Sacramento Health Care Experts, Business Owners Give Health Care Reform Bill Mixed Reviews

From the Sacramento Business Journal - March 22, 2010

“As the owner of a small business, I’m going to get hit on both sides,” said Doug Elmets, president of Elmets Communications, who said he followed the debate closely. He expects his corporate taxes to rise as well as his personal income taxes due to the obligations under health care reform. He said the burden for paying will fall on the next generations for decades to come, which doesn’t bode well for the federal deficit.

“The most disturbing part about the legislation is that you have an entire political party voting in lockstep against it and another party voting for it,” said Elmets, formerly an assistant press secretary to President Reagan. “There are millions of Americans who are very concerned.”


 

History-making health care legislation passed late Sunday by the U.S. House of Representatives and expected to be signed into law by President Barack Obama is getting a mixed reaction by members of the health care industry and other business leaders.

The landmark $940 billion health care reform bill would extend health insurance coverage to 32 million Americans.

Many are praising what the bill does to expand health care coverage and end insurance company abuses by requiring plans to direct 85 percent of revenues to patient care and prohibiting insurers from denying coverage to patients who become sick or have chronic conditions.

At the same time, many also are expressing disappointment in what the bill lacks. For example, it does little to improve access to doctors, according to the California Medical Association.

While the legislation represents a step forward, it comes up short in ways that could hamper patients’ ability to see a doctor in a timely manner, according to the CMA.

“We think it’s a mixed bag,” CMA spokesman Andrew LaMar said. “There are obviously some great things in it that we’ve long advocated for.” At the same time, he said, “there’s a lot of unfinished business here.”

The CMA has pushed for a bill in California for three years that would prohibit insurers from rescinding coverage after people get sick and medical bills start to mount. The bill won’t be needed if the federal legislation becomes law.

On the flip side, there are parts of the bill the CMA opposes, including the failure to repeal a Medicare payment formula that is slated to cut doctor reimbursements by 40 percent over the next several years, and the bill’s failure to increase Medi-Cal reimbursement rates for all physicians. California rates are the lowest in the nation and have driven many doctors away from treating Medi-Cal and Medicare patients.

Medi-Cal is the government program for the poor, and Medicare is the government program for seniors.

“Ultimately we feel pretty strongly that Congress needs to follow up to make sure funding for Medi-Cal and Medicare is sound and reasonable so patients covered by those can see a doctor when they need to,” LaMar said.

The California Hospital Association Board of Trustees on Friday voted to support the legislation that was adopted late Sunday. The CHA has, for two decades, supported comprehensive health care reform.

“Overall we think the legislation is a significant step forward in addressing the problems in the health care system,” said Jan Emerson, vice president of external affairs at the California Hospital Association in Sacramento.

She agreed, however, that “the legislation is not perfect.” While the CHA is “pleased,” Emerson said “people need to understand it’s not a panacea. There are still issues that need to be addressed.”

The CHA is also concerned about proposed payment cuts to hospitals and other providers that would kick in 2014.

“We cannot sustain those cuts,” Emerson said.

In 2009, hospitals in California were not compensated for $12 billion worth of care they provided, she said. The majority of the $12 billion in uncompensated care relates to the under funding of Medi-Cal and Medicare programs, she said.

There will still be millions of people without health insurance that hospitals will have to care for, Emerson said.

“We are losing money on every patient we treat,” Emerson said. “The goal is when more people are covered there would be less uncompensated care, but the government still needs to pay its fair share.”

Patrick Johnston, a former state senator who is president and chief executive officer of the California Association of Health Plans, said that while progress has been made toward ensuring Americans have access to health care, more must be done to control costs.

“The good news is we’re moving closer to universal coverage so everyone can get the health care they need,” Johnston said. “The bad news is that medical cost inflation is likely to continue running well ahead of the cost of living.”

The new law would allow parents to keep their children up to age 26 on their family insurance plans, and would set up regional health insurance exchanges that small businesses, high-risk individuals and others could tap for coverage.

“Designing all those elements will require a collaborative effort by state agencies and affected health plans and other stakeholders,” Johnston said.

Small businesses are concerned about new challenges they will face.

“As the owner of a small business, I’m going to get hit on both sides,” said Doug Elmets, president of Elmets Communications, who said he followed the debate closely. He expects his corporate taxes to rise as well as his personal income taxes due to the obligations under health care reform. He said the burden for paying will fall on the next generations for decades to come, which doesn’t bode well for the federal deficit.

“The most disturbing part about the legislation is that you have an entire political party voting in lockstep against it and another party voting for it,” said Elmets, formerly an assistant press secretary to President Reagan. “There are millions of Americans who are very concerned.”

Colleges will have to wait until the health care bill is implemented to assess the real impact to them as employers, Robert Johnson, executive director of the California Association of Private Postsecondary Schools in Sacramento, wrote in an e-mail.

Colleges, he added, will experience a boost in demand for training and education of health care workers.

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