Many Americans are feeling a sense of hope now that health care reform is close to becoming a reality. While discussions continue at the federal level, many individuals are finding deciphering what the impact to their personal household will be. One of the most widely debated portions of the health care reform plan is the public option. The ultimate goal of this option is open the door for more Americans to obtain federal health care coverage.
The Purpose of the Public Option
The primary purpose of the public option plan is to provide health insurance options to individuals who don’t have access to insurance through their employer or for small business owners who want affordable plan options. The bill would create a Health Exchange, intended to act as a one-stop shop for consumer health insurance. While private insurance companies can participate in this process, they must meet minimum criteria as established by the federal government.
Private Insurer Standards
Some of the standards private insurers will have to meet include:
• The inability to deny coverage based upon pre-existing conditions
• Guaranteed renewable options
• Insurers cannot provide price differentials based upon gender
• Premiums based upon age will still be permitted, but the vast differentials currently charged today will be restricted
• Federal subsidies will be offered to individuals who fall within certain income parameters to pay for health insurance premiums.
• A cap will be applied to all policies for out-of-pocket expenses incurred by the policy holders annually.
In addition to providing these parameters on private health insurance offered to Americans, the primary purpose of the public option is to provide federal health coverage to individuals with methods in which to secure coverage. One of the primary fears felt by insurers is the competition being created and the potential financial impact to their organizations.
Health Care Reform Skeptics
While great progress is being made surrounding health care reform, there are still many sceptics. Will the plan be effective? Will more Americans have access to health insurance? How will these changes impact private health insurance companies? Will the quality of health care provided be compromised? While fear surrounds the changes proposed, the consensus at large is that some sort of change needs to be made. The ultimate question is, ‘What level of health care reform will provide the differences uninsured Americans are searching for?’
A great deal of debate currently surrounds the proposed Obama health care reform package. In particular, individuals are concerned/interested in the public option. What exactly is its purpose? If passed, how will the public option directly impact individuals?
Here are a few of the intended consumer health protections included within the Obama plan:
- No discrimination for individuals with pre-existing conditions. Millions of Americans are excluded from health insurance due to pre-existing conditions. As the population continues to age and as workers continue to switch employers more frequently, pre-existing coverage has become more of a concern.
- Reduced out-of-pocket expenses, including deductibles and co-payments, making not only health insurance more affordable, but health and medical treatments. Insurance companies will be required to abide by a pre-determined annual maximum on the amount charged to an individual in out-of-pocket expenses.
- Increased focus on preventative care achieved through no-cost sharing for individuals seeking this type of medical treatment. Examples of preventative care could include annual pap-smears, mammograms, flu shots, annual exams or physicals and tests designed to prevent illnesses.
- Individuals deemed ‘seriously ill’ will not be able to be dropped by their current insurance carrier for this reason.
- Insurance companies will be unable to discriminate against insured based upon their gender.
- To ensure individuals will have access to quality health care for their entire life, lifetime maximums or caps currently on many policies will be removed or prohibited moving forward.
- To ensure that children and college students retain coverage, the age in which coverage can continue to have eligibility under their parents’ health insurance will be extended to 26.
- Health insurance will be offered as guaranteed renewable, allowing individuals to retain their coverage indefinitely as long as they continue to pay the associated premium.
While anything new often seems challenging to understand or grasp for many, the overall intended purpose of the Obama plan is to improve the accessibility and quality of health care in the U.S. Like any major change, an adjustment period will be required. As you can see from the above suggested changes, no matter what your age or health status, health insurance should become more attainable, and with the renewability options, sustainable for the majority of Americans.
As many of you are aware, the health care system in the United States is very close to being fundamentally transformed. Since the 2008 Presidential Election, President Obama, Congressional Democrats and Congressional Republicans have been working to pass a bill that will create a Public Insurance Option. This bill, if passed, will provide a Government run health insurance option available to Americans regardless of their pre-existing health conditions. Both Democrats and Republicans agree that an overhaul of our current health care system had been needed for quite sometime, however each party has their own opinions on what the final bill should entail.
President Obama and the majority of Democrats argue that the Public Option is necessary to provide affordable health insurance to the estimated 47 million uninsured Americans. They predict the plan will bring healthy competition to the private insurance industry and will bring down the cost of sky rocking health insurance premiums nationwide. In his Weekly Presidential Address on September 12, 2009, President Obama stated:
“ My plan will provide more security and stability to those who have health insurance, offer affordable quality choices to those who currently don’t, and bring health care cost for our families, businesses and governments under control”.
While most would argue that Obama and Democrats have very valid points, many questions are still left unanswered for Republicans and the American people. How much will the Public Option cost? Will there be new taxes? Will the quality of care be the same? …and probably the biggest question of all – How will America pay for it?
These are some serious questions that need to be discussed further as more details of the bill come into view in November 2009.
While the Democrats are emphasizing urgency in passing this option the Republicans remain skeptical expressing concerns. Lets analyze both points of view from each party and then take a look at the studies each side is using to argue their points.
Republicans
- Government run health care will drive cost up. View Study.
- The Government option will add to our deficit.
- New taxes on professionals and small businesses will drive jobs out of our economy and push more families into a government run plan.
- Democrats developing the Public Option exempt themselves from the plan.
- It is irresponsible to cut 500 billion from Medicare. A Government run insurance program for senior citizens that is predicted to run out of funds in 8 years.
- Government will have the power to decide what doctors you can see, treatments you deserve and medications you can receive.
- The plan includes a federal mandate that will require people to pay a fine if they don’t buy health insurance.
Democrats
- Government run health care will lower premium cost
- President Obama has stated that he will not sign a bill that adds to our deficit.
- Insurance premiums have doubled in the last decade and with out significant reform are expected to more than double again in the next decade. Study can be found here.
- Democrats are accusing Insurance Companies and Republicans of misleading the American people through study known as the “Pricewaterhousecoopers Study” stating it is completely “bogus”.
America still has a while before we get the hard facts on what the final health care bill will include. In the current health care reform debate it remains one person’s opinion vs. another. There will be only one true way to test this option and that is for we the American people to live it. Only then will we see what the Public Insurance Option is made of!
