Mix-up 8 Great Health Reform
Fiction: Everyone must purchase health insurance beginning in 2014, no exceptions.
There's also one other large set of people who won't need to buy health insurance.
"Everybody who is eligible for Medicaid or Medicare does not have to purchase additional coverage," notes Deborah Chollet, a senior fellow at Mathematica Policy Research in Washington, D.C., who is helping states set up the new health exchanges.
"The Urban Institute and others have estimated that only about 3% of Americans will be subject to the penalty," says Kathleen Stoll, director of health policy for the health care consumer group Families USA. Fiction: If you're insured through your employer, health care reform won't affect you.
Fact: On the contrary, many new consumer protections under the Affordable Care Act are already benefiting people with job-based health insurance.
For example, the health care reform law bars insurers from placing lifetime limits on what they will pay for a worker's medical care, plus there are new restrictions on annual benefit limits. "If you have employer coverage, health care reform will actually make your life a little better," says Chollet.
New government insurance?
Fiction: The Affordable Care Act creates a new government-run insurance plan.
Fact: The health care reform law includes no such provision.
Rather than centralize health insurance into what's termed a "single-payer" system, health care reform accomplishes many of the same goals through its interwoven expansion of the existing Medicaid program, increased federal regulation of the health insurance industry and tax credits to make private insurance more affordable.
"There will be new insurance plans, but they're not government-run," explains Chollet. Business befuddlement
Fiction: All businesses will be required to provide employee health insurance.
Fact: The Affordable Care Act does not require employers to provide health coverage.
However, it does impose a penalty on larger employers that either do not offer a federally qualified plan or offer unaffordable coverage and whose workers subsequently purchase plans through their state exchange.
According to the Centers for Medicare & Medicaid Services, the Affordable Care Act specifically exempts firms with fewer than 50 employees -- 96% of all firms in the United States -- from any employer responsibility requirements. "Conversely, small businesses that offer health insurance to their employees may be eligible for tax credits," says Scott Holeman, spokesman for the National Association of Insurance Commissioners.
The health care law features a variety of incentives meant to encourage small businesses to insure their employees. The combination of tax credits and access to more affordable plans through new Small Business Health Options Programs, or SHOPs, within the exchanges are designed to give small businesses the same clout as large employers when it comes to purchasing insurance.
Immigrant inaccuracy
Fiction: Undocumented immigrants will receive federal aid to purchase health insurance.
Fact: Undocumented immigrants are excluded from health care reform.
Persons residing illegally in the United States have neither rights nor requirements to purchase health insurance under health care reform. Just as they are ineligible to receive Medicaid insurance for the poor, they are prohibited from purchasing health insurance on the new state exchanges, either with federal subsidies or with their own money.
Fiction: Health reform creates a "death panel" to make decisions about end-of-life care for seniors.
Fact: Early drafts of health care reform would have allowed Medicare to reimburse physicians for time spent talking with older patients about advance care planning. "Advance care planning gives the patient more control over his or her health care," says Stoll. "Unfortunately, opponents distorted a provision that would have allowed Medicare to pay health care providers for the time they spend talking with a Medicare beneficiary about what kind of care he or she would like at the end of life."
"In 2003, President George W. Bush signed into law the Medicare Modernization Act, which allows Medicare to cover advance care planning as part of the Welcome to Medicare physical exam," she explains. Medicare scare
Fiction: Health care reform will reduce Medicare benefits to all seniors.
Health care reform does reduce payments to privately administered Medicare Advantage plans to bring them more in line with traditional Medicare. States on the sidelines?
Fiction: States that don't set up health exchanges will be exempt from the Affordable Care Act.
Fact: If states fail to establish a health exchange, the federal government will set up and run one for them.
On Oct. 1, the first-ever, state-based health insurance exchanges are scheduled to debut online, offering open enrollment to individuals and small businesses for health coverage to begin Jan. 1, 2014.
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