Health law's affect on ERs, doctors' panel, young adults examined

Officials and stakeholders are examining the new health reform law for changes that the reform will mean for their organizations and industries.

The Hill: "The new healthcare law will pack 32 million newly insured people into emergency rooms already crammed beyond capacity, according to experts on healthcare facilities. A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people either have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency." But some expect the newly insured to continue to seek care at an emergency room because they don't have a primary care doctor. "Massachusetts in 2006 created near-universal coverage for residents, which was supposed to ease the traffic in hospital emergency rooms. But a recent poll by the American College of Emergency Physicians found that nearly two-thirds of the state's residents say emergency department wait times have either increased or remained the same" (Heflin, 5/15).

American Medical News: A doctors' Medicare panel has been disbanded after 18 years because of a new provision in the health reform law that makes doctors use other avenues to express their concerns about Medicare reimbursement. "The Practicing Physicians Advisory Council, a 15-member board that met quarterly with federal officials to discuss matters pertaining specifically to Medicare fee for service, was officially disbanded on March 23. A provision in the health reform law repealed the section of the Social Security Act that created the council in 1992." Its end has disappointed some, but officials "stressed that physicians still have numerous ways besides PPAC to keep communicating with the agency, including feedback groups, regular conference calls and public comments on Medicare regulations" (Silva, 5/17).

Modern Healthcare: Medicare officials are preparing to release regulations on accountable care organizations that many hope will change incentives for providing care from quantity of care to quality. "Under the law, Congress gave Medicare leeway to give healthcare providers that curb Medicare spending a share of the savings as long as they reach quality and cost-control targets. To be eligible, providers must create networks, known as accountable care organizations, that contract to manage care and curb spending for a specific group of patients. But how such ACOs will operate and whether they will help slow health spending as reform rapidly expands access — and demand — for medical care to an estimated 32 million uninsured remains unclear" (Evans, 5/17).

The Los Angeles Times, in the meantime, has a story on the popular provision in the new health law that offers young adults the option to remain on their parents' health insurance plans until they turn 26. The Times runs down the particulars around the new provisions. Plans that offer dependent coverage must offer it to adult children if they don't have access to an employer-sponsored plan on their own. In addition, the extension applies to married children, but not their spouses or children. The provision takes effect at the beginning of the new plan year for plans on or after Sept. 23 this year (Lunzer Kritz, 5/17).

Meanwhile, The (Norfolk) Virginian-Pilot/The Roanoke Times reports that for some families, the health law's elimination of lifetime insurance caps won't come soon enough. "That part of the law goes into effect Sept. 23, one of the earlier pieces to fall in place." But for families whose policies are "already in force, the cap won't go away until their policy is renewed on Jan. 1." The Virginian-Pilot profiles a family who is close to exceeding their $1 million cap before then (Simpson, 5/17).

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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.