Congress passes health system reform

After more than a year of contentious debate, President Barack Obama has signed into law a health system reform bill that would extend insurance coverage to 32 million uninsured Americans. On Sunday, March 21, the U.S. House of Representatives voted in favor of the Patient Protection and Affordable Care Act, which the U.S. Senate passed in December 2009. The House and Senate are now hammering out differences in a reconciliation bill, which should be passed before their spring recess.

The legislation contains many beneficial provisions for family physicians and their patients, including a 10-percent bonus payment for primary care services in Medicare, increasing Medicaid payment for primary care to Medicare levels, promoting preventive and primary care, initiating pilot projects to evaluate new patient-centered health care payment models, and protecting Texas’ hard-fought tort reforms. The reform package also removes the pitfalls of the individual insurance market, stops many of the abusive tactics of insurers, and protects Americans from medical bankruptcy by requiring the private insurance market to offer affordable policies to everyone.

But as many TAFP members and leaders have pointed out, the bill is far from perfect. For starters, it does not include important provisions AAFP fought diligently for, such as a permanent solution to the Medicare SGR and responsible medical liability reform that would reduce the practice of defensive medicine.

Much misinformation and anxiety continue to pervade the national dialogue about the reform package. In a recent statement, TAFP President Kaparaboyna Ashok Kumar, M.D., called the bill’s passage a necessary first step in what will be a long journey of health system reform. “The problems plaguing our health care system did not occur overnight, and no single bill is going to solve them all.” He noted that since the reforms will unfold over a number of years, the nation will have ample time to deal with unintended consequences, and that physicians must unite to make sure the implementation of reforms at the state and regulatory level promotes a more efficient, high-quality, patient-centered health care system for America.

To help you understand better some of the questions around the bill, we’ve collected a few recent news articles listed below.

What’s in the bill?

• An Associated Press story from March 24, 2010, lists features of the reform package including reconciliation changes.
• An AAFP News Now article from March 21, 2010, describes provisions of reform from a family medicine perspective.

How will health care reform affect Texas?

• The Texas Tribune examines the question in a March 23 article.
• The Dallas Morning News, March 23, 2010, publishes interesting insight into the differences in projected costs.

When will the various provisions be implemented?

Here is a timeline of health reform implementation TAFP News acquired that was prepared by the staff of the speaker of the House of Representatives.

In addition, the Society of Teachers of Family Medicine published a chart summarizing major consumer and primary care provisions in the health care legislation, including when each measure goes into effect. Download the Excel chart here.

What is TAFP’s position on reform?

TAFP has long contended that our health care delivery system is broken, and must be fixed for the good of all Americans, for the physicians who care for them, and for the state and national economies. In his statement released after the passage of the Patient Protection and Affordable Care Act, TAFP President Kumar called this legislation an initial step in what will be a long journey toward reshaping the U.S. health care system into one that is sustainable, that is based on primary care, and that succeeds in delivering appropriate, high-quality care at the right time, in the right place, at the right cost.

“The hard part is ahead of us, as the success of this legislation will depend on implementation at the regulatory and state level. There will undoubtedly be changes to the legislation over the coming years, and we'll learn from trial and error. The reforms will roll out slowly; many won’t take effect for years, and Congress will have every opportunity to shape them as their consequences are revealed.”

What is AAFP’s position on reform?

AAFP President Lori Heim, M.D., released this statement upon passage of the bill.

To help members better understand the new legislation’s impact on family physicians, AAFP has released an informational PDF, "2010 Health Care Reform and the AAFP."

AAFP has also launched a special section of their website dedicated to health reform. The Health Care Reform 2010 website will be continually updated with information on reform measures and its effects on primary care physicians, the practice of medicine, payment, small-business owners, academic family physicians, and patients.