On One-Year Anniversary, has Health Care Overhaul Helped?

Welcome to Politics Bites, where every afternoon at It's A Free Country, we bring you the unmissable quotes from the morning's political conversations on WNYC. Today on the Brian Lehrer Show, Rima Cohen, counselor for health policy to Health and Human Services Secretary Sebelius, discussed the one-year anniversary of the Obama health care law.

A year after passage of the Affordable Care Act, Rima Cohen says she's still seeing a deluge of misinformation and confusion about what the health care reform law actually does.

I've seen polling of seniors that says they believe the health reform law takes benefits away from them. Nothing could be further from the truth on that score. The Affordable Care Act (ACA) provides seniors all kinds of new benefits and protections: free preventative care services, new benefits in the prescription drug area that have already started to kick in with subsidies for Medicare Part D coverage...There are a host of benefits for seniors.

But Americans can be forgiven for most of the things they don't understand about overhaul. The sheer number of provisions, mandates, tax credits, revenue measures, regulations, etc., are made even more complicated by their staggered starting dates. State opt-outs begin in 2017, health care exchanges won't be established until 2014, and some new policies have already kicked in.

It's just hard to tell what's going on, and when. And if any of it will really make a difference to health care bottom lines across the country.

To top it all off, President Obama is now perceived as backpedaling on some ACA measures. Last month, he told the nation's governors that he would allow them to opt out of Affordable Care Act provisions and impositions early, if states were able to meet the same desired ends through their own initiatives.

However, Rima Cohen said that it was inaccurate to characterize the president's move as a flip-flop.

Under the current law, states may apply for waivers from some provisions of the Affordable Care Act in 2017 if they can demonstrate that they can achieve the goals of the ACA—expansion of health insurance coverage, health security for Americans—without increasing the deficit. If they can meet those basic goals and think of better ways, ways that are more consistent with local market conditions, then they can apply for this waiver. What President Obama has suggested is that perhaps we should move up the date for which states can apply for the waivers from 2017 to 2014. It's not really a change in position.

Of course, the real question on everyone's mind is: Will my health insurance costs be any lower as a result of the Affordable Care Act? Cohen was adamant that the legislation would control costs, but her words ran counter to a caller who said she already pays $18,000 annually for health insurance, saw a $200/month increase in costs through 2010, and has been notified that she can expect another 10-12 percent increase in her premiums this year.

Cohen responded to the scenario by making two points. First, as was already discussed, much of the health care law has yet to kick in; Americans hoping for immediate results should temper their expectations. Second, premiums aren't necessarily going up because of the Affordable Care Act—and indeed may go down once it's met the goal of covering the uninsured.

One thing I don't hear enough conversation about is the fact that everybody who has health insurance today is paying for those folks who don't have insurance and access the health care system. Those folks don't get free care; they may not be paying for it themselves, but somebody is paying for that care...Everyone having insurance actually reduces costs for those people who currently have insurance and are subsidizing those who don't.

"Any insurance company that blames premium increases on the Affordable Care Act is using that as an excuse," Cohen finished.

While that's not entirely comforting to many citizens dealing with the high cost of health care, Cohen stressed the need for patience on this one-year anniversary and beyond. "Americans may not see the effects yet," she said, "but they will very soon."