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I just finished reading the Kaiser Family Foundation's summary of the health care reform (Patient Protection and Affordable Care Act), and I discovered a few very interesting things that I heard nothing of during the health care debate or even afterwards. (They may have been mentioned during the 7 hour health care summit, but who watched that?). So I jotted down the six most interesting things in the ACA that I hadn't heard of before, plus 1 that I had (but I only saw one reference to after passage). Text quoted from the KFF summary is in quotes.

  1. Multi-State Plans
    • "Require the Office of Personnel Management to contract with insurers to offer at least two multi-state plans in each Exchange. At least one plan must be offered by a non-profit entity"

  2. Health Care Choice Compacts
    • "Permit states to form health care choice compacts and allow insurers to sell policies in any state participating in the compact."
    • Compacts may not start until Jan 1, 2016.

  3. State Demonstration Programs To Evaluate Alternatives To Current Medical Tort Litigation
    • "Award five-year demonstration grants to states to develop, implement, and evaluate alternatives to current tort litigations."
    • Starts in 2011, 5 year grant

  4. Grants For Small Businesses To Provide Comprehensive Workplace Wellness Programs
    • "Provide grants for up to five years to small employers that establish wellness programs."
    • Starts in 2011, 5 year grant

  5. Nutrition Labeling Of Standard Menu Items At Chain Restaurants
    • "Require chain restaurants and food sold from vending machines to disclose the nutritional content of each item."
    • Go into effect 1 year after enactment

  6. Nursing Home Transparency and Improvement: Required Disclosure Of Ownership And Additional Disclosable Parties Information
    • "Require skilled nursing facilities under Medicare and nursing facilities under Medicaid to disclose information regarding ownership, accountability requirements, and expenditures."

  7. Increasing the Supply of the Health Care Workforce
    • Involves loan programs, recruitment and retention programs

The interesting this is that a couple of these are either almost what the republicans really wanted or attack problems they brought up: the health care choice compacts allow the selling of insurance across state lines, and the programs to find alternatives to tort litigations should reduce the tort litigation problem. The key difference is that the health care choice compacts respect state rights, and the programs to find alternatives to tort litigation attempt to attack the root problem (malpractice) instead of stripping consumer rights.

On the other side, the Multi-State Plan thing looks strikingly like an "almost" Public Option - it requires every exchange to have a multi-state plan offered by a non-profit entity. This seems to be an attempt to force the availability of non-profit driven insurance, but larger than just at the state level (which public-option supporters argued was too weak). Liberals may complain about the lack of public option, but this is pretty darn close.

As for the other items, I was pleased to see the rules for better information and transparency (nutritional labeling, nursing home transparency). Also, one problematic area I saw circulating after passage was the problem of people getting more care and thus requiring more doctors; this bill attacks that directly with a lot of programs to increase the number of health care professionals.

Overall the bill seemed pretty thorough in trying to provide solutions or means to explore solutions for many aspects of the health care system. It was a nice mix of attacking issues that Republicans wanted solved, but also adding strong consumer protections by means of both regulations and greater information availability. Of course it has the well-known components of trying to reign in insurance company abuses while also trying to attack cost problems. We pretty much threw everything plus the kitchen sink and the pipes in the walls at this problem.

Originally posted to alkaline9 on Tue Apr 13, 2010 at 04:13 PM PDT.

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