get value for their premiums; and
• Coverage of Preventive Health Services including Choice of Health Care Professional.

Additional changes, to take effect March 23, 2011 include:

• Reviews and measures to bring down the cost of health care (effective January 1, 2011); and
• Uniform Explanations of Coverage Documents and Standardized Definition.

Health care reform, as it stands, will completely take effect January 1, 2014 and will include numerous requirements, including the implementation of Health Insurance Exchanges, and the extension of the prohibition on preexisting condition exclusions to all ages. I'll get to these reforms later.

If you just want to know what the Patient Protection and Affordable Care Act says and what it means for the average American, keep reading. I'll address each section of the Act and attempt to provide some interpretation. Whether you think health care reform should be repealed or retained, you should at least know what the bill says, most of our lawmakers do not.

Eventually we'll need to have an informed discussion of how it should be implemented. To start with, check out this article by Richard Thaler, from the New York Times with some refreshing ideas on how to make it work:

Adding Clarity to Health Care Reform