Health Reform & Small Businesses (03/31/2010 Web chat)

Health Reform & Small Businesses (03/31/2010 Web chat)


[music] — HI, I’M JENNY BACKUS. WELCOME TO OUR FIRST
WEBCHAT ON HEALTH REFORM.TODAY’S WEBCHAT IS THE FIRST IN A SERIES OF DISCUSSIONS WE’LL
HOST HERE AT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AS WE WORK TO IMPLEMENT THIS
NEW LAW AND ENSURE HEALTH SECURITY FOR ALL AMERICANS.OUR HEALTH CARE SYSTEM WASN’T BROKEN
IN A DAY, AND IT WON’T BE FIXED IN A DAY EITHER. THIS IS GOING TO TAKE A LOT OF WORK AND WE
WANT YOU, THE AMERICAN PEOPLE, TO UNDERSTAND THIS PROCESS TODAY AND IN THE YEARS AHEAD.
WE KNOW THAT MANY OF YOU HAVE QUESTIONS ABOUT THIS NEW AND VERY COMPLICATED LEGISLATION,
AND WHAT IT MEANS FOR YOU AND YOUR FAMILIES. AND IN THE MONTHS AHEAD, WE’LL BE HERE TO
ANSWER YOUR QUESTIONS DIRECTLY DURING OUR WEBCHATS OR ON OUR WEBSITE, HEALTHREFORM.GOV.
EARLIER THIS WEEK, WE ASKED AMERICANS TO SUBMIT THEIR QUESTIONS, AND TODAY WE’LL ADDRESS AS
MANY QUESTIONS AS WE CAN. WE’LL BE HOLDING THESE CONVERSATIONS REGULARLY IN THE MONTHS
AHEAD, SO IF WE DON’T GET TO YOUR QUESTION, WE’LL MAKE EVERY EFFORT TO COVER IT NEXT TIME.
WE’LL ALSO BE ANSWERING SOME OF THE MOST FREQUENTLY ASKED QUESTIONS ON OUR WEBSITE, IN A SPECIAL
SECTION CALLED YOUR QUESTIONS ANSWERED AT: HEALTHREFORM.GOV. SO KEEP CHECKING THE SITE
FOR MORE INFORMATION AND UPDATES. DURING OUR CONVERSATION TODAY WE’LL DISCUSS HOW HEALTH
INSURANCE REFORM WILL IMMEDIATELY BENEFIT AMERICANS, ESPECIALLY OUR SMALL BUSINESS OWNERS.
I’M JOINED TODAY BY HEALTH AND HUMAN SERVICES SECRETARY KATHLEEN SEBELIUS AND SMALL BUSINESS
ADMINISTRATOR KAREN MILLS. SECRETARY SEBELIUS, LET’S BEGIN BY TELLING PEOPLE HOW THIS BILL
HELPS PEOPLE. — WELL THE PRESIDENT AND THE CONGRESS PROVIDED
AN OPPORTUNITY FOR ALL AMERICANS TO HAVE HEALTH SECURITY.
FOR THOSE THAT HAVE INSURANCE, IT WILL HELP LOWER COST OVER TIME, IT WILL HELP DRIVE HIGHER
QUALITY CARE OVER TIME AND GIVE PEOPLE SOME STABILITY WITH INSURANCE COSTS.
FOR THOSE WHO DON’T HAVE INSURANCE COVERAGE RIGHT NOW.
THERE’S SHORT TERM PROGRESS MADE TOWARD THAT AND THEN EVENTUALLY A NEW MARKETPLACE WITH
LEVERAGE AND COMPETITION, PURCHASING POWER THAT FOLKS DON’T HAVE AND ONCE AND FOR ALL
THE INSURANCE RULES CHANGE SO NO LONGER DO INSURANCE COMPANIES PICK AND CHOOSE WHO HAS
COVERAGE AND WHO DOESN’T. — WELL WE’VE SEEN A LOT OF PEOPLE TALKING
ABOUT THIS IS SMALL BUSINESSES, SO HOW DOES SMALL BUSINESSES IMPACT FROM THE NEW LEGISLATION? — WELL FIRST I’M DELIGHTED TO BE HERE AND
THANK YOU FOR DOG THIS TO ANSWER THE QUESTIONS OF SMALL BUSINESS, YOU KNOW HEALTHCARE IS
THE NUMBER ONE CONCERN OF SMALL BUSINESSES AND IN THE SURVEYS IT’S BEEN THE NUMBER ONE
CONCERN SINCE 1986, HOW DO THEY GET ACCESS TO AFFORDABLE HEALTH INSURANCE.
YOU KNOW RIGHT NOW, SMALL BUSINESSES ARE PAYING 18% MORE FOR HEALTH INSURANCE WHEN THEY CAN
FIND IT AND ABOUT HALF OF THE SMALL BUSINESSES BETWEEN THREE AND NINE PEOPLE OUT FROM, REALLY
CAN’T FIND A QUOTE THAT THEY CAN AFFORD. SO NOW, WITH THE PASSAGE OF HEALTHCARE REFORM,
WE’RE GOING TO BE ABLE TO PROVIDE MORE OPPORTUNITY, MORE ACCESS, NOR AFFORDABILITY. — WELL, THERE’S A LOT OF TALK WHEN THEY TALK
ABOUT THE FIRST THING COMING OUT OF THE BOX FOR THIS TAX EXEMPTION.
SO WHAT DO THEY NEED TO KNOW ABOUT THE TAX CREDITS THAT WILL HELP THEM GET COVERAGE TO
THE WORKERS? — WELL TO ALL THE SMALL BUSINESSES OUT THERE,
THIS IS IMPORTANT BECAUSE TAX CREDITS ARE AVAILABLE THIS YEAR IN 2010.
AND THERE’S ABOUT SIX MILLION SMALL BUSINESSES OUT THERE THAT HAVE EMPLOYEES AND FOUR MILLION
OF THEM, 2/3RDS OF THEM WILL BE ELIGIBLE. SO IF YOU’RE A SMALL BUSINESS OUT THERE, RIGHT
NOW, IT’S IMPORTANT TO CHECK IT ELIGIBILITY. IF YOU HAVE 50 EMPLOYEES OR FEWER AND YOU
MEET A WAGE GUIDELINE YOU MAY BE ELIGIBLE FOR THIS TAX CREDIT THIS YEAR. — WE’LL GET TO THE VIEWER’S QUESTION IN A
SECOND, IS THERE ANYTHING WE NEED TO KNOW ABOUT CREDITS? — WELL THERE’S ALSO HELP THIS YEAR FOR THOSE
COMPANIES THAT HELPED COVER THE RETIREES. SOMETIME FIST YOU’RE A SMALL BUSINESS ONE
OR TWO RETIREES IN VERY ILL SHAPE CAN TOTALLY BLOW UP YOUR AFFORDABLE INSURANCE RATES, SO
THERE WILL BE A HIGH RISK POOL SET UP AND HELP FOR BUSINESS OWNER WHO IS ARE TRYING
TO DO THE RIGHT THING WHO ARE HELPING TO PAY FOR THE RETIREMENT COVERAGE AND HELP TO LOWER
THOSE EXTRAORDINARY COSTS. — WELL I THINK WE HAVE A LOT OF QUESTIONS
TO TOUCH ON BOTH OF THESE SO LET’S GO TO THEM AND WHAT WE WILL DO IN THE NEXT SEGMENT IS
GO THROUGH SOME OF THE QUESTIONS WE GOT SO YOU KNOW OUT THERE, WE GOT OVER 600 QUESTIONS
FOR THIS WEB CHAT. I’M NOT GOING TO BE MAKING OUR GUESTS COVER
ALL THE QUESTIONS, BUT WE’LL COVER WHAT WE CAN IN THE SHORT TIME WE HAVE.
AND IN THE COMES WEEKS WE WILL INTRODUCE A NEW FEATURE FOR OPEN GOVERNMENT WEEK THAT
ALLOWS YOU THE PUBLIC TO VOTEOT QUESTIONS IN FUTURE WEB CHATS YOU WANT ANSWERED MOST.
SO WE’LL GET MORE INPUT FOR YOU TODAY WE JUST TOOK THE CATEGORIES.
AND EVERY DAY WE’RE GOING TO BE POSTING A NEW QUESTION, FROM THE ONES WE GET IN THE
MAIL BOX, AND YOU CAN CHECK OUT YOUR ANSWER, NEW ANSWER, NEW QUESTION EVERYDAY ON THE WEB
SITE AND ALSO AS I GO THROUGH, AS WE ASK QUESTIONS WE MAY PARAPHRASE THEM SLIGHTLY TO HOW YOU
SENT THEM IN TO SAVE US TIME. SO LET’S START WITH THE QUESTION, OUR FIRST
QUESTION COMES FROM MARIA, AND MARIA SAYS, MY FAMILY AND I ALREADY HAVE HEALTH INSURANCE
THROUGH MY EMPLOYER, HOW IS THIS NEW BILL GOING TO AFFECT ME?
YOU WANT TO TAKE THAT ONE? — WELL, THERE WON’T BE A BIG IMPACT.
THE COVERAGE WILL STAY IN PLACE IN PLACE THROUGH YOUR EMPLOYER, ALL THE PLANS ARE GOING TO
HAVE PREVENTIVE CARE WITH NO CO PAYS. SO AS THE PLAN GETS RENEWED, THAT WILL BE
A CHANGE, THE INSURANCE COMPANIES WILL REDESIGN THE PLAN TO MAKE SURE THAT PREVENTIVE COVERAGE
WILL BE PROVIDED AND HOPEFULLY YOU’LL SEE LESS TAKEN OUT OF YOUR POCKET OVERTIME BECAUSE
WE HOPE THAT COMPREHENSIVE HEALTH REFORM WILL HELP LOWER COST FOR EVERYBODY; TAKE SOME OF
THE ADMINISTRATIVE OVERHEAD OUT OF INSURANCE COST.
IT SHOULD BE A BENEFIT AND STABILIZE THE PLAN YOU HAVE. — AND NORRIS WANTS TO KNOW: — WHEN IS THE PRE EXISTING CONDITION GOING
TO START FOR CHILDREN? FOR ADULTS?
HE HEARD THAT CHILDREN WILL START IN SIX MONTHS; ADULTS IN 2014. IF SO WHY THE
DIFFERENCE? — NORRIS IS PARTIALLY RIGHT.
INSURANCE COMPANIES THIS YEAR, STARTING IN SEPTEMBER WILL HAVE TO INCLUDE CHILDREN WITH
PREEXISTING CONDITIONS ON THEIR PLANS AND ANY CANCER SURVIVOR, ASMATIC WHO MIGHT HAVE
BEEN MEDICALLY WRITTEN OUT OF THE PLAN OR TREATMENTS THAT WERE COVERED, THAT WILL CHANGE
THIS YEAR, FOR ADULT THIS IS YEAR, THERE WILL BE A HIGH RISK POOL.
THERE ARE ADULTS WITH PREEXISTING CONDITION WHO HAVE NO INSURANCE BECAUSE NO ONE WILL
GIVE THEM A QUOTE. SO WE ARE HELPING STATES SET UP POOLS WHERE
THERE WILL BE INSURANCE AVAILABLE IN 2014 WHEN THE BRAND NEW MARKETS EXIST, ALL THE
RESTRICTIONS ARE AT PREEXISTING CONDITIONS WILL CHANGE.
EVERY COMPANY WILL HAVE TO OFFER POLICIES TO EVERYONE WITH A PREEXISTING CONDITION AND
THERE WILL BE A NEW MARKETPLACE WHERE COMPANIES WILL HAVE TO COMPETE FOR YOUR BUSINESS.
SO IT’S HELP IMMEDIATELY FOR KIDS ACROSS THE BOARD, HELP IN A HIGH RISK POOL FOR ADULTS
AND THEN NEW MARKET FOR ADULT WHEN IS WE GET THE EXCHANGES SET UP. — GREAT.
RICHARD HAS A QUESTION THAT I THINK LOOKING AT IT MIGHT BE FOR BOTH OF YOU.
OKAY, RICHARD SAYS THAT THE SUBJECT OF CONGRESSIONAL EXEMPTION TO THE NEW HEALTH CARE REFORM AND
THE HIRING OF 16,500 NEW IRS EMPLOYEES TO ADMINISTER THE HEALTH CARE REFORM ARE HOT
TOPICS AT OUR MORNING COFFEE CLUB. I’VE CHECKED FACT CHECK WHICH DENIES BOTH
OF THESE CLAIMS; HOWEVER, THIS DOESN’T SEEM TO SATISFY SOME MEMBERS.
PLEASE CLARIFY THIS FOR ME. SO MAYBE CAN YOU DO IRS AGENTS AND YOU DO
EXEMPTION OR WHATEVER YOU WANT. — WELL I BELIEVE THAT FACT CHECK IS CORRECT.
THAT THESE ARE NOT NOT THESE IRS AGENT VS NOT BEEN HIRED AND YOU MAY WANT TO
— IT’S NOT ASSUMED THEY WILL BE HIRED. THE EXEMPTIONS ARE BASICALLY AS I UNDERSTAND
IT BEING RUN THROUGH KIND OF EXISTING SYSTEMS SO UNFORTUNATELY OVER THE COURSE OF THIS DEBATE,
LOTS OF INFORMATION PRESENTED AS FACTS AT EVERY STEP ALONGLET WAY SO ONE OF OUR ALONG
THE WAY SO ONE OF OUR JOBS AND IT’S WHY WE’RE HAVING THE WEB CHAT TODAY AND WE’LL CONTINUE
TO DO THAT AND I’M GLAD KAREN MILLS IS HERE TO TALK ABOUT THE BUSINESS PIECE OF THIS IS
TO TELL PEOPLE WHAT ACTUALLY IS IN THE BILL AND WHAT ISN’T IN THE BILL.
SO GLAD YOU ASKED THE QUESTION BUT IT’S NOT TRUE. — GREAT AND THE SAME FOR CONGRESSIONAL EXEMPTION?
I WANT TO HIT THAT TOO. — YES. — SELENA WANTS TO KNOW: I’M GOING TO DIRECT
THIS TO YOU ADMINISTRATOR MILLS, SHE WANTS TO KNOW WHAT THIS MEANS FOR SMALL BUSINESSES? ARE WE GOING TO BE REQUIRED TO PROVIDE HEALTH
INSURANCE FOR EMPLOYEES? — THIS IS FRIGHTENING SMALL BUSINESS OWNERS THERE,
IS NO MANDATE THAT YOU HAVE TO PROVIDE HEALTH INSURANCE.
THE WAY IT WORKS IF YOU HAVE 50 EMPLOYEES OR FEWER, YOU ARE EXEMPT.
THERE’S NO ISSUE AT ALL. IF YOU HAVE 50 OR MORE EMPLOYEES ONE OF YOUR
EMPLOYEES DOES GO IN THE EXCHANGE AS AN INDIVIDUAL BECAUSE YOU DO NOT PROVIDE HEALTH INSURANCE,
THEN YOU ARE REQUIRED TO PAY BACK THE CREDIT, THE GOVERNMENT SUBSIDY THAT THAT PERSON WILL
HAVE USED AS AN INDIVIDUAL AND YOU ARE REQUIRED TO DO THAT ON A NUMBER OF YOUR EMPLOYEES.
NOT ALL 50, BUT THOSE THAT YOU HAVE, I THINK IT’S ABOVE 30.
SO, YOU WILL NEED TO PARTICIPATE. IT TURNS OUT THAT THERE ARE VERY, VERY, FEW
BUSINESSES TO WHICH THIS WILL APPLY. THERE’S ABOUT SIX MILLION SMALL BUSINESSES
AS I SAID EARLIER AND 5.8 MILLION OF THEM ARE BELOW 50 EMPLOYEES.
AND OF THE 200,000 THAT ARE LEFT, MOST OF THEM ACTUALLY PROVIDE HEALTH INSURANCE RIGHT
NOW. SO THIS ISSUE, WHICH WE CALL EMPLOYER RESPONSIBILITY
THAT YOU’RE RESPONSIBILITY TO PAY BACK SOMETHING IF YOU DON’T PROVIDE HEALTH INSURANCE ONLY
WILL APPLY TO 10,000 SMALL BUSINESSES. — I THINK YOU’RE TOUCHING ON THE TOPIC OF
OUR NEXT QUESTION, BUT BECAUSE WE DON’T HAVE THE INFORMATION FROM DAN.
DAN FROM TEXAS SAID: NEVER KNOW WHERE WE FALL IN REGARDS TO SMALL
BUSINESS. CAN YOU GIVE ME DEFINITION?
ANYTHING THAT SMALL BUSINESS OWNERS NEED TO KNOW IN TERMS OF CATEGORIES? — WELL IF YOU’VE DONE ANYTHING WITH THE SMALL
BUSINESS ADMINISTRATION BEFORE, YOU’LL KNOW THAT WE HAVE OTHER DEFINITIONS FOR SMALL BUSINESS,
SO YOU ARE ELIGIBLE FOR OUR LOAN PROGRAMS UP AT DIFFERENT LEVELS, BUT FOR THE PURPOSES
OF THE HEALTHCARE TAX CREDITS, AND THE HEALTHCARE EMPLOYER RESPONSIBILITY COSTS, THE CUT OFF
POINT AT THIS TIME IS 50 AND SO THAT THAT WOULD BE RELEVANT FOR THIS QUESTION. — YES. AND I WISH I KNEW HOW MANY COULD HAVE
HELPS DAN GET A BETTER ANSWER SO WE’LL TRY TO GET MORE DETAILS NEXT TIME.
JEFF WANTS TO KNOW: HOW IS MANDATING EVERYONE IN THE UNITED STATES
TO PURCHASE SOMETHING FROM COMPANIES HELPING OUT THE COUNTRY?
YOU WANT TO TAKE A CRACK AT THAT MADAM SECRETARY? — WELL, CURRENTLY WE HAVE A SYSTEM WHERE
MOST PEOPLE WHO WE’VE TALKED TO AND HAVE CONTACTED ACROSS THE COUNTRY WOULD LIKE TO
HAVE THE SECURITY OF HEALTH INSURANCE. SOME CAN’T AFFORD IT; SOME ARE PUSHED OUT
OF THE MARKET BECAUSE OF THE SICKNESS OR ILLNESS. SO STEP ONE IS TO CHANGE THE RULES, BUT STEP
TWO IS TO REALLY SAY, IF THE SYSTEM IS GOING TO WORK, INSURANCE IS ABOUT BALANCING RISK,
SO WE NEED PEOPLE WHO ARE NOT ONLY SICK TO DRAW BENEFITS BUT ALSO PEOPLE WHO ARE WELL
TO BE IN THE SYSTEM OR YOU DON’T HAVE HEALTH INSURANCE AT ALL AND I THINK PART OF WHAT
THE PRESIDENT HAS SAID IS THERE IS RESPONSIBILITY, ADMINISTRATOR MILLS HAS JUST DEFINED EMPLOYER
RESPONSIBILITY. THERE IS AN INDIVIDUAL RESPONSIBILITY THAT
GETS WAVED IF YOU CANNOT AFFORD STILL INSURANCE COVERAGE.
YOU GET HELP FROM THE GOVERNMENT TO HELP PURCHASE INSURANCE COVERAGE AND IT PROVIDES SOME STABILITY
AND SECURITY RIGHT NOW. WE HAVE PEOPLE WHO FOR INSTANCE DON’T BUY
INSURANCE IF THEY ARE IN A CAR ACCIDENT OR MOTOR CYCLE ACCIDENT, COME THROUGH THE DOORS
OF THE EMERGENCY ROOM AND EVERYBODY, WHETHER THEY BUY FOR INSURANCE OR NOT, PAYS THAT COST.
IT’S ABOUT A THOUSAND DOLLARS ON EVERYBODY’S HEALTH POLICY TO PAY FOR THE PEOPLE WHO DON’T
HAVE COVERAGE. SO RIGHT NOW, A LOT OF FAMILIES AND BUSINESS
OWNERS ARE ACTUALLY PAYING EXTRA NOT ONLY FOR THEMSELVES AND FAMILIES, OR THEIR EMPLOYEES
BUT FOR LOTS OF PEOPLE WHO COULD AFFORD IT BUT HAVE CHOSEN NOT TO GET IT. — WALT HAS ANOTHER QUESTION FROM HEALTH INSURANCE
COMPANIES. WALT’S FROM FLORIDA.
HE SAYS: HEALTH INSURANCE COMPANIES ARE TELLING THE
MEDIA THAT FOLKS CAN EXPECT TO SEE LARGE INCREASES IN INSURANCE PREMIUMS NOW THAT THERE ARE NEW
REGULATIONS ALLOWING FOR GREATER COVERAGE. WE WERE TOLD THAT PREMIUMS WOULD DECREASE.
WHAT IS THE REAL ANSWER? — THE ANSWER IS, FIRST OF ALL, WE’LL HAVE
A MUCH BIGGER POOL, THAT’S GOOD NEWS SO YOU’LL BALANCE SOME OF THE SICKNESS AND THE PEOPLE
WHO DRAW DOWN MORE BENEFITS WITH PEOPLE WHO ARE NOT SO SICK.
IT’S PART OF HAVING A LARGER PURCHASING POOL, BUT SECONDLY, A LOT OF THE UNDERLYING PIECES
OF THE PLAN ARE ACTUALLY ABOUT HEALTH AND WELLNESS.
HAVING HEALTH INSURANCE OFTEN LETS YOU GET INTO THE HEALTH SYSTEM AT A MUCH EARLIER STAGE
SO BEFORE YOU HAVE A CHRONIC DISEASE, BEFORE YOU HAVE AN ILLNESS, BEFORE YOU COME THROUGH
THE DOORS OF AN EMERGENCY ROOM TO ACCESS HEALTH AND WELLNESS, TO KEEP PEOPLE HEALTHIER AT
THE FRONT END WHICH DEFINITELY DOES LOWER COSTS SO I THINK ON BALANCE, YOU KNOW, WHAT
WE HAVE RIGHT NOW, IS MOST PEOPLE GET HEALTHCARE BUT OFTEN THEY GET IT AT THE MOST EXPENSIVE,
LEAST EFFECTIVE TIME. WE WANT TO MAKE SURE THAT WE BEGIN TO SHIFT
THOSE COSTS AROUND AND WE HAVE NOW OVERSIGHT OVER INSURANCE COMPANIES.
INSURANCE COMPANIES, RECENTLY SENT NOTICES OUT, ACROSS THIS COUNTRY THAT THEY WERE RAISING
RATES, 30, 40, 50, 60% AFTER FILING HUGE PROFIT STATEMENTS.
THE NEW LAW SAYS MOST OF THE MONEY THEY TAKE IN THE DOOR HAS TO BE PAID OUT IN HEALTH BENEFITS.
NOT CEO SALARIES, NOT ADVERTIZING COSTS AND WE’LL ACTUALLY BE ABLE TO GET THAT INFORMATION
AND MEASURE THAT MOVING FORWARD. WE’LL ALSO MAKE COMPANIES IN THE NEW MARKET
COMPETE WITH ONE ANOTHER. THEY CAN’T PICK AND CHOOSE THEIR CUSTOMERS
AND THEN IN A MONOPOLY, WHICH WE HAVE NOW IN MANY MARKETS, JUST KEEP RAISING THOSE RATES.
THERE WILL ACTUALLY BE COMPETITION. — THIS HAS BEEN TRUE FOR SMALL BUSINESSES,
THEY HAVE SUFFERED ENORMOUS RATE INCREASES SO AS WE’VE BEEN TRAVELING AROUND THE COUNTRY,
SOMETIMES SMALL BUSINESSES WILL SAY WHAT INCREASE THEY JUST GOT, IT’S ALWAYS DOUBLE DIGIT AND
SOMETIMES IT BEGINS WITH A THREE OR A FIVE OR ONE SMALL BUSINESS, SAID, AS I NINE AND
THEY REALLY HAVE NO OPTIONS, BECAUSE THEY CAN GET VERY FEW QUOTES, SO A SMALL BUSINESS
WILL GO TO A BROKER, MAYBE GET ONE OR TWO QUOTES, VERY, VERY, DIFFICULT FOR THEM TO
GET WHAT THEY’RE GOING TO BE ABLE TO NOW ACCESS IN THE FUTURE WHICH IS AN EXCHANGE, A MARKET
PLACE WHERE THEIR RISK IS POOLED AND THEY HAVE THE LEVERAGE OF WHAT BIG BUSINESSES HAVE.
THIS 18% PREMIUM THEY HAVE NOW, IT’S JUST BECAUSE THEY’RE SMALL AND THEY DON’T HAVE
ENOUGH PEOPLE TO DISPERSE THE RISK. SO WE ARE LOOKING TO SEE COSTS GO DOWN FOR
SMALL BUSINESS AND ACCESS GO UP. AND I THINK THE FIRST ESTIMATES ARE, YOU KNOW AT LEAST
A FEW PERCENT DOWN AS OPPOSE TO HUGE INCREASES THEY’VE BEEN SEEING.
NOW WE’RE TALKING ABOUT MANDATE IN A BIGGER MARKET, ONE GROUP THAT’S TRADITIONALLY UNDERINSURED
OR HAS NOT GOTTEN INSURANCE ARE YOUNGER PEOPLE AND THEY HAVE A QUESTION ABOUT THIS: IS OUR
UNMARRIED DAUGHTER, AGE 21 WHO’S GRADUATING FROM COLLEGE ON MAY EIGHT, 2010 GOING TO BE
COVERED UP TO AGE 26 NOW THAT OBAMA SIGNED THE HEALTHCARE BILL? — WITHIN SIX MONTHS OF THE PRESIDENT’S SIGNATURE,
SO THE 23RD OF MARCH, SO WE’RE TALKING THE 23RD OF SEPTEMBER, POLICIES WILL COVER DEPENDENTS
UP TO THE AGE OF 26, THAT’S VERY GOOD NEWS AND IN MY CASE, OUR TWO SONS, WERE NOT HEADED
INTO JOBS WHERE THEY HAD HEALTH INSURANCE. WE WERE LUKEY BECAUSE THEY’RE BOTH HEALTHY
AND WE WERE ABLE TO HELP THEM OUT, FIND POLICIES THAT WERE RELATIVELY AFFORDABLE, THEY HAD
FRIENDS WHO WEREN’T SO LUCKY. SO, I COUPLE OF FRIENDS DECIDED JUST TO TAKE
A RISK AND IT’S A DANGEROUS PLACE FOR A FAMILY OR YOUNG PERSON TO BE IN WHERE YOU ARE A STEP
AWAY FROM HAVING WHAT COULD BE A LIFETIME OF DEBT.
SO THE GOOD NEWS FOR FAMILIES AGAIN CONGRATULATIONS TO THE ALMOST COLLEGE GRADUATES OUT THERE,
THAT’S GREAT, BUT YOU WON’T HAVE TO LOSE YOUR HEALTH INSURANCE COVERAGE THIS YEAR. — STICKING TO SOUTHWEST, KENNETH HAS A QUESTION.
I WANT TO GIVE THIS TO ADMINISTRATOR MILLS: MY SISTER HAS A BBQ RESTAURANT IN TEXAS.
SHE ONLY HAS 6 EMPLOYEES. DOES THIS NEW HEALTH CARE REFORM BILL REQUIRE
HER TO PROVIDE INSURANCE? SHE CURRENTLY DOESN’T BECAUSE SHE IS IN A
VERY SMALL BUSINESS MARKET AND NEEDS TO KNOW FOR THE FUTURE. — THIS IS EXACTLY WHAT WE WERE TALKING ABOUT
AND IN A BARBEQUE RESTAURANT IN TEXAS, I HOPE SHE HAS PLENTY OF BUSINESS THERE, BUT WITH
SIX EMPLOYEES SHE WILL NOT BE REQUIRED TO BUY HEALTH INSURANCE UNDER THIS NEW REFORM.
SHE WILL HOWEVER HAVE OPPORTUNITY. SHE WILL GET A TAX CREDIT WHICH COULD BE 35%
OF WHAT SHE’S SPENDING AND WHEN THE EXCHANGE IS OPEN, SHE WILL BE ABLE TO GO ON THE EXCHANGE
AND ASSESS, MAYBE THERE’S GOING TO BE GOING TO BE DIFFERENT LEVELS OF POLICIES AVAILABLE
AND HOPEFULLY FIND ONE THAT’S AFFORDABLE. ONE THING WE DO KNOW IS WHEN EMPLOY EMPLOYERS
WANT TO PROVIDE HEALTH INSURANCE, THEY KNOW IT MAKES FOR MORE EMPLOYEES, LONGEVITY THAT
EMPLOYEES WILL STAY WITH THEM AND SMALL BUSINESSES ARE LIKE A FAMILY.
IF SOMEBODY GETS SICK AND THEY DON’T HAVE HEALTH INSURANCE, THERE’S ENORMOUS COST, EMOTIONAL
AND FINANCIAL COST ON THE SMALL BUSINESS AND THE SMALL BUSINESS OWNER. — ALL RIGHT, WE TALKED ABOUT SMALL BUSINESSES;
MELANIE FROM DC WANTS TO TALK ABOUT SELF EMPLOYED. HOW ARE SELF EMPLOYED PEOPLE TREATED UNDER
THE HEALTHCARE BILL. DO THEY QUALIFY FOR SMALL BUSINESS TAX CREDITS
OR INDIVIDUAL TAX CREDITS INSTEAD? — WELL I THINK THAT THEY CERTAINLY WILL BE
ELIGIBLE FOR THE NEW MARKETPLACE, IF THE SELFEMPLOYED PERSON HAS A PREEXISTING CONDITION, THEY CAN
GET IMMEDIATE ASSISTANCE BEFORE THE EXCHANGE IS SET UP.
IF THEY MAKE BELOW A CERTAIN AMOUNT, THEY’LL EVENTUALLY GET A SUBSIDY TO HELP PURCHASE
INSURANCE COVERAGE. IN TERMS OF ELIGIBILITY FOR TAX CREDIT TO
BUY THEIR OWN COVERAGE, I DON’T — THEY’RE GOING TO BE COVERED AS AN INDIVIDUAL.
A FIRM WITH EMPLOYEES, THE BEST WAY FOR THEM IN THIS IS TO BE TREATED AS AN INDIVIDUAL
AND HAVE THE BENEFIT WHICH WILL BE TAX CREDIT AND ACCESSIBILITY TO THESE EXCHANGES AS AN
INDIVIDUAL, GREAT. — WE’RE GOING TO SWITCH OFF THAT TOPIC AND
GO TO PUBLIC HEALTH. ANDREA IS A PUBLIC HEALTH NURSE. — GREAT.
ANYBODY LISTENING OUT THERE ,WE NEED MORE, IT’S A GREAT PROFESSION. — WILL LOCAL HEALTH DEPARTMENTS LOSE FUNDING
AS A RESULT OF THIS REFORM? WHAT WILL PUBLIC HEALTH LOOK LIKE FROM NOW ON? — WELL FIRST OF ALL THERE’S NO LOSS, WE HOPE
IT WILL HELP STABILIZE THE PUBLIC HEALTH AND IT’S SUCH AN IMPORTANT COMPONENT OF, FRANKLY,
HEALTH SECURITY IN THIS COUNTRY, THERE’S A MAJOR INVESTMENT IN COMMUNITY HEALTH CLINICS
WHICH ARE IMPORTANT HEALTHCARE DELIVERY SYSTEMS THAT OFTEN OPERATE IN UNDERSERVED AREAS TO
REACH OUT TO FOLKS AND THAT CONTINUES TO HAVE AN INVESTMENT.
THERE IS A MAJOR INVESTMENT WHICH WAS START IN THE RECOVERY ACT AND CONTINUED HERE IN
HEALTHCARE PROVIDERS, SO, MORE SCHOLARSHIPS AVAILABLE FOR FUTURE DOCTORS, FOR NURSES,
FOR NURSE PRACTITIONERS FOR HEALTH PROFESSIONALS, FOR BEHAVIORIAL HEALTH FOLKS, RECOGNIZING
THAT WE NEED MORE PROVIDERS TO TAKE CARE OF FOLKS IN THE SYSTEM, SO I THINK THERE IS A
SERIES OF AREAS WHERE PUBLIC HEALTH INFRASTRUCTURE IS ACTUALLY STRENGTHENED BY THIS MOVING FORWARD.
AND WE HOPE IN THE LONG RUN THAT THERE WILL BE LESS INAPPROPRIATE DEMAND ON HOSPITAL SYSTEMS
AND MORE PEOPLE WILL HAVE A HEALTH HOME TO BEGIN WITH.
MORE PEOPLE WILL HAVE THE CARE PROVIDERS, THEY WILL ACCESS PRIMARY CARE AND PREVENTIVE
CARE, AGAIN, I THINK SUCH AN IMPORTANT ASPECT OF PUBLIC HEALTH INITIATIVE IS TO KEEP PEOPLE
HEALTHY IN THE FIRST PLACE AND NOT WAIT UNTIL THEY GET SICK. — OKAY, LARRY HAS A QUESTION.
HE’S A SENIOR WHO’S ALREADY IN THE GAP IN MEDICARE PRESCRIPTION DRUG COVERAGE
KNOWN AS THE DONUT HOLE. WILL THE REBATE OF $250 BE SENT TO ME AUTOMATICALLY
OR MUST I APPLY FOR IT AND HOW? — WELL, LARRY, WE’RE DEVELOPING THE SPECIFIC
RULES RIGHT NOW BUT THIS YEAR, THE $250 WILL BE SENT THE QUARTER THAT YOU SORT OF HIT THAT
GAP IN COVERAGE, SO IF I UNDERSTAND IT CORRECTLY, IF YOU’RE ALREADY THERE, AND WE’RE ONLY IN
MARCH, BY JUNE, YOU WILL GET A $250 CHECK BECAUSE THAT WILL BE MEASURED BY OUR MEDICARE
SYSTEM FOR THOSE WHO MAY HIT IT LATER IN THE YEAR, THERE WILL BE ADDITIONAL CHECKS GOING
OUT IN SEPTEMBER THAT WILL TAKE CARE OF THAT AND OVER TIME, THE DONUT HOLE WILL BE COMPLETELY
CLOSED, SO YOU WON’T BE FACING THAT KIND OF GAP ANY LONGER.
NEXT YEAR, ABOUT A 50% DECREASE IN THE GENERIC DRUG COST BEGINS TO TAKE EFFECT AND WE’LL
MOVE ON FROM THERE BUT THE GAP IS CLOSED OVER TIME. — OKAY WE ONLY HAVE TIME FOR A COUPLE MORE
QUESTIONS; I WANT TO GO TO WILLIAM, NEXT. WILLIAM IS WORRIED ABOUT THE FINANCIAL OBLIGATION
THAT THE STATES ARE FEELING. WHAT WILL BE THE FINANCIAL OBLIGATION OF THE
STATES DURING HEALTHCARE REFORM? THIS IS IN RELATION TO HIGHER TAXES FOR ALL IF THE STATES
HAVE TOO MUCH OF A BURDEN. — WELL THAT’S A GOOD QUESTION.
THIS IS ONE OF THE MOST STATE FRIENDLY BILLS COMING OUT OF WASHINGTON IN A LONG TIME AND
THE PRESIDENT UNDERSTANDS THE BURDEN ON STATES RIGHT NOW.
NOTHING IS IMPOSED ON STATES. NO ADDITIONAL COVERAGES IS EXPECTED UNTIL
2014 WHEN THE NEW MARKETPLACE HITS AND AT THAT POINT IT’S 100% PAID FOR BY THE FIRST
THREE YEARS FOR FEDERAL DOLLARS SO WE’RE OUT TO 2017 FOR ANY KIND OF COVERAGE EXPANSION,
EVEN A PORTION OF WHICH WOULD BE PICKED UP BY THE STATE.
OVER THE COURSE OF THE BILL IT’S A SMALL FRACTION, IT’S LESS THAN 10%.
IN THE MEAN TIME STATES ARE SEEING A LOT OF BENEFIT.
THE PRESIDENT IN HIS BUDGET THIS YEAR HAS AN ADDITIONAL 25 BILLION DOLLARS FOR STATES
TO HELP PROVIDE CARE FOR FOLKS WHO ALREADY HAVE IT.
THERE’S ADDITIONAL COVERAGE AND COST FOR CHILDREN’S HEALTH INSURANCE, ADDITIONAL MONEY IN THE
BILL FOR THE DRUG REBATES TO STATES. THERE IS INVESTMENT IN PRIMARY CARE IN COST,
THAT RIGHT NOW STATES PICK UP IN UNCOMPENSATED CARE TO HOSPITALS SO UNBALANCED, WE FEEL STRONGLY
THAT MOST STATES WILL BE WINNERS, AS PART OF THIS PROGRAM, THERE’S MORE INVESTMENTS
IN HEALTH ASPECTS STATES THAN THERE IS REQUIREMENT AND NONE OF THOSE REQUIREMENTS HIT UNTIL WE
ARE WELL DOWN THE ROAD IN TERMS OF THE IMPLEMENTATION IN THIS BILL. — OKAY, I’M GOING TO GIVE ONE MORE QUESTION
AND THEN I’M GOING TO ASK EACH OF YOU FOR A QUICK FINAL THOUGHT AND IT’S FROM OHIO.
HAVE TO GO BACK TO YOUR HOME STATE HERE. CINDY WANTS TO KNOW: WHAT WILL BE THE STATE OF MEDICARE ADVANTAGE
PLANS IN THE HEALTH REFORM LEGISLATION? IF THEY’LL NO LONGER BE AVAILABLE, WHAT, IF
ANYTHING WILL TAKE THEIR PLACE? — WELL FIRST OF ALL, CINDY, AGAIN THIS IS
A POINT OF A LOT OF MISINFORMATION AND I WOULD SUGGEST INTENTIONAL MISINFORMATION.
NOTHING DOES AWAY WITH MEDICARE ADVANTAGE PLAN.
WE ANTICIPATE THIS WILL BE A VERY VIBRANT MARKETPLACE AND COMPANIES MOVE IN AND OUT
OF THAT MARKETPLACE, AND HAVE FOR YEARS BUT WE THINK THAT THEY WILL STILL VERY MUCH BE
AVAILABLE. WHAT’S GOING TO STOP OVER TIME AND GRADUALLY
PHASE OUT IS THE OVERPAYMENT TO INSURANCE COMPANIES FOR MEDICARE ADVANTAGE PLANS, AND
FRANKLY IS PAID FOR BY THE SENIORS IN MEDICARE, COMPANIES PROVIDING MEDICARE PLANS ARE CHOSEN
ONLY BY ONE IN FIVE SENIORS, EVERYBODY PAYS A HIGHER COST AND THEY DON’T DELIVER HIGHER
HEALTH BENEFITS. SO OVERTIME, CONGRESS HAS SAID WE NEED TO DECREASE THE OVER SPENDING
BUT MEDICARE ADVANTAGE PLANS WILL BE AVAILABLE AS A CHOICE WHO DON’T WANT TO TRADITIONAL
MEDICARE SERVICES. — OKAY, WE HAVE 30 SECONDS LEFT FOR EACH
OF YOU. ANYTHING FINALLY THAT YOU WANT SMALL BUSINESS
OWNERS TO KNOW TONIGHT OR PEOPLE FROM YOUR HOME STATE OF MAINE I THINK YOU’RE GOING THERE
TOMORROW. — I WILL BE THERE TOMORROW WITH THE PRESIDENT.
HE’S GOING TO TALK ABOUT THE HEALTHCARE IN THE STATE OF MAINE AND WE ARE PRETTY MUCH
A STATE OF SMALL BUSINESSES SO WE’RE LOOKING FORWARD TO IT.
THIS IS A VERY CRITICAL BILL FOR SMALL BUSINESSES. IT ADDRESSES THE NUMBER ONE CONCERN AND AS
THE SECRETARY SAID, WE NEED TO MAKE SURE THAT SMALL BUSINESSES UNDERSTAND WHAT THIS IS GOING
TO DO FOR THE COST RIGHT NOW. YOU COULD BE ELIGIBLE FOR A TAX CREDIT IF
YOU’RE UNDER 50 PEOPLE AND YOU ALREADY PROVIDE HEALTHCARE SO KEEP AN EYE OUT FOR THAT YOU
CAN COME TO OUR WEB SITE AND I KNOW THERE’S A NUMBER OF OTHER INFORMATION WEB SITES AND
WE CAN MAKE SURE THAT IF YOU’RE ELIGIBLE YOU CAN GET THE CREDIT. — GREAT, ANYTHING ELSE FROM YOU SECRETARY? — WELL, WE WILL BE TRYING TO GET THE INFORMATION
AS QUICK AS POSSIBLE. THE STEPS OF THIS BILL ARE FIRST, TO GET THE
BENEFITS FOR 2010 AND TO MAKE SURE THAT THE AMERICANS KNOW THEY’RE COMING STARTING WITH
THE SMALL BUSINESS TAX CREDIT WHICH IS A GREAT BENEFIT AND I THINK THAT THIS IS NO QUESTION
THAT IT WILL HAVE A VERY POSITIVE IMPACT ON FAMILIES ON BUSINESS OWNERS ON SENIORS BENEFITS
THAT WE HOPE WILL KEEP PEOPLE HEALTHIER AND KEEP OUR NATION MORE PROSPEROUS. — WELL THAT’S ALL THE TIME WE HAVE TODAY.
I WANT TO THANK YOU BOTH FOR JOINING US. KATHLEEN SEBELIUS, SECRETARY OF THE U.S. DEPARTMENT
OF HEALTH AND HUMAN SERVICES AND KAREN MILLS, ADMINISTRATOR FOR THE U.S. SMALL BUSINESS
ADMINISTRATION. WE HOPE YOU GOT SOME GOOD INFORMATION FROM
THE WEBCAST AND WE WILL MAKE IT AVAILABLE ON DEMAND SHORTLY AND SOON IT WILL BE AVAILABLE
AS AN ARCHIVED WEBCAST AT OUR WEBSITE AT: WWW.HEALTHREFORM.GOV WEEP KEEP ALL OUR ARCHIVED VIDEOS.
THERE. WE HOPE YOU’LL BROWSE THE SITE AND FIND EVERYTHING
YOU NEED. I’M JENNY BECKUS, AND WE’LL SEE YOU NEXT TIME.
THANK YOU!

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