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NEWS
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THE UNIVERSITY DAILY KANSAN
THURSDAY, DECEMBER 3, 2009
HEALTH CARE BILLS: A GUIDE
As millions of uninsured Americans remain vulnerable to medical costs, policymakers in Washington debate the future of health insurance in the United States and whether or not those Americans will finally have a shot at the coverage they need.
Two bills generating the most discussion are the Affordable Health Care for America Act, or H.R. 3962, proposed and passed by the House; and the Patient Protection and Affordable Care Act, submitted to the by Senate Majority Leader Harry Reid (D-Nev).
H. R. 3962 passed the House on Nov. 7, 220-215. The bill estimates it would insure 96 percent of the U.S. population, up from the 83 percent currently covered. According to the Congressional Budget Office, this bill would reduce the deficit by $109 billion by 2019. The bill costs an estimated $1 trillion over 10 years and would be paid mostly by a tax on high-income households and penalties for businesses that don't insure workers.
The Senate bill entered into a full-house debate with a 60-39 vote Nov. 21. A combination of bills passed by various Senate committees, the newest bill would cover 31 million more Americans while cutting the most money from the budget deficit of any bill — $130 billion over 10 years. The CBO estimates the bill will cost $849 billion over the next 10 years, which will be paid for through a new excise tax on insurance companies with expensive insurance plans and penalties for those who don't buy health insurance.
Brian Platt, his wife Sara and their 17-month-old son, Henry, are currently living with three separate health insurance plans. The plans cost the family more than $4,000 a year in premiums
Although the bills attack the same flawed health care system, they approach the problems in varying ways. Areas of most concern to students include the age limit of dependents, employer-based health insurance, health insurance costs and pre-existing conditions. Here's a look at how the bills address these issues.
Alex Bonham-Carter/KANSAN
Eric Foss, Overland Park law student and chairman of the College Republicans, said he disagrees with some in his party on one issue of the health reform debate: length of dependent coverage.
Both bills would extend coverage through age 26.
Today, most full-time students are covered as dependents until they reach the ages of 19 to 25, depending on the state and their parents' insurance plan
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"I certainly think that extending the dependent clause to 26 is a good step in the right direction," he said. "I'm glad that's being considered."
However, both the Senate and House would extend dependent coverage until age 26.
Foss said maintaining the status quo for dependents was a detriment to the U.S. economy because it would prevent students from seeking a post-graduate education and continue to place even more liability on already debt-ridden students.
According to one federal analysis, one out of 10 uninsured young adults in America paid more than $700 out of pocket in medical expenses in 2005. Last year, a quarter of uninsured young adults were contacted by collection agencies.
HEALTH CARE (CONTINUED FROM 1A)
when he graduated from the University, iobless, in 2003.
Under his father's pressure,
Athey, now 29 and living in
Lawrence, purchased a private
health insurance plan, costing him
a $100-a-month premium and a
$500 annual deductible.
BYE, BYE BENEFITS
House Bill: requires businesses with payrolls greater than $500,000 to provide some form of health benefit to their workers.
BYE, BYE BENEFITS
In the nine years he's had the plan. Athey's insurance company has modified it several times. Rather than paying more each month, Athey decided to take a hit from his deductible each time his plan changed. Since 2003, the cost of his deductible has tripled.
Bethany Christiansen, Emporia junior, went without health insurance for an entire year after her father quit his job. He had a job as a private contractor out of Missouri before he quit, she said, but the new company wouldn't cover her dad or the rest of the family.
nesses employing more than 200 workers to provide some form of health coverage for their employees.
Although most of the insured college students rely on their parents' health insurance plans provided through their parents' jobs, employer-based insurance is becoming less standard.
She said she hoped the health care reform would offer a backup plan for people who are between jobs or whose employers don't offer benefits.
Senate Bill requires businesses with more than 200 employees to purchase health coverage for their workers.
plan, she said, leaves her and her two siblings without dental and eye care.
"It doesn't make any sense that you don't have a job or health insurance when you're most vulnerable to being sick or getting injured," Christiansen said. "That's how people get bankrupt."
Christiansen said her parents spent the year trying to find an affordable plan. Their current
The House bill would require all businesses with payrolls greater than $500,000 provide some form of health coverage for employees, whereas the Senate bill would require busi-
"Now I pay a $1,500 deductible, which is completely useless to me," he said. "But at least I'm insured, I guess."
Because his insurance company won't start paying bills until he's paid the $1,500 deductible. Athey has to absorb most of his health care costs out.
Even with health insurance, Athey has had to completely finance two trips to the emergency room because of epileptic episodes — one in
care costs out of-nocket
From 2000 to 2008, the percentage of firms offering health insurance benefits decreased from 69 percent to 63 percent, according to the Kaiser Family Foundation. A 2008 MEPS found that one in six Americans lost their employer health care coverage since 2006.
Employer-sponsored health insurance has been on the decline since the late 1980s, with businesses large and small lowering their co-pays, decreasing employee dependents and even cutting worker health coverage altogether.
Athey isn't the only college graduate struggling to find affordable health care. According to a 2006 survey, 34 percent of college graduates spend part of their first year out of school without health insurance. This number is on the rise as employer-based health insurance declines.
2004 and one in 2006. The ambulance rides and in-patient care have left him with a $10,000 tab. He pays $150 a month, which increases his annual health costs to more than $4,500. He is able to pay his bills through his salary as a general manager at the Goodwill store in Topeka.
But this isn't just affecting veteran employees. According to a Current Population Survey, 28 percent of employed ages ages 19 to 29 were uninsured in 2008.
CHRIS CASSIDY JayDoc executive director
If finding a job in this economy is difficult, even more rare is finding a job with health benefits.
"They are not the low-life people of the earth. They're people you go to lunch with at work."
BYE, BYE BENEFITS
According to a recent U.S. Census report, 541,000 residents — or 72 percent — of Douglas,
Wyandotte and Johnson counties rely on their employers for health insurance.
"They are not the low-life people of the earth," Cassidy said. "They're people you go to lunch with at work. They don't have health insurance because it's ridiculously expensive."
The reason most often cited for the decline in employer-based coverage is the escalating cost of health insurance premiums, which have increased 131 percent in the last 10 years, according to
a 2009 Kaiser Family Foundation report.
According to JayDoc statistics, 91 percent of its patients don't have health insurance. And most of them, Cassidy said, lost their insurance within the past year. Forty-five percent of JayDoc patients are between 20 and 35 years old.
By the time Chris Cassidy, second-year medical student and one of the executive directors for the clinic, goes to make his first round, the lobby is packed, standing room only, with about 60 people.
The effects of declining employer-sponsored health insurance are felt close to home, about 40 miles away at JayDoc, a free health clinic provided by University of Kansas Medical School students.
Every Monday, Tuesday and Wednesday night, Southwest Boulevard Family Health Care closes at 5 p.m. to make room for JayDoc. The waiting room fills with patients, each hopeful for a chance at free treatment. While some will be treated on site, others will be referred to other affordable clinics in the area.
On the surface, when people buy health insurance they're essentially paying to protect themselves financially from the cost of medical conditions. But those without that protection piggyback on those who have it.
AFFORDING THE UNAFFORDABLE
In what is known as a "hiden health tax," the uninsured millions still receive medical treatment, but the cost is transferred to the insured. Insurance carriers see
the "tax" added to premiums and deductibles.
In the past 10 years, the average cost of health insurance premiums for one person increased 120 percent, from $2,196 to $4,824, according to the Kaiser Family Foundation. Premiums for an average family plan went up 114 percent.
With the increase in cost came an increase not only in those unable to afford health insurance, but also in the cost of unpaid health bills — leading to medical bankruptcy.
"It doesn't seem right that we should have to be on three separate insurance plans."
health care at Watkins Memorial Health Center. The student health fee of $115.80 per semester allows students at the University to receive most office visits for no extra charge. The primary services the fee won't cover are medical procedures and ancillary services such as X-rays, pharmaceuticals.
Douglas, Wyandotte and Johnson counties incurred $55 million in uncompensated health bills and had 1,200 health-care related bankruptics, according to the most recent statistics from the Department of Health and Human Services.
Whether listed as their parents' dependents or not, University students receive practically free
physical therapy and lab fees, said Diana Malott, assistant director of Watkins.
Brian Platt, a graduate teaching assistant in environmental studies, has had the plan for seven years. He said he hasn't had too many complaints for the relatively inexpensive plan except he wishes he
However, the Board of Regents plan has its faults.
Students attending Kansas Board of Regents universities and colleges also have the option of a student health insurance plan, which costs $915 a year per
could afford to add his wife, Sara,
and his 17-month-old son, Henry.
person. Between 3,500 and 4,000 students at the University purchase this plan, Malott said.
Adding Sarah to the plan would increase his yearly payment to $4,691. Adding Sara and Henry would be $7,945 a year.
Platt said Sara has insurance through her employer, but adding Henry to her plan would cost an additional $350 a month or another $750 for the whole family. So Brian and Sarah decided to buy Henry his own plan at $124 a month.
"It doesn't seem right that we should have to be on three separate insurance plans." Platt said.
Another shortcoming of the Board of Regents Plan, as with the majority of health insurance plans, is the coverage for people with pre-existing conditions.
Pre-existing conditions, known sometimes as chronic conditions, range from mental disorders and asthma to high blood pressure and diabetes.
UP A CREEK WITHOUT AN INHALER
People with pre-existing
AFFORDING THE UNAFFORDABLE
The average health insurance premium in Kansas rose 105 percent from 1999 to 2009 while the average wage increased only 39 percent in that time, according to the Kaiser Family Foundation.
Both bills would keep costs competitive with a public option and insurance exchange.
"The federal budget would not be restricted by that," he said. "We all know that the federal government spends however much they like and then goes to the federal treasury for more money."
As the number of uninsured continues to climb, it's taking a heavy toll on America's budget. One study estimated that the federal health care spending would reach $2.5 trillion by the end of this year and $4.4 trillion by 2018. The estimated 2010 federal budget for the United States is $3.6 trillion.
After receiving backlash from Republican counterparts and the American public, the Democrats
Foss said the private insurers couldn't compete with a government option because private companies had to answer to stockholders and operate on a fixed budget.
Opponents, however,say the measure discourages competition.
in the House have scaled back the public health option by requiring that rates be negotiated with private providers.
With the rapidly increasing cost of health care and health insurance, both the Senate and House bills offer two solutions on how to cap the costs and provide more coverage at the same time.
The first is to offer a public insurance option operated and funded by the federal government. Proponents of the bill claim the public option would benefit the customers because it would keep prices down by increasing competition among private insurers.
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Foss was more skeptical.
"It's a fact of life," said Dennis Moore, representative of the 3rd District of Kansas. "If we negotiate rates with some of the providers, think that's going to be the incentive they need to adjust their rates when necessary."
"Any time the government says that they're going to negotiate prices with private companies, it usually means that the federal government is going to mandate what price the private companies have to offer their product or services at," he said.
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Instead, Foss said most Republican Party members wanted to break the political barriers preventing a truly free market for health insurance and let the capitalist system lower the price on its own.
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Deviating from one of the more prominent committee bills in the Senate, the latest Senate bill includes a provision for the public option. However, states would be allowed to opt out of participating.
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