With healthcare reform legislation now passed, this will be the beginning, not the conclusion, of the difficult and highly partisan legislative process of the past year.
The next step will be implementing and regulating the new law which is likely to be marked by the contentious fighting among the administration, political parties and lobbyists.
Take, for example, one of the first elements of the reform legislation to be put in place. Beginning three months after the date of its passage, adults with preexisting conditions who have been uninsured for at least six months can enroll in a temporary high risk health insurance pool and receive subsidized premiums. This high risk insurance pool will be available by June, 2010. But many things remain unclear.
Among the questions to be answered through regulation are the following:
1. Will this high risk insurance program be a government plan? If so, will it be seen by opponents as a public option plan that many disagree with?
2. Will the high risk plan be more like the federal employee's health plan where the federal government coordinates an exchange open to private insurance companies who can submit competing insurance plans for consideration by the covered population?
3. How will the premiums be established? What portion of the premium will require payment from the insured and will there be an out-of-pocket limit on the amount paid by the insured?
4. Will the lifetime limits on total insurance expenditures, normally found in current insurance plans, be eliminated?
Keep you your eye on the regulatory actions taken to answer these questions. How they are resolved will be a precursor of what is yet to come. This clarity is needed so patients can really know how the changes will impact them and if these new opportunities are truly helpful.
Mike Stephens blogs regularly at Action for Better Healthcare.