Fine print raises alarms over health bill

News reports forecast that some provisions in the Senate health-overhaul legislation could create distractions for Democrats seeking to pass a bill by the year's end. "In a victory for people with cancer and other serious medical problems, the White House agreed Friday to help close a loophole in the Senate health care bill allowing annual dollar limits on their care...," the Associated Press/San Francisco Chronicle reports. "Tucked in a clause of the Senate bill captioned 'No lifetime or annual limits' is a provision that would permit such caps." By stipulating that the limits must not be "unreasonable," the legislation opens to the door for insurers to override the provision. As the bill is written, administration officials could set the bar for what constitutes a reasonable limit (Alonso-Zaldivar, 12/12).

Another issue, The Baltimore Sun reports, is that "little-noticed fine print in the legislation includes delays on many benefits of health reform. And those extended timelines will likely come as news to many who need and are expecting aid now, according to some of those monitoring the rancorous and evolving process." Other benefits are tied to delayed timelines, such as financial aid packages to help people buy insurance (Cohn, 12/14).

A gray area between purely cosmetic surgery and reconstructive surgery is heating the debate over the so-called "botax," a tax on plastic surgeries, the Houston Chronicle reports. The Senate health reform bill "would impose a 5 percent levy on cosmetic procedures not considered medically necessary — the liposuction, nose jobs and hair plugs that weren't caused by disfiguring disease, congenital abnormalities or injury." The area is already a matter of dispute between plastic surgeons and insurers, who may not pay claims that address purely aesthetic issues. The surgeons argue that the tax is discriminatory to women, who receive the vast majority of the operations and that insurers sometimes argue that medically necessary procedures are mere beautification rites to avoid paying. "Dr. Jeff Friedman of Methodist Hospital, president of the Houston Society of Plastic Surgeons, tells of one patient born without breasts, another without a vagina. None of the patients' insurance plans covered the surgeries in question" (Ackerman, 12/14).

All these, and the many other issues, leave Americans divided on the health reform plan, and presents a "fundamental question: Could any legislation that significantly overhauls the health care system win broad support? Probably not," the Milwaukee Journal Sentinel reports. The public is split by a series of contradictions in their opinions, such as the fact that people think their insurance premiums are too high, but don't recognize that they reflect underlying costs of care, or that people want to lower costs without affecting their own coverage and care. "The contradictions provide some perspective on the challenge facing Congress in the coming months -- and the odds against any legislation being greeted with applause" (Boulton, 12/13).

---

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.