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TRENDS

A year after of health care reform--where do we stand?

Despite all the ink spilled over the last few years on the subject of health care, it appears the public isnít sure whatís going on. The Patient Protection and Affordable Care Act was signed into law on March 23, 2010, and no part of it has been repealed. Neverthless, in a recent poll by the Kaiser Family Foundation, 22% of respondents said it had been repealed altogether, and another 26% said they werenít sure.

The picture gets muddier when when you get into the publicís specific opinions about health reform. On one hand, a Rasmussen poll in March found that just 41% of the public favor the Act while 54% disapprove.

On the other hand, just a few weeks before that, Consumer Reports published a poll indicating that 26% of respondents favor "fundamental changes" to the health care system, with another 22% who want at least some change.

Surveys like these are generally based on samples of 1,000-to-2,000 telephone responders, so itís possible they arenít completely accurate. Even so, the general drift appears to be that the public isnít comfortable with the status quo, but doesnít necessarily favor Obamacare either.

The bulk of the lawís provisions donít go into effect until 2014. Between now and then, there will be challenges from Congressional Republicans, and potentially from the Supreme Court or from a new president depending on the result of the 2012 election.

Even so, there are several "earlybird" provisions that are already in effect--or will come online shortly. (We list those below.) Presumably, it will be harder to reverse any part of the law that the public feels is already producing benefits for them.

  • Tax credits for small businesses--these are intended to encourage them
    to offer health insurance to employees or keep the coverage they have. (Phase-in began in September, 2010, with full implementation in 2014.)

  • Dependent children up to 26 years old can be retained on parents plans. (Effective date: September, 2010.)

  • Excluding children because of pre-existing conditions is prohibited (effective date: September, 2010)--extending to all policy holders, children and adults, beginning in 2014.

  • List of "Essential services" for new plans created under insurance exchanges will include mental health and substance abuse (MHSA) treatment. (Effective date: 2014.)

  • Lifetime caps on benefits are prohibited, with annual limits phased out over three years, and prohibited on all plans by 2014. (Phase-out began: September, 2010.)

  • Mental health and addiction parity laws will be expanded to apply to plans for small business and individuals. (Effective date: 2014.)

Itís still unclear what if any impact these provisions have made on the small and mid-size psychotherapy practice--or on the managed behavioral health care industry in general. Weíll be following up on that as the year wears on.

 

 

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