Presidents Of All Stripes Pushed Health Reform

As President’s Day comes and goes, it’s important to look back on why so many presidents from both parties have pushed to reform health care – and how all of those efforts led to the reform law that was passed nearly two years ago.

The Republican presidents who have pushed reform include Theodore Roosevelt and Richard Nixon. More recently, former Governor (and current presidential candidate) Mitt Romney passed his own plan in Massachusetts. The Democratic presidents who have pushed reform include Franklin Roosevelt, Harry Truman, Bill Clinton, and most recently, Barack Obama.

They have pushed health reform for different reasons. Of course, the fact that many of our friends and neighbors would not be able to get appropriate medical treatment has always been a great concern. Another is a matter of simple economics. As health care costs have increased faster than the rates of inflation for many other services and products, presidents have sought to find a way to keep such costs from spiraling out of control.

For instance, right now 75 percent of health care costs and 7 in 10 American deaths come from chronic diseases such as Type 2 diabetes, cancer, and heart disease. Yet these diseases are often preventable. That is the big reason that the health reform law – officially called the Affordable Care Act (ACA) – requires Medicare and private insurance to cover many preventive services with no co-pay or deductible attached. Investing some money upfront ultimately saves money and lives because you’re catching things when they’re easier and less expensive to treat.

While many different ways of doing reform were talked about over the years and some proposed doing a single payer “Medicare for All”-type plan, ultimately Congress and the President decided to do a private insurance-based reform plan when they passed health reform in 2010. This means that rather than replace private, employer-based insurance with a plan like Medicare, the law instead keeps private insurance but places tighter rules on insurance companies in order to protect patients.

These protections include things like eliminating lifetime limits, phasing out annual limits, allowing parents to keep their young adult children on their insurance until age 26, and making sure that insurance companies can’t discriminate against kids with pre-existing conditions or disabilities (this will apply to adults in 2014). It also dedicates money through tax credits to help people pay for their insurance if they meet certain income criteria. Small businesses that provide insurance can also get credits of up to 35 percent now and up to 50 percent starting in 2014.

For those who can’t get insurance through an employer, health reform is creating what is called an “exchange.” This is a marketplace of private insurance plans that will be created by 2014 in each state, including ours, and Members of Congress will be required to get their insurance from it. Small businesses and individuals will be able to go on a website, similar to reserving a hotel or airplane ticket, and compare private insurance plans in an “apples to apples” fashion. By having folks be able to compare plans and prices so easily, insurance companies will have to keep premiums competitive.

Health care has become increasingly complex over the past century and that’s why so many presidents have tried to tackle it. I hope the information in this column helps break down what has been done in the health reform law to make insurance companies more responsive to us.

Doug Hill lives in central Wisconsin and is director of Know Your Care Wisconsin, a non-partisan education group focused on informing citizens about the Affordable Care Act. For more on the health reform law, visit www.knowyourcare.org or www.healthcare.gov.