from staff
Randy Kammer, vice president of regulatory affairs and public policy for Jacksonville-based Blue Cross and Blue Shield of Florida, has been reading, reviewing and explaining the almost 2,500-page Patient Protection and Affordable Care Act, known as the health care reform bill, signed into law a year ago by President Barack Obama. The law is being challenged in courts.
How many times have you read the health care reform bill?
When this bill was first released, I read several sections five to 10 times. I must admit that for sections that did not apply to our business, I merely skimmed them. I have gone back to the bill, many times, for specific questions and issues.
How many public presentations have you made regarding the bill?
On the day after its release, I made four presentations for the employees of the company. It is estimated that more than 1,200 employees attended those presentations. A videotape was made for employees who were unable to attend. Also, videotapes were made for use in our Florida Blue Centers. Since that time, I have probably made close to 100 presentations regarding the bill.
What’s the biggest misunderstanding of it?
I would say that there are two major misunderstandings. First, most people do not understand that the guarantee issue positions of the bill (intended to provide universal coverage) do not go into effect until 2014 and are not “free.” The other misconception is that the health insurance “reforms” can succeed without a mandate or incentive. Unless healthy people buy coverage, requiring insurers to cover all may result in only unhealthy people purchasing coverage and private health insurance will be even more
unaffordable and unsustainable.
Any major surprises in it that we don’t know a lot about?
I think there are several surprises in the bill. Most people don’t realize that insurance companies and pharmacy companies face a significant surcharge beginning in 2014. Insurers will have to pay an additional $8 billion, nationwide, for the cost of implementation. Issues regarding coverage for children have been inaccurately characterized publicly. The bill requires payment for pre-existing conditions, however, the interpreting regulations went beyond that, requiring that all children who apply be accepted regardless of medical condition.
What’s next with it? How many pages will the interpretations be?
Since passage, there have been regulations and guidance to interpret the bill ranging from interim final regulations and guidance to notices of proposed remaking. Many people estimate that there may be up to 100,000 pages of additional regulations and guidance. Of course, all of this is contingent on any decision of the U.S. Supreme Court regarding the validity of the mandate and the rest of the law.