Director defends health care law

The next round of phased-in benefits have taken effect as the new GOP congressional majority is attempting a legislative repeal of health care reform.

Judy Baker, regional director for Region 7 of the U.S. Department of Health and Human Services in Kansas City, defended the controversial health care law on Thursday and cautioned that there are “consequences” to an all-out repeal.

“I don’t think people realize the impact of repeal when they talk about it in such political terms. This is not a game and there are real consequences if we repeal the law,” Baker said by telephone, “At this point, people will lose valuable freedoms and face higher deficits and higher health care costs.”

Baker pointed to popular small business tax credits, high-risk pools and allowing children to remain on their parents’ insurance plans until age 26 as already implemented provisions that will be lost if repeal efforts are successful.

For seniors, the next step in closing the “donut hole” in the Medicare Part D prescription drug benefit kicked in Jan. 1. Under a provision of the Patient Protection and Affordable Care Act signed into law by President Barack Obama last March, seniors who reach the coverage gap — a benefit cap from about $2,800 to about $6,300 where seniors must pay 100 percent of costs — will receive a 50 percent discount when buying Medicare Part D covered brand-name prescription drugs.
 
Seniors will receive additional savings on prescriptions until the coverage gap is closed in 2020.

Baker said she has heard firsthand from seniors about how the “donut hole” forces many to take expensive medications at less-than-recommended doses so their supply lasts longer, or may opt to stop buying medications they can’t afford.

“Those effects have been as costly or more so than just the cost of continuing care,” Baker said.

Medicare recipients also will see new coverage for certain free preventive services, such as annual wellness visits and personalized prevention plans, for seniors on Medicare.

New provisions also include requiring insurance companies to spend 85 percent of all premium dollars collected for large employer plans on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80 percent of the premium must be spent on benefits.

Insurance companies that fail to meet the standard face paying a rebate to customers. Baker called the standards “very attainable.”

“I think people expect when they pay their premium that is what they are getting, instead of large portions of those dollars going to administrative or other costs. We are asking insurance companies to meet that expectation. Many already meet that or are close to it,” Baker said.

Baker’s statements stand in stark contrast to statements made by newly seated 4th District Rep. Vicky Hartzler, who campaigned on pledges to repeal the law.

Hartzler made her first speech from the floor of the House during debate leading up to Friday’s procedural vote — calling the law “unconstitutional” and blaming it for adding “$1.2 trillion of debt on our country.”

“By passing this last year, you have taken away my freedom, the freedom of the people of the 4th District and the freedom of this country,” Hartzler said.

However, in what appears to be an ever-increasing debate over whose numbers are valid, Hartzler’s $1.2 trillion debt claim is disputed by the Congressional Budget Office. The nonpartisan legislative budget referee said last week that repeal would raise deficits by $230 billion from 2012 to 2021, because spending cuts and new taxes are incorporated into the law, which will offset the cost of expanding coverage.

Hartzler spokesman Steve Walsh joined a chorus of Republicans on Friday who allege Budget Office numbers have been gamed and do not reflect the true costs of the law.
With the implementation of the law’s most controversial provision — the individual mandate for purchase — now the focus of both repeal efforts and lawsuits by states challenging the constitutionality of the law, the matter is more likely to be settled in the courts than by lawmakers in Washington, D.C.

While Republicans control the House and will likely see easy passage of their repeal legislation, Democrats remain in control of the Senate, and Obama has signaled his intention to veto repeal.

In reaction to the shooting of Rep. Gabrielle Giffords and others in Tucson on Saturday, House Majority Leader Eric Cantor, (R-Virginia) has said that the House will postpone repealing the law, which had been scheduled for Wednesday, along with all other legislation, so that lawmakers “can take whatever actions may be necessary” in response to the tragedy.

The reform law, meant to control skyrocketing medical costs that have left some 50 million Americans without health insurance, would provide coverage to about 30 million Americans by expanding Medicaid to include more low-income Americans and offering tax credits to middle-class Americans to help pay for coverage.

Baker said that despite narrowly split public opinion and ongoing challenges to the law, HHS and state insurance commissions, including Missouri, are moving forward with implementation.

“We want to make this law apply the best benefits possible for the American people. We are moving forward on all cylinders putting together a new health care system and developing new delivery innovations to bring down costs and expand access,” Baker said.