The federal health care reform law wound up being the most hotly debated piece of legislation in 2010. And the same may be true in 2011, as Republicans in Congress seek to repeal the law.
The issue has divided the American public as well as politicians. A new Gallup Poll found that 46 percent of Americans support repeal of the health care reform law, while 40 percent of Americans want it to stay intact.
Everyone has an opinion about federal health care reform, so separating fact from fiction is challenging. Factcheck.org, a site that monitors the claims of politicians and others, notes that it’s never come across a piece of legislation that's been so misrepresented.
Take this four-part quiz to see how informed -- or misinformed -- you are about some aspects of health care reform. (By the way, 38 percent of American adults acknowledge they're pretty clueless about health care reform, according to a survey by Deloitte Center for Health Solutions.)
1. True or false? “Death panels” will decide who gets health care and who doesn't.
“There’s no death panel in the health care law, and there never was,” says Robert Moffit, a senior fellow domestic and economic policy studies at the Heritage Foundation, a conservative think tank in Washington, D.C.
But there’s a legitimate issue here, according to Moffit -- whether it’s wise for government officials to wield the power to deny access to medical care. The issue is rationing.
We make “rationing” decisions every day, Moffit notes. “When you decide to buy something, you make a rationing decision – whether it’s a computer or TV or car,” he says.
But Moffit says consumers should be concerned about decisions that'll be made further away -- because of the federal government’s involvement -- from the patient-doctor relationship. Indeed, numerous surveys show that we're split about whether the federal government should be involved in health care. Some Americans think the government sure ensure health coverage for everyone; about the same percentage say the government should keep its hands off.
2. True or false? You’ll be required to purchase health insurance, whether you can afford it or not.
Starting in 2014, U.S. citizens and legal residents must have health insurance. But there are mitigating factors: Coverage will be more affordable for those with modest incomes, thanks to new state-based insurance exchanges. Also, insurance companies will be prohibited from charging higher premiums for people who are ill and from rejecting those with pre-existing health conditions.
You might be eligible for an exception, however. Those will be granted to:
• People who've been without coverage for less than 90 days.
• American Indians.
• Americans living outside the United States.
• People who don’t have to file taxes because their income is too low.
• People who find that the least expensive health insurance plan would consume more than 8 percent of their income in 2014.
• People whose purchase of insurance would violate religious beliefs or create an economic hardship.
3. True or false? Thanks to health care reform, health care costs will skyrocket.
Statistics show the real driver of rising health care costs has little to do with health care reform.
Before the health care reform law was enacted in 2010, "medical costs were soaring out of control,” says Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, which represents providers of health benefits to more than 200 million Americans. Health care expenses are climbing because of several factors, he says, including higher prescription drug costs, new and expensive medical technology, and increased use of medical services.
A November 2010 report from the International Federation of Health Plans showed that when comparing 14 medical procedures in a dozen countries, the United States charges the most for nearly all of them. If you need hip replacement surgery, for example, it will cost you an average of $12,737 in the Netherlands versus $75,369 in the United States.
A 2010 report from the Commonwealth Fund identifies 10 ways that health care reform is expected to rein in health care costs. They include:
• Establishing state-level health insurance exchanges, which are marketplaces for uninsured people to shop for health care coverage at competitive prices.
• Creating a board authorized to ferret out to waste and improve quality in the Medicare program.
• Setting up accountable care organizations. These organizations, made up of health care providers, assume responsibility for the cost and quality of health care given to a certain group of patients.
4. True or false? The law may cause millions of Americans to lose their current coverage.
After federal health care reform became law in 2010, the Obama administration released estimates indicating about 55 percent of large employers and about one-third of small employers would be offering the same insurance coverage in 2013 that they do now.
A June 2010 survey by the International Foundation of Employee Benefit Plans found that 87 percent of employers would continue offering health care benefits. A Congressional Budget Office study said companies that do drop coverage likely would be smaller employers hiring low-income workers who'd be eligible to receive subsidies for their own coverage.
So, should employees be concerned about future health insurance coverage from their employers? Mike Aitken, director of governmental affairs for the Society for Human Resource Management, says employers still have reasons to continue offering solid health care coverage to employees. Good health care benefits help employers retain and recruit workers, for instance.
Aitken notes that employer provisions of federal health care reform will be phased in over several years, with many of them taking effect in 2014.
“We’ve told organizations that they need to take a long-term perspective,” Aitken says. “We see employers taking a constructive, strategic approach."
Many major employers appear to be adopting that approach. In a November 2010 survey by consulting firm Mercer, just 6 percent of large employers indicated they'd stop offering health insurance in 2014. However, one-fifth of small employers (those with 10 to 499 workers) said they were likely to terminate their health insurance plans in 2014.
“You can see why the idea of dropping employee health plans would be attractive to small employers,” says Beth Umland, who directed the Mercer study. “On the other hand, when you look at the experience in Massachusetts, where insurance exchanges have been operating under state-based health reform for over three years, it hasn’t happened.”
As for employees, what can they do? Aitken advises them to:
• Keep up to date on the facts about health care reform.
• Take advantage of preventive health care measures, such as annual checkups.
• Educate yourself on ways to stay healthy, such as proper diet and exercise.