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Officials skeptical of health reform
Luke Lafferre listens as a panelist speaks during a public forum on health care reform, Tuesday, July 13, 2010, at the Marshall University Student Center.
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HUNTINGTON -- Uncertainty.
The overwhelming choice for the word of the evening during the public forum on health care reform at Marshall University' Memorial Student Center Tuesday night. A large crowd, from medical students to retirees, listened intently to experts' analysis and opinion on how the reform bill will impact families, small businesses, health care professionals and the state of West Virginia as a whole.
"This is not a debate on whether we support this or we don't," said forum moderator Dr. Harry Tweel, director of the Cabell-Huntington Health Department. "Our focus is informational. We have this law -- now, what is it?
"There is complexity to this issue, uncertainty and confusion for all of us."
Perry Bryant, executive director of West Virginians for Affordable Health Care, presented the major components of the bill to the crowd, including expansion of the health care system, including Medicaid.
"At the very heart of this bill, is the expansion of services, which will bring in 122,000 to 150,000 more West Virginians covered than are covered right now," he said. "This is a good coverage. It's a typical insurance product you would see with preventive services, prescription drugs, oral and vision. It's a significant step in the right direction."
A family of four, Bryant said, making $55,000, would pay $4,100 in premiums, but earn $10,100 in subsidies in the form of tax credits, and will save the average family about $2,100. He addressed when reforms go into effect (when a new insurance plan year starts); guaranteed issuance (insurance companies can't look at pre-existing conditions); and the controversial "individual mandate," which requires all Americans to have insurance coverage.
"Without the individual mandate, I can pick and choose when I want to be insured," he said. "It would drive up premiums for the rest of us playing by the rules. You can't have the reforms without the individual mandate."
Physician Hoyt Burdick called the reform "terra incognito," Latin for "unknown land."
"The primary goals are to expand coverage to 32 million Americans, reform the delivery system to improve quality and lower overall costs, but the devil's in the details," he said. "There are a lot of things we just don't know how they're going to work."
Luke Lafferre, attorney with Huddleston Bolen LLP, lightened the mood on the serious topic by saying he thought the positive of health care reform would be more work for lawyers, but was critical of nearly every other point, especially for small-business owners.
"This is a little frightening because there are lots of unknowns, but ultimately, I think it's going to be problematic for the business community," he said.
Lafferre cited increased regulations and paperwork and also higher costs and more taxes placing a strain on business owners.
"Rationing will have to occur, uncertainty will continue. Will you hire more staff if you don't know what it's going to cost you? Probably not," he said.
Lafferre offered two examples in which health care reform will create extra headaches for business owners, including a federal requirement for businesses to submit a 1099 for every merchant they spend more than $600 with and further restrictions on employees with health savings accounts dictating what types of over-the-counter medications they can spend their health dollars on.
Sen. Evan Jenkins (D-Cabell) said though much of the talking has been at the federal level, West Virginians should be looking to the state level for the real meat of the bill.
"While the feds have spoken, those who will be implementing will be at the state level," he said, citing 39 states who have petitioned in some way to halt the reform laws from taking effect in their states. "There's a lot of work left to be done."
Jenkins spoke candidly of his feelings on the reform package.
"I am very unsettled. A big concern, from my perspective, is that we're expanding this on the shoulders of Medicaid. Medicaid is already a significant underpayer.
"I'm also very concerned about West Virginia. Most of West Virginia is already medically underserved. Will we have the providers to care for the enormous increase in coverage? I don't know," he said. "I think every ounce of skepticism is appropriate at this point."
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