Health reform creates winners, losers and an interesting timeline

The health legislation creates a slew of winners and losers, as well as immediate effects and changes that will arrive slowly.

USA Today has an interactive timeline of when provisions will take effect as well as an article about how the bill could affect "nearly all" Americans. "Poor adults will get Medicaid. Low-income families will get federal subsidies to buy insurance. Small businesses will get tax credits. Children will be able to stay on parents' policies until they turn 26. Seniors will gain additional prescription-drug coverage. ... On the other hand, the wealthy will pay higher taxes to help finance the 10-year, roughly $940 billion cost. Businesses with 50 or more workers will have to insure them or pay a penalty. Individuals, too, will have to pay a fine if they don't buy insurance" (Wolf and Young, 3/23). 

Politico: "Match the effective dates of key reform provisions against the election calendar, and it becomes clear that Democrats were as focused on writing a legislative overhaul of the health care system as they were on devising a political road map for selling it to voters." Senior citizens in the Medicare drug program's doughnut hole will receive rebates this year and young people will be able to stay on their parents' insurance plans beginning in September. But, the most "bitter" taxes will not go into affect until 2013 - or even 2018 - well after this year's midterm elections and President Obama's 2012 reelection campaign (Brown, 3/23).

Related KHN story: The Immediate Effects Of The Reform Bill (Appleby and Steadman, 3/22).

Other major changes would not go into effect until 2014, such as "a mandate that most Americans obtain health insurance, a prohibition against insurers turning down adults for coverage because of pre-existing conditions, and the creation of a marketplace or purchasing pool to make it more affordable for people to buy insurance," according to the San Francisco Chronicle (Colliver, 3/23).

The Boston Globe: "The real fireworks in the bill, the core components that will provide coverage for more than 30 million uninsured Americans by 2019 and establish a system of shared responsibility for its cost, don't start for another four years" (Wangsness, 3/23).

The Wall Street Journal adds that, now that the legislation - and its timeline - are in place, the government's focus will turn towards implementing the provisions. "With the health bill passed, the focus now turns to enacting the most-massive changes to the health system in more than four decades. That task will be made difficult by a tight window for launching the first provisions of the bill, and a contentious relationship between government and industry" (Johnson and Adamy, 3/22). 

The Washington Post: Over time, "[b]y far, the most direct effect will be on insurers. Over the next several years, health insurance will evolve into something more closely resembling a publicly regulated utility: It will have a guaranteed base of customers, thanks to the coverage requirement, but it will be bound by much tighter restraints than today's individual insurance market, where regulations vary widely from state to state" (MacGillis, 3/23).

Reuters: "Companies and their lobbyists said a host of new rules and regulations are likely to increase taxes and health insurance premiums while hampering job growth for manufacturers, retailers and other large businesses" (Heavy and Zieminski, 3/22).