As Obama signs health care bill into law, Missouri legislators work on exemption measure

Efforts to exempt Missourians from insurance mandates and fines moved forward Tuesday as President Obama signed his landmark reform package into law.

The Missouri House of Representatives on March 16 voted 109-46 to approve a joint resolution calling for a constitutional amendment that would exempt Missourians from being compelled to “participate in any government or privately run health care system, nor prohibit a patient or employer from paying directly for legal health care services.” The measure must be approved by the Senate before going in front of voters in November.

State Sen. Jane Cunningham, a 7th District Republican from the St. Louis area, is the chief sponsor of a similar resolution in the Missouri Senate. She said debate on the proposal will begin Wednesday.

“When the discussion in Washington started happening on health care reform ideas I started hearing loudly and strongly from constituents who were frightened and angry and who asked if anything could be done. ... It has gained huge momentum since Sunday."

Cunningham called the measure, which removes penalties for consumers, businesses, and health care providers and exempts Missourians from the mandate to buy insurance, a “grass roots effort that is pushing this.

“This a truly a ‘people’s bill,’ ” Cunningham said.

Cunningham said some in the state had “misinformation that this would be an opt-out for Missouri or would prohibit Missourians form participating in options the government provides.”

“It does not do that. This only expands the options and leaves it totally open for people’s choices,” Cunningham said.

Some 38 states have passed or are considering similar legislative efforts, Cunningham said.

The new law also is meeting resistance from attorneys general from 13 states who filed suit to stop the overhaul just minutes after the bill signing, contending the law is unconstitutional. Florida Attorney General Bill McCollum took the lead in the lawsuit, joined by colleagues from South Carolina, Nebraska, Texas, Michigan, Utah, Pennsylvania, Alabama, South Dakota, Louisiana, Idaho, Washington and Colorado. Other GOP attorneys general may join the lawsuit later or sue separately.

Under the bill, starting in six months, health insurance companies would be required to keep young adults as beneficiaries on their parents' plans until they turn 26, and companies would no longer be allowed to deny coverage to sick children.

Other changes would not kick in until 2014.

That's when most Americans will for the first time be required to carry health insurance — either through an employer or government program or by buying it themselves. Those who refuse will face tax penalties.

“This is the first time in American history where American citizens will be forced to buy a particular good or service,” said Nebraska Attorney General Jon Bruning, explaining why his state joined the lawsuit.

Tax credits to help pay for premiums also will start flowing to middle-class working families with incomes up to $88,000 a year, and Medicaid will be expanded to cover more low-income people.

Although many components do not kick in until 2014, some measures are expected to be in place by September, including:

• Insurance companies will be prohibited from placing lifetime caps — limits on the amount of money that can eventually be paid out – on their policies. They’ll face new restrictions on setting annual caps, as well.
• Insurance companies also will be prohibited from pulling your coverage, except in case of fraud or intentional misrepresentation.

• Children won’t be excluded from coverage due to pre-existing health conditions. Plus, children will be able to stay on their parents’ policy until age 26.

• Small businesses that offer health coverage to employees will be eligible for tax credits of up to 50 percent of premium costs.

• Seniors who fall into the coverage gap, or “doughnut hole”, in the middle of the Medicare Part D prescription drug coverage plan will get $250 to help them pay their bills.

• People with pre-existing health conditions will be able to enroll in a new, but temporary, national high-risk insurance plan.

The nonpartisan Congressional Budget Office said the law will cut federal budget deficits by an estimated $143 billion over a decade. The law is expected to cost $938 billion and guarantees coverage for 32 million uninsured Americans.

— The Associated Press contributed to this story

What Sedalia Democrat readers say:

• Stephanie Lefevers, owner of Sedalia-based Porta & Grace Midwest Distributing, said she believes reform needs to take place but is still undecided about the new law.
“I’m not sure how it will unfold. I am concerned about some of the language in the bill. I am eagerly anticipating more detail about how it will affect us economically. How will this affect our taxes? If it will decrease the deficit and how? I see it as an encouragement for people without health insurance like myself, but I am more concerned with the big picture and how it will affect everyone and not just a few. We have Blue Cross Blue Shield. I can’t be a part of that because of an injury to my back. For me to have health care I would have to have a $5,000 deductible and a 30-70 split. For me it would work, but I am a part of a minority in the country in comparison with working Americans who have health coverage.”

• Mark Cooper, 53, said health care reform “is a deliberate ploy by Democrats to save Obama’s reputation and presidency.”
“I detest the whole idea. They didn’t listen to any of the people and they know it. They are laughing at us. I don’t care for Obama. I’m not real happy with it. I truly believe he is a foreign-born Muslim, so everything they are passing isn’t really the law. We have a socialist Democratic Congress and a socialist Democratic Senate. This country is going to hell in a hand basket. This health care will bankrupt us. I am disabled veteran and I do have Medicare, but no one will take it and all I see is bad coming.
They say they will make everybody have to pay. What about people that can’t? Pay for all these wild-ass ideas. (Democrats) know they will lose all their seats in 2012. They will get crucified for this.”

• Charla Gordon, a retired teacher from Sedalia, said she would have preferred a single-payer system, but supports reform.
“I’m very supportive. I think it is ridiculous in this country that we haven’t had a comprehensive health care bill until now. I would have preferred single payer, but I think there are a lot of good things about this bill. I think single payer would have solved some of the financial problems and been a cleaner system. I think it will solve a lot of problems. I am on Medicare and I’ve dealt with the VA system — they work very well. Those are basically single-payer systems. With any program there are some gripes but you have that with private doctors too. I think not kicking people off their polices if they are ill is a good thing. I have a granddaughter born two weeks premature. Without some help she would never be able to get insurance. That is just wrong.”