Brace yourself for drama when debate begins on HR 3962, the modified Affordable Health Care Act for America. It’s 1900 pages long (though truly, those are 1/2 pages so it’s really only 850 pages long), which will offer Republicans ample opportunity to raise the very large book over their heads while dramatically declaring desperate government bloat.

I’m still reading the whole thing, but there are some key provisions that have been added that are meaningful. Most important, the ones that take place immediately are incredibly important to those who need health care reform the most: the uninsured.

Immediate coverage available for the uninsured and uninsurable

Effective Date: January 1, 2010
Key Provisions:

• Available to anyone who has been uninsured for more than 6 months OR has been refused insurance for pre-existing conditions OR has an “eligible medical condition.” Eligible medical conditions are undefined, but I am assuming chronic conditions like diabetes or heart disease.
• Also available to anyone who has been offered coverage with their pre-existing condition excluded, or is being charged a rate higher than the pool rate.
• Covers spouse and dependents
• Annual deductible limited to $1,500 for individuals, higher for families but not specified.
• Annual cost-sharing limited to $5,000 for individual, $10,000 for families
• Integrates existing State high-risk pools rather than overriding them.
• Effective until National Exchange is available (2014)

In addition to establishing the high-risk pool, there is an immediate ban on policy rescissions and coverage for dependents is extended through their 27th birthday.

This is an imperfect, but workable solution. For our family, families like ours, small family business and sole proprietors, it appears to be a way to avoid catastrophic loss from illness while not bankrupting us on the premium side of things either.

Sunshine on Price Gouging by Health Insurance Issuers

Effective immediately, insurers will have to submit proposed premium increases for review, along with justification for any premium increases. Will this really work to limit premium increases? Hard to tell. That particular section needs to be fleshed out a bit, given some context. Numbers are easy to manipulate to give the appearance of a loss or pending loss while shifting the gains into the pockets of executives and shareholders.

Immediate investment in training programs for Primary Care

This is pretty self explanatory, but I was gratified to see that they broadened the category to include nurses and other public health professionals.

COBRA extension

For those individuals who are facing COBRA expirations (18 months), coverage is extended through the date the Health Insurance Exchange is available. Of course, this assumes that the families who are on COBRA can afford COBRA coverage. Many cannot, and with the expiration of the ARRA premium subsidy, I’m afraid many will drop from the ranks of the insured to the uninsured.

These are the key provisions that are immediately effective. I haven’t addressed the public option as proposed by the House, or any of the other provisions yet. Those will come in a separate post.

cross-posted to odd time signatures