{"id":501940,"date":"2010-04-01T10:33:34","date_gmt":"2010-04-01T14:33:34","guid":{"rendered":"tag:www.southernstudies.org,2010:\/\/5.12208"},"modified":"2010-04-01T12:54:47","modified_gmt":"2010-04-01T16:54:47","slug":"voices-health-care-reform-a-step-forward-but-long-road-ahead","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/501940","title":{"rendered":"VOICES: Health care reform &#8211; a step forward but long road ahead"},"content":{"rendered":"<p>        <i>By Maya Rockeymoore, <a href=\"http:\/\/news.newamericamedia.org\/news\/view_article.html?article_id=206b0d8b35f76c345cfa2935104f9061\">New America Media<\/a><\/i><\/p>\n<p>Now that the health care reform bill has been signed into law, President<br \/>\n Obama and the Democratic Congress have a significant legislative<br \/>\nvictory to call their own. While many are relieved that the United<br \/>\nStates has finally been able to gain a foothold on reform &#8212; an<br \/>\naccomplishment that has eluded presidents for almost 100 years &#8212; plenty of<br \/>\n others are still wondering what the changes will mean for their lives. <\/p>\n<p>This &#8220;health reform anxiety&#8221; is especially prevalent among racial and<br \/>\nethnic minorities, who &#8212; as a majority of the nation&#8217;s uninsured &#8212; have a<br \/>\ndisproportionate need for access to quality health care. <\/p>\n<p>Although the law falls short of what many supporters of reform wanted &#8212; it<br \/>\n doesn&#8217;t cover every single individual and doesn&#8217;t contain a public<br \/>\ncoverage option &#8212; all in all, it does represent a good beginning for<br \/>\ntackling America&#8217;s worse health insurance abuses and provides a<br \/>\npromising framework for prevention.   <\/p>\n<p>Prior to the bill&#8217;s passage, low-income individuals and families, those<br \/>\nwith pre-existing conditions, small business employees and individuals<br \/>\nlooking for insurance coverage were largely out of luck or at the mercy<br \/>\nof rapacious insurance companies seeking to minimize risk and maximize<br \/>\nprofit. Now these vulnerable populations, disproportionately low-income<br \/>\nand black and brown, have a basic guarantee against the health care<br \/>\ndiscrimination that previously excluded or took advantage of them.<br \/>&nbsp;<br \/>\nEmbedded in the 2,073-page law (plus the second &#8220;reconciliation&#8221; package<br \/>\n signed this week to fix earlier problems with bill) are myriad measures<br \/>\n promising to generate reams of discussion. For now, though, racial and<br \/>\nethnic groups should find some provisions of special interest. <\/p>\n<p>Among the health care law&#8217;s affordability and access provisions, new tax<br \/>\n credits should help middle and working class Americans, who aren&#8217;t<br \/>\neligible for the low-income Medicaid program. This tax assistance is<br \/>\ndesigned to offset the costs of health care premiums.  <\/p>\n<p>Because people of color disproportionately have lower incomes, they will<br \/>\n also find help in the statute&#8217;s expansions of Medicaid coverage across<br \/>\nstates for those at or below 133 percent of the federal poverty level.<br \/>\n Legal immigrants, however, will have to wait five years to be eligible.<\/p>\n<p>Seniors of color, who are more likely to report being in poor health,<br \/>\nwill find relief in the gradual closure of the &#8220;donut hole&#8221; in<br \/>\nMedicare&#8217;s Part D prescription drug benefit.  <\/p>\n<p>Elders and people with disabilities with serious (and costly) medication<br \/>\n needs, must now bite into the donut hole after Medicare&#8217;s initial help<br \/>\npaying for their drugs. At that point, they must pay the full cost of<br \/>\ntheir medicines until they reach a level of drug spending considered<br \/>\neconomically catastrophic before Medicare picks up the cost again.<br \/>\nMedicare will provide significant help this year and next, and close the<br \/>\n hole completely by 2020. <\/p>\n<p>In addition, the new state insurance exchanges will give businesses and<br \/>\nindividuals a place to purchase affordable health insurance options. <\/p>\n<p>Measures in the law that support disease prevention &#8212; backed by an<br \/>\nunprecedented $15 billion investment &#8212; are as important for racial and<br \/>\nethnic minorities as the health care access provisions. That&#8217;s because<br \/>\nthey suffer excessively from health disparities, particularly<br \/>\nobesity-related chronic diseases, such as heart disease, hypertension,<br \/>\ntype 2 diabetes and renal disease.  <\/p>\n<p>The new law will target prevention efforts largely at community-based<br \/>\nservices and interventions that support public health and wellness. It<br \/>\nalso provides free clinical preventive services, such as cancer and eye<br \/>\nscreenings through Medicare and other health insurance plans.  <\/p>\n<p>The legislation also includes incentives to bring more doctors and other<br \/>\n health workers and providers &#8212; especially racial and ethnic<br \/>\nminorities &#8212; into traditionally underserved areas. Backing this provision<br \/>\nare Medicaid reimbursement increases aimed at increasing the number of<br \/>\nproviders willing to serve Medicaid patients.<br \/>&nbsp;<br \/>\nFurthermore, several aspects of the law focus on eliminating health<br \/>\ndisparities. Among these are wider support for community health centers,<br \/>\n minority health professionals and the collection of data by race,<br \/>\nethnicity, sex, primary language and disability status. <\/p>\n<p>What are the disappointments?  <\/p>\n<p>Small business owners wanting to provide health insurance for their<br \/>\nemployees may be discouraged by provisions that give tax-credit<br \/>\nassistance only to the very smallest of small businesses among them. <\/p>\n<p>Additionally, the state and regional exchanges that the law allows<br \/>\nstates to establish will lack the same economies of scale that a<br \/>\nnational exchange would have given to individual and small business<br \/>\npurchasers. That national option would have generated insurance-market<br \/>\ncompetition and driven down premium costs significantly.  <\/p>\n<p>Critical to our aging population is that although the new law eliminates<br \/>\n discrimination based on pre-existing conditions and gender (women have<br \/>\nbeen subject to higher insurance rates than men), it continues to allow<br \/>\nage-based discrimination. The legislation allows companies to charge<br \/>\nolder adults three times what they charge younger adults.  <\/p>\n<p>While this is likely to have significant implications for seniors on a<br \/>\nfixed income, older adults in moderate and lower-income households can<br \/>\nstill qualify for tax credits or Medicaid assistance to offset their<br \/>\ncosts.  <\/p>\n<p>Despite its unprecedented investment in prevention, the implementation<br \/>\nof this law by itself is unlikely to spawn a wellness revolution that<br \/>\nkeeps Americans healthy and reduces their need for acute care.  <\/p>\n<p>At the end of the day, health care reform represents a solid step<br \/>\nforward in expanding health care access and affordability.  Although it<br \/>\nis not a radical departure from the existing system &#8212; after all, it does<br \/>\nkeep the basic infrastructure of employer-based and for-profit care<br \/>\nintact &#8212; the law does a lot to defend and protect Americans&#8217; right to<br \/>\nlife &#8212; a human right that has been too long ignored.  <\/p>\n<p><i>Maya Rockeymoore is president and CEO of Global Policy Solutions, a<br \/>\nsocial change strategy firm in Washington, D.C.<\/i> <\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Maya Rockeymoore, New America Media Now that the health care reform bill has been signed into law, President Obama and the Democratic Congress have a significant legislative victory to call their own. While many are relieved that the United States has finally been able to gain a foothold on reform &#8212; an accomplishment that [&hellip;]<\/p>\n","protected":false},"author":4086,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-501940","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/501940","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/4086"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=501940"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/501940\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=501940"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=501940"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=501940"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}