Health Care Reform

Straight Talk on Health Care Reform

The historic debate continues in Washington, D.C., about how to best overhaul the nation's health care system. The concept of creating a comprehensive national system of health insurance is not new. Presidents and Congress have been trying to do it for 75 years. Today, health care reform is about both providing coverage for the uninsured and lowering the cost of health care and improving quality.

President Obama made health care reform a central legislative priority when he took office in January. Since then, there has been a national discussion and debate about what reforms are needed and how to best implement them.

While the answers to these questions are as complex as the problems themselves, hospitals believe that at the heart of reform should be one thing: getting people the care they need, when they need it. Hospitals support meaningful reform.

The Proposals

To date, there have been more than a dozen pieces of legislation introduced, as well as draft proposals or policy options made public. The focus of the most current debate surrounds the "Affordable Health Care for America Act of 2009" (or H.R. 3962), submitted by House Speaker Nancy Pelosi (D-CA) from work done by three House committees with oversight on the issue, and the "Patient Protection and Affordable Care Act" (or H.R. 3590), introduced by Senate Majority Leader Harry Reid (D-NV) which represents the combined efforts of the Senate Finance Committee and the Health, Education, Labor and Pensions Committee.

The Senate plan would provide coverage for 94 percent of people legally residing in the U.S.--31 million more individuals. The Congressional Budget Office estimates the bill's price tag at $848 billion. The bill includes an individual mandate for insurance, but not an employer mandate to provide such insurance, as well as a national public health insurance option. States would be allowed to opt out of this public plan.

The approved House plan seeks to expand health coverage to 96 percent of people legally residing in the U.S. at a cost of just under $900 billion over ten years. It would do so by creating a new government-run public insurance option requiring nearly all Americans to sign up for health coverage either through an employer or through a government program by 2013.

A "public option" generally means that uninsured Americans would now have the option to choose a new public health insurance product. Older Americans on Medicare would keep their Medicare coverage, and people with employer-based insurance would keep their coverage. But individuals who do not have health insurance, can't afford their insurance, or lose their job, could get insurance from the public option plan.

The Senate's work may not be done until December. Because neither the House nor the Senate is expected to agree to either plan completely, Congressional leaders will form a conference committee, and using both bills, try to reach a compromise. Many political analysts believe that an agreement will be reached early 2010, though President Obama hopes to sign legislation by the end of the year.

The Impact on Hospitals

As the debate moves forward, hospitals understand that everyone shares the costs of improving the health care system. But if Congress cuts government payments to hospitals too much, health care will be compromised.

Next Steps

Continue to follow reports about the health care reform debate and its impact on hospitals and patients. Check CareforPA.org regularly for any updates. If the hospital family needs to speak out for or against the final compromise, be prepared to answer the call of your hospital leader and CareforPa.org to take action.