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Despite
all the ink spilled over the last few years on the subject of health
care, it appears the public isn’t sure what’s 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March 23, 2010, and no part of it has been repealed.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said it had been repealed altogether, and another 26% said they
weren’t sure.
The
picture gets muddier when when you get into the public’s 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 it’s possible they aren’t completely
accurate. Even so, the general drift appears to be that the public
isn’t comfortable with the status quo, but doesn’t necessarily
favor Obamacare either.
The
bulk of the law’s provisions don’t 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.
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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.)
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Dependent children up to 26 years old can be retained on
parents plans. (Effective date: September, 2010.)
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Excluding children because of pre-existing conditions is
prohibited (effective date: September, 2010)--extending to all
policy holders, children and adults, beginning in 2014.
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List of "Essential services" for new plans created
under insurance exchanges will include mental health and substance
abuse (MHSA) treatment. (Effective date: 2014.)
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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.)
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Mental health and addiction parity laws will be expanded to
apply to plans for small business and individuals. (Effective date:
2014.)
It’s
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. We’ll be following up
on that as the year wears on.
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