On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act, followed by the Health Care and Education Reconciliation Act of 2010 on March 30. Both laws, and the numerous health care reform provisions they contain, will take effect in stages over the next four years to accomplish such key goals as expanding eligibility for Medicaid, establishing health insurance exchanges, subsidizing premiums, and prohibiting the denial of coverage based on pre-existing conditions.
Dubbed "ObamaCare" by the press and critics, the reforms are currently progressing through the establishment of high risk insurance pools managed by the states to provide coverage for citizens with pre-existing conditions. (This arrangement will remain in place until 2014.) Additionally, the government is attempting to work with the insurance industry to put in place voluntary compliance with key reform provisions before they actually become law.
Multiple states are now working on getting their high risk pools in operation. The premium rates for the pools will be tied to the cost of insurance in each state, therefore prices will vary widely by location, from as low as $140 to as much as $900 per month. The average cost to consumers will be $400 to $600 a month.
With medical debt the cause of more than 60 percent of bankruptcies in the United States each year, even the financial hardship of the high premium costs under this program will, for many Americans, represent significant relief from the medical expenses they have been carrying alone.
Experts estimate that at any one time, 200,000 to 750,000 Americans will be enrolled in the high-risk pool program, which is funded by a $5 billion allocation of monies.
In addition to these efforts, Kathleen Sibelius, Secretary of Health and Human Services, has undertaken an effort to gain the cooperation of insurance companies and employees to embrace elements of the new health care law before they are actually enacted later in 2010 or early in 2011.
For instance, more than 65 insurers have agreed to allow young adult children to remain on their parents' policies up to the age of 26 for no additional cost or only a minimal fee. However, since most of the policies involved are an aspect of job benefits, employers will have to agree to participate in the extension.
Speaking at a news conference the week of May 24, Sibelius said, "We are reaching out to large employer groups, asking them to open their plans earlier than mandated and make this coverage available. This is likely to be an overwhelmingly healthy group of individuals," keeping the costs incurred at a minimum.
Over the next two years, as the full scope of health reform falls into place, the Obama administration fears that insurers, in reaction to regulatory changes that will negatively affect their bottom line, will raise premium payments and price more people about of coverage. "The worse of all worlds," said Sibelius, "is to have more Americans driven out of the market in the next couple of years" before the law's major elements take effect in 2014.