Finally, after all the wrangling and debating and crazy conjectures, some provisions of the health insurance reform legislation will go into effect this week. Perhaps the most important operative term here is “health insurance reform”. It definitely is not healthcare reform but insurance reform. With this legislation, Congress left the majority of determinations about how the various provisions will be implemented to the Secretary of Health and Human Services. According to a recent news story, the legislations contains the phrase “the Secretary shall” more than 3,000 times.
So until implementation of the law begins, no one knows for sure how it’s going to work, which is why this week is so important. Since September 1, federally subsidized “high-risk pools” have been insuring adults who cannot otherwise get insurance. The plans are a bridge until 2014, when mandates kick in and Americans will be able to buy insurance from state-based exchanges.
Starting with the next enrollment after September 23, insurers can’t deny coverage to sick children or rescind coverage for people who become ill (except in cases of fraud), and must cover children on their parents’ policies until age 26. Moreover, insurers have to cover preventive services, including mammograms, cholesterol screening, and routine physicals, without collecting copayments. The new law should transform the insurance industry. This month, and especially this week, we’ll begin to see just how well it does this.
The proof of the pudding, after all, is in the eating. And the “proof” of health insurance reform is in the doing. This comes not a moment too soon: Last week, the U.S. Census Bureau said 50.7 million people, or 16.7% of the population, had no coverage in 2009. And this recession doesn’t seem anywhere near over yet.
 Prout JS. “Reform not quite there.” Cincinnati Enquirer. September 19, 2010, page F2.