Health overhaul will boost coverage for millions, but leaves gaps, too

The health legislation President Barack Obama signed into law would extend insurance to 32 million Americans by 2019, but that still leaves out 23 million, The Christian Science Monitor reports. "Among the still-uninsured will be illegal immigrants, plus people who choose to avoid the law's mandate to buy insurance - and pay a penalty as a result. It will also include some middle-class families who decide they can't afford coverage despite subsidies offered under the law. Depending on what insurance would cost, they may or may not owe a penalty" (Trumball, 3/23).

While helping the uninsured, the legislation may have several effects on other consumers, too, HealthDay/BusinessWeek reports. "People who get their benefits through small employers, however, may encounter some upheaval. The Congressional Budget Office (CBO) estimated that 8 million to 9 million individuals, mostly lower-wage workers and people who work for smaller employers, could lose their employer-sponsored coverage as a result of the legislation" (Pallarito, 3/23).

The New York Times has an interactive graphic that shows the impact of the legislation on specific groups of consumers, such as an "Insured employed older married couple" in good health and with a high income and an "Uninsured self-employed single man" who earns $30,000 a year and suffered a recent heart attack. The latter example, for instance, could expect "subsidized coverage through a new high-risk insurance program until 2014." At that point, he would receive subsidies to buy insurance on state-run exchanges. The subsidies would limit his premium spending to $2,850 (Hossain, 3/24).

Reports also point out some coverage issues that could arise because of - or in spite of - the overhaul legislation. The Associated Press reports: "The Obama administration is scrambling to fix a potential problem with a much-touted benefit of its new health care law, a gap in coverage improvements for children in poor health, officials said Tuesday. ... [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." But, firms could still refuse to offer new coverage to children with existing medical problems (Alonso-Zaldivar, 3/24).

The Philadelphia Inquirer: One much-touted provision of the overhaul would allow children up to age 26 to remain on their parents' insurance plans. But, the "bill Obama signed leaves a giant loophole, one that will be fixed if the reconciliation bill now being debated in the Senate passes. The law exempts current insurance policies from having to include coverage for the young adults." Changes that would be made by a reconciliation bill, now pending in the Senate, could close the loophole (Von Bergen, 3/24).

The Boston Globe: "The health care bill President Obama signed yesterday will probably force thousands of Massachusetts residents who receive subsidized health insurance through the state's insurance exchange to eventually write two checks each month to pay for their coverage, to comply with strict new rules for abortion coverage." Abortion coverage must be included in plans sold through an insurance exchange in Massachusetts, but coverage under the federal program would require additional steps (Lazar, 3/24).