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A Times Editorial

Good, bad, and ugly of health care reform

While Congress turns its attention toward banking regulation, climate change and immigration, Florida and the rest of the nation are digesting the landmark health care reforms. Sifting through some of the good, the bad and the ugly:

The good: As a graduation present for many college students, at least five health insurers have announced they are voluntarily allowing those young adults to remain on their family's coverage. The new law says young people must be allowed to remain on their parents' health plan until age 26. But that provision does not become effective until mid September, and it would not kick in until family health plans are renewed, which normally would be January. Now Blue Cross Blue Shield, Humana, UnitedHealthcare, Kaiser Permanente and WellPoint/Anthem say they will allow college graduates to remain on their family plans without interruption. That should provide some relief to many families as their children leave college and hunt for jobs in a tight market.

In another positive development, the insurance industry announced that starting this month it will honor a new ban on canceling the coverage of sick policyholders. The ban had not been scheduled to take effect until September, but insurers are responding to outrage over reports that WellPoint allegedly canceled the coverage of women suffering from breast cancer. Even if the change is designed to mitigate bad publicity, it is another indication that reform is taking hold and benefiting Americans.

Meanwhile, U.S. Rep. Kathy Castor of Tampa and others are educating small businesses about the tax credits they could receive this year for offering health coverage. Employers with fewer than 25 workers and an average salary of less than $50,000 can receive the tax credits. But some small employers say they are reluctant to offer coverage because they fear the law might be changed. It doesn't help calm those concerns when Attorney General Bill McCollum has asked a federal court to declare the reforms unconstitutional.

The bad: Some of the insurers' maneuvering is aimed more at protecting their bottom line than their policyholders. The new law says insurers must allocate at least 80 percent of their premiums to paying claims and improving care. The bar is 85 percent for insurers selling coverage to large groups. So WellPoint essentially did some fancy accounting and transformed $500 million in administrative costs into medical expenses. Regulators will have to keep an eye on that kind of cost shifting that undermines the intent of the law. Florida Insurance Commissioner Kevin McCarty held a public hearing on the so-called medical-loss ratio issue Tuesday in Orlando.

In another disappointment, Florida is one of 18 states that has declined to run a temporary insurance pool to provide coverage for uninsured people with pre-existing conditions. That means the federal government will have to run the pool on its own in Florida. Florida's high-risk pool has been closed to new patients since 1992. While there are legitimate concerns that the $5 billion earmarked for the high-risk pools nationwide is inadequate, the state should have been more cooperative.

The ugly: As if there are not enough questions about the law, con artists are taking advantage of the lack of understanding. The New York Times reports that telemarketers in Illinois are offering fraudulent coverage against "death panels." In other states, callers claiming to be government employees collecting for "Obamacare" insurance. It's only a matter of time before such scams arrive here, and Floridians should rely on trusted sources to get their questions answered about health care reform.

Good, bad, and ugly of health care reform 05/04/10 [Last modified: Tuesday, May 4, 2010 6:30pm]
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