What goes into effect now

The major parts of the new health care reform law won’t go into effect until 2014 or later, with some kicking in during 2012.  But some measures go into effect either now or in a few months:

Indoor tanning salons will charge customers a 10 percent tax beginning today in just one of the changes Americans will see as a result of the U.S. health-care overhaul signed into law by President Barack Obama.

Insurers will be required by September to begin providing health coverage to kids with pre-existing illnesses and allow parents to keep children younger than 26 on their plans as the clock has begun ticking on many of the law’s provisions. Medicare recipients will receive a $250 rebate for prescription drugs when they reach a coverage gap called the donut hole if the Senate passes and the president signs companion legislation approved March 21 by the U.S. House.

Within 90 days, the law will provide immediate access to high-risk insurance plans for people who can’t get insurance because of a pre-existing medical problem, Harris said. These high-risk pools will be funded by $5 billion in federal grants.

Companies led by Minnetonka, Minnesota-based UnitedHealth Group Inc., the largest health insurer, will be banned within six months from dropping a person’s coverage because of severe illness and from limiting lifetime or annual benefits.

Participants in Medicare, the U.S. government’s health coverage for those 65 and older, are expected get a $250 rebate toward prescription drugs once their benefits run out — a coverage gap know as the “doughnut hole.” The benefit is part of the package of amendments to the legislation now pending in the Senate. Drugmakers led by New York-based Pfizer Inc. will have to offer discounted drugs to Medicare recipients next year, according to an analysis of the legislation by the Kaiser Family Foundation, a nonprofit group based in Menlo Park, California. . . .

Insurers also will have to reveal how much of members’ premiums they spend on medical care, as opposed to executive salaries or other administrative costs. Next year, they’ll owe a rebate to customers if the insurers spend less than 80 percent on benefits for people in individual or small-group plans. . . .

The legislation also creates an Independent Payment Advisory Board to suggest cuts in spending by Medicare, the government health program for the elderly and disabled, that could threaten payments for drug and device-makers.

via Health-Care Overhaul Changes to Start Taking Effect This Year – Bloomberg.com.

About Gene Veith

Professor of Literature at Patrick Henry College, the Director of the Cranach Institute at Concordia Theological Seminary, a columnist for World Magazine and TableTalk, and the author of 18 books on different facets of Christianity & Culture.

  • Joe

    “children younger than 26″

    aren’t all children younger than 26?

  • Joe

    “children younger than 26″

    aren’t all children younger than 26?

  • http://www.geneveith.com Gene Veith

    Good eye, Joe. Actually, what this does is extend childhood for five more years. But aren’t 21-26 year olds a major cadre of the “young adults” who aren’t buying insurance because they are so healthy they don’t need it all that much? And the idea was to make these people buy insurance so as to drive down the costs the rest of us?

    If it’s possible to stay on your parents’ insurance until you are 26, you won’t need to buy insurance, which undermines a foundational assumption of the whole system. By the time you are 27, you are probably fairly established in a “real job” that will provide insurance as a benefit.

  • http://www.geneveith.com Gene Veith

    Good eye, Joe. Actually, what this does is extend childhood for five more years. But aren’t 21-26 year olds a major cadre of the “young adults” who aren’t buying insurance because they are so healthy they don’t need it all that much? And the idea was to make these people buy insurance so as to drive down the costs the rest of us?

    If it’s possible to stay on your parents’ insurance until you are 26, you won’t need to buy insurance, which undermines a foundational assumption of the whole system. By the time you are 27, you are probably fairly established in a “real job” that will provide insurance as a benefit.

  • Manxman

    Not true on the immediate protection for kids with pre-existing conditions. From the Fox News web site -

    “Obama made better coverage for children a centerpiece of his health care remake, but it turns out the letter of the law provided a less-than-complete guarantee that kids with health problems would not be shut out of coverage.

    Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

    However, if a child is accepted for coverage, or is already covered, the insurer cannot exclude payment for treating a particular illness, as sometimes happens now. For example, if a child has asthma, the insurance company cannot write a policy that excludes that condition from coverage.

    The new safeguard will be in place later this year.

    Full protection for children would not come until 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That’s the same year when insurance companies could no longer deny coverage to any person on account of health problems.

    Obama’s public statements have conveyed the impression that the new protections for kids were more sweeping and straightforward.”

  • Manxman

    Not true on the immediate protection for kids with pre-existing conditions. From the Fox News web site -

    “Obama made better coverage for children a centerpiece of his health care remake, but it turns out the letter of the law provided a less-than-complete guarantee that kids with health problems would not be shut out of coverage.

    Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

    However, if a child is accepted for coverage, or is already covered, the insurer cannot exclude payment for treating a particular illness, as sometimes happens now. For example, if a child has asthma, the insurance company cannot write a policy that excludes that condition from coverage.

    The new safeguard will be in place later this year.

    Full protection for children would not come until 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That’s the same year when insurance companies could no longer deny coverage to any person on account of health problems.

    Obama’s public statements have conveyed the impression that the new protections for kids were more sweeping and straightforward.”

  • Bryan Lindemood

    I feel for the tanning salon owners. Hit with such a tax out the blue with very few sympathetic to their plight on the federal level… Very few sympathetic to their plight on any level!

    Can I still spray-on for a low-low price – or is there a new federal tax for that too?

  • Bryan Lindemood

    I feel for the tanning salon owners. Hit with such a tax out the blue with very few sympathetic to their plight on the federal level… Very few sympathetic to their plight on any level!

    Can I still spray-on for a low-low price – or is there a new federal tax for that too?

  • Anonymous

    Would any of you be willing to say how representative of the Missouri synod your health care reform views are? This is a blog with a “Lutheran twist.” There are aspects of confessional Lutheranism that I like, but, after reading this blog for awhile, I’m thinking twice about a synod whose members get outraged at the thought that insurers will no longer be able to deny health coverage to adults with children w/pre-existing conditions.
    I realize the posters don’t represent the synod; my question is, how prevalent are your conservative views?

  • Anonymous

    Would any of you be willing to say how representative of the Missouri synod your health care reform views are? This is a blog with a “Lutheran twist.” There are aspects of confessional Lutheranism that I like, but, after reading this blog for awhile, I’m thinking twice about a synod whose members get outraged at the thought that insurers will no longer be able to deny health coverage to adults with children w/pre-existing conditions.
    I realize the posters don’t represent the synod; my question is, how prevalent are your conservative views?

  • DonS

    The tanning salon owners definitely needed better lobbyists.

    Of course, whenever government is involved, you have winners and losers, not chosen by merit, but by the elites in power.

  • DonS

    The tanning salon owners definitely needed better lobbyists.

    Of course, whenever government is involved, you have winners and losers, not chosen by merit, but by the elites in power.

  • http://www.toddstadler.com/ tODD

    A tanning salon tax? Well I guess now we know why someone was so opposed to this bill … or at least parts of it.

    Veith (@2), I think it’s funny that you think childhood ends at 21. Legally, you’re off by 3 years. Perhaps you think that, until they can legally drink, they’re still children?

    Anyhow, I fail to see how a parent having his child on the parent’s insurance “undermines a foundational assumption of the whole system.” You do realize that the parent pays more for this, right? The child is not covered for free.

  • http://www.toddstadler.com/ tODD

    A tanning salon tax? Well I guess now we know why someone was so opposed to this bill … or at least parts of it.

    Veith (@2), I think it’s funny that you think childhood ends at 21. Legally, you’re off by 3 years. Perhaps you think that, until they can legally drink, they’re still children?

    Anyhow, I fail to see how a parent having his child on the parent’s insurance “undermines a foundational assumption of the whole system.” You do realize that the parent pays more for this, right? The child is not covered for free.

  • http://www.toddstadler.com/ tODD

    Anonymous (@5), not all confessional Lutherans think like the majority on this blog. Maybe just the loud ones do?

  • http://www.toddstadler.com/ tODD

    Anonymous (@5), not all confessional Lutherans think like the majority on this blog. Maybe just the loud ones do?

  • Don

    DonS, your comment that “whenever government is involved,” merit goes out the window, precisely sums up my opposition to our wars in Iraq and Afghanistan. I’m glad that you share my views that our government-led military is without merit.

  • Don

    DonS, your comment that “whenever government is involved,” merit goes out the window, precisely sums up my opposition to our wars in Iraq and Afghanistan. I’m glad that you share my views that our government-led military is without merit.

  • Anonymous

    Todd, certainly not all do. Right.
    But if just the loud ones do, am I right to suspect that they’re just as loud in the synod?

  • Anonymous

    Todd, certainly not all do. Right.
    But if just the loud ones do, am I right to suspect that they’re just as loud in the synod?

  • George B.

    In the late 70′s, I got to stay on my father’s health insurance after age 18 as long as I stayed in college (because I interrupted college with my own military service, I stayed, off and on, on his policy under about age 26).

    My old man was retired military, and I suppose his health insurance was provided by the govt. I could be wrong, but I don’t recall that this was a problem.

  • George B.

    In the late 70′s, I got to stay on my father’s health insurance after age 18 as long as I stayed in college (because I interrupted college with my own military service, I stayed, off and on, on his policy under about age 26).

    My old man was retired military, and I suppose his health insurance was provided by the govt. I could be wrong, but I don’t recall that this was a problem.

  • http://www.toddstadler.com/ tODD

    Anonymous (@10), though I am a confessional Lutheran, I’m not a member of the Missouri Synod (LCMS). I’m in the Wisconsin Synod (WELS). I definitely can’t speak for how loud the right-wingers are in the actual LCMS churches, and I’ve only attended a few WELS churches out here in Portland, Oregon, which is definitely a more liberal part of the country.

    Sure, confessional Lutherans do tend to be more politically conservative than the average bear (if for no other reason than the issue of abortion). But as one of this blog’s token liberals (I consider myself more centrist, but then, don’t we all?), I’ve been very comfortable in my WELS church experiences. In fact, I can’t remember any politically conservative comments in church (certainly not from the pulpit!), and only a few outside of church (and, you know, that will happen).

  • http://www.toddstadler.com/ tODD

    Anonymous (@10), though I am a confessional Lutheran, I’m not a member of the Missouri Synod (LCMS). I’m in the Wisconsin Synod (WELS). I definitely can’t speak for how loud the right-wingers are in the actual LCMS churches, and I’ve only attended a few WELS churches out here in Portland, Oregon, which is definitely a more liberal part of the country.

    Sure, confessional Lutherans do tend to be more politically conservative than the average bear (if for no other reason than the issue of abortion). But as one of this blog’s token liberals (I consider myself more centrist, but then, don’t we all?), I’ve been very comfortable in my WELS church experiences. In fact, I can’t remember any politically conservative comments in church (certainly not from the pulpit!), and only a few outside of church (and, you know, that will happen).

  • Anonymous

    tODD, I appreicate that. Thanks very much.
    It’s not so much that I would expect political sermons as much as I wonder how someone who is a political liberal would be recieved. But I guess those differences are in most places, and, as you say, will happen.

  • Anonymous

    tODD, I appreicate that. Thanks very much.
    It’s not so much that I would expect political sermons as much as I wonder how someone who is a political liberal would be recieved. But I guess those differences are in most places, and, as you say, will happen.

  • Stephanie

    Anonymous – I do attend a LCMS church and while individual members may be more politically conservative, we actually don’t talk politics at church. I know it is a foreign concept to much of American Christianity, but we spend our time at church discussing *gasp* theology and scripture and stuff like that. I’m not saying we don’t have other topics of conversation when not in a service or class (say, at coffee hour). But I have seldom heard politics discussed and have certainly never heard any incivil arguments / fights about it.

  • Stephanie

    Anonymous – I do attend a LCMS church and while individual members may be more politically conservative, we actually don’t talk politics at church. I know it is a foreign concept to much of American Christianity, but we spend our time at church discussing *gasp* theology and scripture and stuff like that. I’m not saying we don’t have other topics of conversation when not in a service or class (say, at coffee hour). But I have seldom heard politics discussed and have certainly never heard any incivil arguments / fights about it.

  • Bryan Lindemood

    tODD – That picture IS pretty funny!

  • Bryan Lindemood

    tODD – That picture IS pretty funny!

  • http://lutherama.blogspot.com Dr. Luther in 21st Century

    Politics does come up somewhat in our Bible studies, but then we have been doing a major push on teaching vocation. Politics can’t be avoided when discussing our vocation as a citizen. Overall, our congregation at least is fairly conservative fiscally and socially. There is a small but growing number of us who are more libertarian in our political views, but that is something of a backlash against the two major parties.

  • http://lutherama.blogspot.com Dr. Luther in 21st Century

    Politics does come up somewhat in our Bible studies, but then we have been doing a major push on teaching vocation. Politics can’t be avoided when discussing our vocation as a citizen. Overall, our congregation at least is fairly conservative fiscally and socially. There is a small but growing number of us who are more libertarian in our political views, but that is something of a backlash against the two major parties.

  • Dan Kempin

    Anonymous, #5,

    “whose members get outraged at the thought that insurers will no longer be able to deny health coverage to adults with children w/pre-existing conditions.”

    I haven’t heard anyone express outrage about that. Maybe I wasn’t reading closely enough.

  • Dan Kempin

    Anonymous, #5,

    “whose members get outraged at the thought that insurers will no longer be able to deny health coverage to adults with children w/pre-existing conditions.”

    I haven’t heard anyone express outrage about that. Maybe I wasn’t reading closely enough.

  • DonS

    tODD @ 7: OK, the Boehner photo was pretty good :-).

    As for your point on extending coverage to children aged 26 on their parents’ policies, typically there will be no additional premium for this. Usually, you pay a self only or self and family premium. The family might be just your spouse, just your kid (if you are no longer married), or maybe 20 kids if you have a TLC show. All at one family rate. So, unless you are unmarried and the 25 year old is your last child eligible for coverage, you are probably not going to pay anything additional for the extra coverage. However, since there is obviously some additional cost for it, someone else will pay.

    The point that Dr. Veith was making was that health insurance cost control, particularly when you are covering those with pre-existing conditions, requires a large healthy pool of insured, paying premiums and not using many medical services. If young adults are still covered on their parents’ policies until they are 27, they will not be in this healthy pool, paying premiums.

  • DonS

    tODD @ 7: OK, the Boehner photo was pretty good :-).

    As for your point on extending coverage to children aged 26 on their parents’ policies, typically there will be no additional premium for this. Usually, you pay a self only or self and family premium. The family might be just your spouse, just your kid (if you are no longer married), or maybe 20 kids if you have a TLC show. All at one family rate. So, unless you are unmarried and the 25 year old is your last child eligible for coverage, you are probably not going to pay anything additional for the extra coverage. However, since there is obviously some additional cost for it, someone else will pay.

    The point that Dr. Veith was making was that health insurance cost control, particularly when you are covering those with pre-existing conditions, requires a large healthy pool of insured, paying premiums and not using many medical services. If young adults are still covered on their parents’ policies until they are 27, they will not be in this healthy pool, paying premiums.

  • http://www.toddstadler.com/ tODD

    Don (@18), are you just speaking out of personal experience? Because I am. And the health care from my employer comes in one of three packages: employee, employee+spouse, and employee+family (spouse and kids, at least up to some number of kids). I definitely pay more (because, yes, I have to pay some part of my health insurance fees; rising costs mean the days of “free” health insurance are long gone) for my child, no matter what you say.

    Now, if you’d like to provide some statistics on available health insurance plans and which ones cover kids for no additional costs, then we can talk. Until that time, we’re just sharing personal anecdotes. And I know you hate that. :)

    Additionally, this discussion about “undermining a foundational assumption of the whole system” seems a wee bit overblown absent some actual numbers. Will every person under the age of 26 get a free ride on their parents’ insurance plan? For that to be true, we have to assume that (a) the parents’ plan charges little or nothing for keeping the child on there, and (b) that no additional plan is available to the child that is equally as good. I got off my parents’ plan somewhere around the age of 23, once I got out of college and got a job (with health care benefits).

  • http://www.toddstadler.com/ tODD

    Don (@18), are you just speaking out of personal experience? Because I am. And the health care from my employer comes in one of three packages: employee, employee+spouse, and employee+family (spouse and kids, at least up to some number of kids). I definitely pay more (because, yes, I have to pay some part of my health insurance fees; rising costs mean the days of “free” health insurance are long gone) for my child, no matter what you say.

    Now, if you’d like to provide some statistics on available health insurance plans and which ones cover kids for no additional costs, then we can talk. Until that time, we’re just sharing personal anecdotes. And I know you hate that. :)

    Additionally, this discussion about “undermining a foundational assumption of the whole system” seems a wee bit overblown absent some actual numbers. Will every person under the age of 26 get a free ride on their parents’ insurance plan? For that to be true, we have to assume that (a) the parents’ plan charges little or nothing for keeping the child on there, and (b) that no additional plan is available to the child that is equally as good. I got off my parents’ plan somewhere around the age of 23, once I got out of college and got a job (with health care benefits).

  • DonS

    tODD @ 19: Yes, you’re right, I probably should have qualified my comment, because different states tend to do things differently, and even here in CA it might be possible to get a self and spouse plan separately from a self and family plan, under some plans.

    I don’t think, though, that very many family plans limit the number of kids on the plan, so I think my larger point holds — that unless your 25 year old is the only child left on your family plan, you won’t be paying a separate additional premium if he/she stays on your policy for an extra 4 or 5 years.

    I agree with the notion that it doesn’t undermine the foundational nature of our insurance system. It’s just an additional cost that will probably be compensated for by somewhat increased premiums for all of those paying family premiums.

  • DonS

    tODD @ 19: Yes, you’re right, I probably should have qualified my comment, because different states tend to do things differently, and even here in CA it might be possible to get a self and spouse plan separately from a self and family plan, under some plans.

    I don’t think, though, that very many family plans limit the number of kids on the plan, so I think my larger point holds — that unless your 25 year old is the only child left on your family plan, you won’t be paying a separate additional premium if he/she stays on your policy for an extra 4 or 5 years.

    I agree with the notion that it doesn’t undermine the foundational nature of our insurance system. It’s just an additional cost that will probably be compensated for by somewhat increased premiums for all of those paying family premiums.

  • http://www.toddstadler.com/ tODD

    Don (@20), in order for this to increase premiums, it would have to be a significant change*. As I’ve already noted, many insurance plans already cover children well beyond their 18th year. Again, there would have to be a significant shift of under-26-year-olds to their parents’ insurance plans that doesn’t now exist.

    *In a logical world. In the real world, of course, premiums have been increasing steadily for many years for no reason that I’m aware of.

  • http://www.toddstadler.com/ tODD

    Don (@20), in order for this to increase premiums, it would have to be a significant change*. As I’ve already noted, many insurance plans already cover children well beyond their 18th year. Again, there would have to be a significant shift of under-26-year-olds to their parents’ insurance plans that doesn’t now exist.

    *In a logical world. In the real world, of course, premiums have been increasing steadily for many years for no reason that I’m aware of.

  • http://www.newreformationpress.com Patrick Kyle

    Anonymous,

    Loud and occasionally angry- well that would be me at times. I am assuming you are the anonymous that replied to some of my comments awhile back.

    I don’t think anyone on this blog is angry that insurance companies will have to cover children with pre – existing conditions, or that they will be unable to drop people who had insurance but became seriously ill. Many of us are angry at other provisions in the bill that will force us to fund things with our tax dollars that we think are terribly wrong , or force us to purchase health care under penalty of fines if we choose not to do it. Also the way it was done made a mockery of the legislative process. Certainly there are a number of health care issues that needed to be addressed, I just think there were better ways to solve these problems that didn’t even get any play from either Republicans or Democrats.

    As to all LCMS people being hardcore conservative, that is not necessarily so.

    I attended church and worshipped in the same pews with Frank, a frequent commenter on this blog, (aka fws) for more than ten years, and we are good friends, but are very far apart on the political spectrum. In the liturgy we are citizens of God’s kingdom and political agreement is not needed to be able to worship together. Our congregation was (and still is, though neither of us attend there now) very diverse ethnically and politically.

    As to synodical politics inside the various synods – even I avoid those trainwrecks. I am thankful that the LCMS is congregational in structure and we can carry on with Word and Sacrament ministry quite apart from whatever regime holds sway “at Synod.” But I think denominational politics are a downside to whichever church or denomination you chose.

  • http://www.newreformationpress.com Patrick Kyle

    Anonymous,

    Loud and occasionally angry- well that would be me at times. I am assuming you are the anonymous that replied to some of my comments awhile back.

    I don’t think anyone on this blog is angry that insurance companies will have to cover children with pre – existing conditions, or that they will be unable to drop people who had insurance but became seriously ill. Many of us are angry at other provisions in the bill that will force us to fund things with our tax dollars that we think are terribly wrong , or force us to purchase health care under penalty of fines if we choose not to do it. Also the way it was done made a mockery of the legislative process. Certainly there are a number of health care issues that needed to be addressed, I just think there were better ways to solve these problems that didn’t even get any play from either Republicans or Democrats.

    As to all LCMS people being hardcore conservative, that is not necessarily so.

    I attended church and worshipped in the same pews with Frank, a frequent commenter on this blog, (aka fws) for more than ten years, and we are good friends, but are very far apart on the political spectrum. In the liturgy we are citizens of God’s kingdom and political agreement is not needed to be able to worship together. Our congregation was (and still is, though neither of us attend there now) very diverse ethnically and politically.

    As to synodical politics inside the various synods – even I avoid those trainwrecks. I am thankful that the LCMS is congregational in structure and we can carry on with Word and Sacrament ministry quite apart from whatever regime holds sway “at Synod.” But I think denominational politics are a downside to whichever church or denomination you chose.

  • Anonymous

    Patrick, thanks for the thorough and thoughtful response.

  • Anonymous

    Patrick, thanks for the thorough and thoughtful response.

  • DonS

    tODD @ 21: Yes, I don’t disagree. I don’t think the extension of coverage to 26 year olds is the big problem with the HC bill. It will increase premiums at the margins, but in the scheme of the other cost drivers the bill imposes, it will be negligible.

  • DonS

    tODD @ 21: Yes, I don’t disagree. I don’t think the extension of coverage to 26 year olds is the big problem with the HC bill. It will increase premiums at the margins, but in the scheme of the other cost drivers the bill imposes, it will be negligible.


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