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Health & Fitness

Health Reform: What to Watch!

Affordable Care Act – what's next?

Lot's of debate is happening on the Supreme Court decision. The reality is that SCOTUS left it up to the political process with the current status being full speed ahead on implementation. Here are some key points for all of us to stay involved with:

1. Health Exchange Set-Up: What will Georgia do? If they do not set up the State Exchange the Feds can run it according to the law.

2. Coverage Mandates and Premiums: The Department of Health and Human Services will establish coverage requirements. What will happen to insurance premiums? What will be the amount of money needed to subsidize (Exchanges).

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3. Physician Reimbursements and Doctor Networks: Medicare is due to be slashed to help fund exchange subsidies. Stay in touch with your doctor’s business office on what they will accept and your responsibility.

4. Will Georgia participate in the expanded Medicaid program now that punitive measures have been thrown out?   

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Without major political change, I believe this law will drive us toward a two-tier system of healthcare. The tiers will be physicians who completely opt out of accepting insurance for business reasons...and those that continue to accept insurance. With the latter bracket probably declining, I am very fearful that "healthcare supply" will decrease and rationing will happen. This is already compounded by a shortage of physicians. Remember the word "Capitation" which simply means putting an upper limit on income. This is defacto rationing.   

While the Mandate "Tax" is getting all the press, far more attention is needed to the subsidized health insurance exchanges and what that will cost U.S. taxpayers.  Surveys show some employers will reduce or eliminate benefits. This will push more of us to the subsidized exchanges driving the taxpayer bill up even more.  Exchange plans will be required to provide robust (and costly) benefits (this is a new entitlement).

I could go on and it is noteworthy that some have improved benefits but unfortunately it is likely short lived due to the financial unsustainability of the new system. There are solutions but the politics remain in the way.

If you want to know what I suggest, read the previous posts on Consumer Directed Healthcare.

Editor's Note: is a health, long-term care and life insurance professional, and blogger for Cumming Patch.

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