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Obama Has Signed the Bill. Now What?

March 23, 2010

Many of you are furious, frightened, or even frenzied over the new heath care bill signed into law by President Obama today. But with the bill at over 2000 pages in length, you might be asking yourself: just what the heck is going to happen now?

The Times, despite its usual liberal streak, has a semi-useful post on the near effects of the new law:

Most of the major provisions in the health care legislation do not take effect for months, if not years.

Even some popular changes that Democrats are promoting as “immediate benefits,” like  allowing adult dependent children to remain on their parents’ insurance policies, do not actually take effect for six months.

But when President Obama signed the Senate bill into law at the White House on Tuesday morning, some provisions took effect immediately.

For example, states will be required to maintain their existing Medicaid and children’s health insurance coverage based on policies currently in effect. While states can expand their programs, they are not allowed to cut back on eligibility and are not allowed to put in place any paperwork requirements that would make it harder for people to sign up for coverage, according to Jocelyn A. Guyer, co-executive director of the Center for Children and Families at Georgetown University.

The provision could prove crucial given that states are facing big budget shortfalls because of the recession. Arizona, for instance, dropped its children’s health insurance program last week in a budget bill signed by Gov. Jan Brewer, a Republican, a move that will leave 47,000 low-income children uninsured.

States had already been banned from tightening Medicaid eligibility through the end of the year as a condition of new federal aid provided in last year’s economic stimulus program. But as a result of the signing of the Senate health care bill today, states will have to maintain their Medicaid and children’s health insurance rules until new state-based insurance exchanges are up and running in 2014.

Given that the Senate bill is more than 2,400 pages long, it is not easy to pinpoint the effective date for every provision. But there are other provisions that seem to go into effect immediately, or at least as quickly as officials can implement.

For instance, “freestanding birth centers” are now eligible for Medicaid payments.

Another provision that appears to take effect right away is an expansion of Medicare to cover certain victims of “environmental health hazards,” which was aimed specifically at the town of Libby, Mont.

As Robert Pear reported in the Times in December, the beneficiaries are people who were exposed to asbestos from a vermiculite mine. The provision was inserted by Senator Max Baucus, Democrat of Montana and a lead author of the Senate health care measure.

Another provision that takes effect immediately is a requirement that the secretary of health and human services establish criteria “for determining whether health insurance issuers and employment-based health plans have discouraged an individual from remaining enrolled in prior coverage based on that individual’s health status.”

Other provisions will kick in shortly. For example, a provision on “transparency in government” requires the secretary of health and human services to post on the Internet within 30 days “a list of the authorities provided to the secretary under this act.”

Another provision requires that within 60 days the secretary “develop a standardized format to be used for the presentation of information relating to coverage” — so that consumers have a more understandable way of comparing health benefits — like medical, surgical, hospital and prescription drug coverage — offered by private insurers.

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What about the bill are you concerned about? Share your thoughts with us below!

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One Comment
  1. Matthew Ryan permalink
    March 25, 2010 11:24 pm

    I heard someone saying how what is going on now really resembles the climate in the nation just before JFK was assassinated. JFK’s death, while unrelated, basically slowed down the hysteria in the country. You had the birth of the John Birch Society in 1958, and a vicious right wing movement gaining ground, who saw JFK as an illegitimate president. Sound familiar? I am really afraid something really horrible is going to happen as a result of all this. Democrats receiving death threats after voting for healthcare reform‎ is unnerving. Bricks through windows and racial slurs?! That is not democracy – that is ignorance. Now you have the conservatives, the crazy right-wing people, the religious right and the conspiracy theorists all coming together against one common enemy. I am scared for the future of this country. God Bless America. We need to stick together as a nation.

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