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Letter: Explaining Health Care Legislation

Please afford me this opportunity to reply to Dr. Hollander’s letter, which appeared in your last edition (“Health Care Bill Critique,” The Roslyn News, April 8, 2010.) But before providing a factual second opinion responding to his regrettably misleading critique of two elements of the recently enacted, comprehensive health care insurance reform legislation which he refers to as “Obamacare,” I would like to strongly caution your readers to be aware of the never-ending stream of misinformation that accompanied a year-long debate on the bill, and continues even now that the legislation has been signed into law.   

The first clue as to whether you can trust the information you are being given is when the critic uses the buzz word “Obamacare” to describe the most comprehensive reform of our nation’s health care insurance system in its history. “Obamacare” is almost exclusively used by conservative ideologues who never wanted health-insurance reform in the first place. These people use “Obamacare” as a derisive and derogatory slogan to demonize – as they do to the president – this serious attempt to deal with one of our nation’s most serious problems – the ever-increasing costs of health care services and health-insurance premiums, the abuses of health insurers in denying and limiting the coverage given to Americans, and the fact that some 46-million of our neighbors have no health-insurance coverage whatsoever. (They don’t refer to Medicare as Kennedy-Johnsoncare, do they?)

Your readers would be well advised to remember that these are the same people who told you the legislation contained “Death Panels” (not true and shame on them for trying to frighten our senior citizens); these are the same people who warned about reduced health care services under Medicare (not true and, once again, shame on them for trying to frighten our senior citizens); the same people who charged a “government takeover of our health care system” (totally not true); who claimed the bill gave us “socialized medicine” (the legislation actually provides for more than 30-million additional citizens to purchase PRIVATE health insurance); the same people who insist the bill gives health insurance coverage to illegal immigrants (the bill specifically prohibits this); the same people who stated the bill allows the federal government to pay for abortions (the fact is the prohibition on the use of federal funds to provide for abortions remains intact); and the list of mistruths, misrepresentations, misleading information and outright lies goes on-and-on.

The other clue is when someone, as Dr. Hollander did in his letter, tells you to “...fix those situations locally.” It’s all well and good to believe in states’ rights. Indeed, if every state had provided a program for seniors to retire with financial security and dignity, we wouldn’t have needed to enact Social Security; if every state had provided seniors with a program to pay for their health care needs, we wouldn’t have needed federal law to enact Medicare; if every state had laws to prohibit discrimination due to a person’s race, we wouldn’t have needed to enact the Civil Rights Act; and if every state provided protections against health insurers’ abuses and covered the uninsured residents of their states with health insurance, we wouldn’t have had to enact the bill recently signed into law by President Obama.

Now, about Dr. Hollander’s critique of those two points.

First, the new law is clear that children cannot be discriminated against because of pre-existing conditions by health-insurance companies. The doctor’s premise is that the new federal law does nothing, because New York has a law that takes care of it. He forgets we have 50 states, and misunderstands New York law. The Department of Health and Human Services will issue regulations shortly—consistent with the new law—to ensure there is no ambiguity about guaranteed issuing of insurance with regard to children with pre-existing conditions. And, starting this September in New York State, and across the country, children with pre-existing conditions cannot be denied health coverage under their parent’s health-insurance plans, and insurance companies will no longer be able to insure a child but then exclude treatment for that child’s pre-existing condition.

Dr. Hollander implies we don’t need the new law, because he says that New York law already protects children from being denied health-insurance coverage because of pre-existing conditions. He is partially correct with regard to New York, though your readers should (and do) understand that when we pass a federal law, it covers all of the people in this country, not just the residents of this state. New York State is a “guaranteed-issue state,” and adults and children with pre-existing conditions cannot be denied coverage entirely. However, before President Obama signed the bill, even under New York law, insurance companies COULD deny payment for claims related to a specific pre-existing condition for up to one year. For one year in New York State, your child could have been denied treatment for something like a birth defect, asthma, juvenile diabetes, cancer, leukemia or sickle cell anemia if your family for whatever reason got a new insurance plan. Doesn’t it make sense for Congress to pass a law so insurance companies in New York State and states across the country (in fact, 44 states don’t have such “guaranteed-issue” laws) can no longer do this to children? The answer is: Yes We Did.

Of course, changing the law for pre-existing conditions doesn’t matter much if you don’t have any health insurance. In our Congressional District alone, there are 70,000 people without any health care insurance coverage. In New York State, 2.7-million people don’t have health care insurance with over 300,000 of them being children. Yours and the average American family pays $1,100 a year as part of your current premium for them to access health care through our emergency rooms. Doesn’t it make sense for Congress to pass a law so that more people can get comprehensive health care insurance based upon what they can afford to pay? The answer is: Yes We Did. It is morally right and economically sensible. The new health care insurance reform law will help 94 percent of our 70,000 neighbors in our community without insurance get comprehensive health care insurance at an affordable cost.

Dr. Hollander incorrectly infers that the recently-passed health-insurance reform bill will not benefit dependents under 26-years old in New York because state law already allows children to stay on their parents’ insurance policies up until the age of 29. Not so fast. Even if he were right about New York, what about the rest of the country? As for New York, the State currently has no mandate that dependent coverage must be provided past age 19. Last year, New York State did pass into law two options for unmarried adult children up to age 29 to remain on their family’s health-insurance policy: the “Make Available Option” and the “Young Adult Option.” What the doctor doesn’t understand about the law is that the Make Available Option lets employers decide if they want to offer their employees the option of purchasing coverage for an unmarried child up to age 29. The upside is that if the employer makes the option available, the employee can get that coverage at the price of a typical family policy; the downside is that the option is at the employer’s discretion and because of the higher price of family policies, they may not make it available to their employees. With the “Young Adult Option,” unmarried adults can choose to stay on their parent’s coverage until age 29. What the doctor didn’t understand about this option however is that none of the costs—including premiums—are paid by the employer; the young adult or their parents pay the full cost of the premium themselves, which means it’s as expensive as a full COBRA premium. Wouldn’t it make sense for Congress to step in and pass a law that requires insurance companies to cover young adults under their parent’s family policies? The answer is: Yes We Did.

The new federal law will help dependent children in New York State (and now in all states) stay on their family’s health-insurance policies until age 26 in a more affordable way. Under the new federal law, beginning this September, health plans must –it’s a mandate– make dependent coverage available until age 26 for unmarried dependents. For unmarried adults under 26, the federal law goes well beyond New York State’s options for young adult coverage by making it both more affordable and more available.

I hope this clears up some of the misinformation propagated by opponents of health-insurance reform about how the new law will help children and young adults in New York State.

 U.S. Rep. Gary Ackerman