President Obama campaigned on reforming health care, and true to his word, he is hard at work trying to get it accomplished. But how will people with developmental disabilities fare in this health care reform? First, you must realize that President Obama is not creating the health care plan. Instead he gave Congress three principles and told them to come up with a plan that meets them. He said that the plan must reduce costs, guarantee every American can choose their own plan (including a public option) and ensure quality and affordable health care.
Currently there are three very similar health care bills being worked on in various House committees, but the thought is that the “Affordable Health Choices Act” that just passed out of the Senate Health Education Labor and Pensions (HELP) Committee could be the bill that becomes the final plan. (See a mark-up of the bill at http://help.senate.gov/) It appears the bill will help to standardize the benefits and limit costs as well as giving insurance companies some operative guidelines, such as not excluding pre-existing conditions. This is a great aspect for people with life-long disabilities. It should also help bring down co-pays and deductibles.
From what I am reading, it looks like the Community Choice Act (the long term care bill) will not be included in the final health care plan because of the cost. Mental health parity does seem to be included in the plan though, which means mental health treatments will be covered equal to physical treatments. Medicaid will remain an option for those who qualify.
Section 323 of the bill requires that within 9 months of the bill’s passage, standards will be set with technical criteria for medical diagnostic equipment and dental exams and procedures so that equipment is accessible to and usable by people with disabilities, allowing independent entry and exit as much as possible.
There will be grants to establish community health teams to support a medical home model, something our state has already been implementing. Grants are also provided for family caregiver training to support individuals with disabilities, dental programs targeting people with disabilities as well as developing training curricula for use in health professions, schools and continuing education programs that include working with individuals with disabilities.
Another large concern for families with autism is whether the plan will stop autism insurance discrimination. Some states have already passed bills to fix this problem, but it needs to be included in the national health care reform bill. It was not included in the Senate bill, although the House has been addressing it in their versions. Autism Speaks has rallied a national campaign on this issue.
There have been a lot of fears expressed about the public option that is being discussed, that it would be a centralized, government controlled plan. In reality, it would be a network of choices that are cheaper because more people are enrolled in them. The more people in a group, the more the costs of those who may need high cost care is spread out. For example, if one person requires $1,000,000 in care, his individual insurance would have to cover all $1,000,000. If one million people are in the same plan, that person’s costs could be covered by $1 from each person. This is an advantage to individuals with disabilities that can be fairly expensive to treat, as they are then not shouldering all the cost or being shut out because they are high risk.
It is hard to say exactly what the final plan will look like, as it appears that Congress will not decide anything until at least next fall. Hopefully this explains some of what is being considered. Please let us know if you see other advantages or problems for individuals with developmental disabilities in the health care plans being considered by leaving your input in the comments section of this blog entry.
Stay healthy-
Diana Stadden
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