Health Reform

Two new reports provide striking evidence that President Obama's health-care overhaul will keep countless Americans healthier, cut the federal deficit, and even save millions of lives — though how many will depend on whether Republican-run states opt for good medicine over partisan politics.   The Affordable Care Act faces continued opposition from presidential candidate Mitt Romney and GOP members of Congress, despite passing a historic legal review by the Supreme Court in June.

Eric Aycox wasn't feeling well on Nov. 18, 2006, but he didn't have health insurance so he went to an emergency room, where he was sent home with a prescription for codeine and an antibiotic. But he didn't have money to fill the prescriptions, and he later died of a bacterial infection that morphed into menigitis. He was only 44. Yesterday, his mother, Joan Kos-loff, and his father, Frank Aycox, gathered with members of Healthcare for America Now, the American Federation of Labor and Congress of Industrial Organizations, the Service Employees International Union, and the United Food and Commerical Workers, Local 1776, to protest and demand that Cigna Insurance Co. stop blocking health-care reform.

Emboldened congressional Republicans are predicting a rocky couple of years ahead for the health-care overhaul that they disparagingly call "Obamacare" - as they hatch plans to scuttle the law by holding up funding for key elements. But they had better act quickly. Millions of Americans already are enjoying tangible benefits from the health-care law, and they're not likely to look kindly on having those benefits weakened, much less revoked. The list of benefits so far includes: required coverage of preventive services such as childhood immunizations and cancer screenings for women; a ban on denying coverage for youngsters with preexisting medical conditions; letting young adults still at home remain on their parents' health plan; barring insurers from setting lifetime limits on coverage; and a $250 rebate for seniors facing the Medicare "doughnut hole" in drug coverage.

The draft of President Clinton's health-care reform plan calls for sweeping changes in the way medical services are delivered, dramatic savings from government and private insurance plans, and the promise that the patient - a bloated health-care system - will make an amazingly swift recovery. At the same time, though, the administration proposes to provide medical care to an estimated 37 million Americans who are currently uninsured, expand services for the elderly, and increase spending on medical research - all without any new taxes.

On this second anniversary of the health-care reform law, and on the eve of its consideration by the Supreme Court, it's worth recalling what preceded it.Before the Patient Protection and Affordable Care Act came into being, insurance companies could deny coverage to those with preexisting conditions, cancel policies when people needed them most, place lifetime limits on coverage, and raise rates without justification. Before President Obama signed the legislation into law, 45,000 Americans were uninsured due to preexisting conditions.

President Clinton's yearlong crusade to guarantee health insurance for all Americans ended in failure yesterday as Senate Majority Leader George J. Mitchell announced he was giving up on efforts to pass any bill this year. "It is clear that health-insurance reform cannot be enacted this year," a somber Mitchell (D., Maine) told reporters. In a statement issued by the White House yesterday, Clinton called the collapse of health-care reform a "rough spot" but not the end of the road.

THERE are two glaring problems with the Senate health bill. First, it takes $464 billion out of Medicare over 10 years, of which $120 billion comes out of Medicare Advantage, unless you live in New York, Oregon or Florida, exempted cuts through a special deal made before the bill went to the floor. These cuts can't be good for Medicare, which is already becoming insolvent. Those with Medicare Advantage will be forced to buy a Medigap policy to replace the coverage they now have.

In this autumn-like moment of late August, the pruning of health reform proceeds apace. There is not much left, of course. It is a 95-pound weakling, its sternest stuff having bitten the dust: No more grand talk about bringing 39 million uninsured Americans into the loop. No more can-do talk about squeezing down medical costs. House Speaker Tom Foley, the Washington Democrat, says he'll settle for tinkering with insurance rules - the ones that kick out sick people, or cheat them out of benefits for existing conditions, or stop coverage when they switch jobs.

Ted Kennedy's voice and leadership will be sorely missed in the effort to pass health-care reform. But when Republicans say Democrats don't have anyone to take his place in achieving a bipartisan compromise, they are either missing - or deliberately obscuring - the relevant lesson of Kennedy's example. The truth is that Senate Finance Committee Chairman Max Baucus (D., Mont.), with the support of the White House, has worked hard for months to reach consensus with Sens. Chuck Grassley (R., Iowa)

Members of Congress have been trooping back from the holidays with grim news about health reform. The optimism that once gave loft to Harris Wofford's Senate campaign has dissipated. The bipartisan bear hugs that greeted President Clinton's first forays have turned into arm-wrestling matches. There's a can't-do, proceed-with-caution mood emerging. It is a message the President - and health maven Hillary Rodham Clinton - had better listen to. And quickly respond to. It was nearly a year before the White House began taking the rumblings over NAFTA seriously.

Look no further than Steven Brill's "Why Medical Bills Are Killing Us," in the March 4 issue of Time, to see why there is little role, if any, for the marketplace in health care. Simply put, government must be a key player if we are ever to rein in runaway health-care costs. Brill presents a bill-by-bill description of the staggering costs associated with hospital care: An uninsured patient billed $7,997.54 for a stress test using a radioactive dye (Medicare reimbursement rate for this procedure is $554)

By Kathleen Sebelius This week marks the third anniversary of the Patient Protection and Affordable Care Act. For Pennsylvanians, that means a health-care system that is stronger than it was three years ago, and a future that looks even brighter. Pennsylvanians who have health insurance have benefited from market reforms and consumer protections under the law. Preventive services like mammograms and flu shots are newly accessible to 3.2 million people with private plans. More than 220,000 of the state's Medicare beneficiaries have saved an average of $753 on their medications.

TRENTON - Gov. Christie on Thursday vetoed legislation establishing a state-run health-insurance exchange, saying the federal government had failed to provide the answers he needed to make a fiscally sound decision on the best way to comply with the Affordable Care Act. The governor said he had not eliminated any of the options available to states to comply with the national health-care overhaul. But he said it would be irresponsible to choose one over the others without knowing the costs of each.

Even after President Obama's reelection eliminated the possibility of repeal of the Affordable Care Act, the state health insurance exchanges at its core remain embedded in uncertainty. The administration on Friday extended a deadline from this coming Friday to Dec. 14 for states to submit a blueprint for how they will set up an insurance exchange, as opposed to accepting one designed by the U.S. Department of Health and Human Services. States still must notify regulators by Friday of their intention to set up their own exchanges.

So now Mitt Romney actually likes parts of President Obama's signature health-care overhaul - the same "Obamacare" that Romney and congressional Republicans have vowed to repeal on Day 1? What a difference the start of the fall campaign can make. In a move widely interpreted as a bid for undecided, middle-of-the-road voters, the GOP presidential nominee on Sunday said he'd retain provisions that assure young adults coverage on their parents' health plans, as well as the pivotal rule that people with preexisting conditions cannot be denied coverage.

Two new reports provide striking evidence that President Obama's health-care overhaul will keep countless Americans healthier, cut the federal deficit, and even save millions of lives — though how many will depend on whether Republican-run states opt for good medicine over partisan politics.   The Affordable Care Act faces continued opposition from presidential candidate Mitt Romney and GOP members of Congress, despite passing a historic legal review by the Supreme Court in June.

With the economy still struggling, it's tough to predict how big a role the new health-care law will play this November. But now that the Supreme Court has spoken, this much is clear: This election should matter deeply to anyone who embraces the goal of expanding access to health care, as well as to anyone who thinks it's a misplaced priority. Beyond the spin and confusion, that's what this is about. For all its shortcomings, the Patient Protection and Affordable Care Act — the 2010 law that nearly everybody calls Obamacare — represents the largest stride ever toward universal coverage, a goal of Democrats for more than half a century that has already been achieved by every other industrialized nation.

Conservatives fought Social Security, Medicare and the weekend when they were proposed. But once enacted, Republican and Democratic Presidents embraced all three as they became part of American life. We can expect President Obama's court-tested health-care reforms — which shift payment for uninsured people's health care from hospitals to taxpayers — will also go on, even if Republican Mitt Romney is elected President. Veteran Philadelphia investor James M. Meyer, of Tower Bridge Advisors, which manages $1 billion in other people's money, wrote a thoughtful account of the costs, purpose and likely durability of "Obamacare," in a note for clients of the West Conshohocken-based investment brokerage Boenning & Scattergood: "Republicans want to repeal the law. Indeed, the House will vote on or about July 11 to try and do just that.

Area health-care leaders said Thursday that implementation of health reform will pick up speed now that it is clear where the U.S. Supreme Court stands. The momentum, they said, could make it harder for Republicans to dismantle all or part of the law if they prevail in the fall elections. For their part, politicians and advocacy groups reacted along predictable lines. The biggest question is what will happen to the Affordable Care Act's expansion of Medicaid, the state-federal insurance program for the poor.