The Health Care Reform Bill Passed ... Now What?

The House of Representatives finally passed the controversial health care reform bill Sunday night in a 219-to-212 vote.

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The House of Representatives finally passed the controversial health care reform bill Sunday night in a 219-to-212 vote. The bill is a landmark change to the current health care structure in the US and will change the way everyone from individuals to small businesses and enterprise-sized companies must obtain health care. As everyone tries to make sense of the complicated details of the plan, the biggest question resonating is, "What exactly is going to happen, and when?"

According to the Christian Science Monitor, one of the positives about the new health care bill is that it makes the order of changes very clear, even revealing specific details about small business and family coverage. Under the new system:
- Insurance companies won't be allowed to put lifetime caps on the amount of money that can be paid out and will have new guidelines to follow with annual caps.
- Insurance companies won't be able to pull coverage unless a person commits fraud.
- Children will not be uninsurable because of pre-existing conditions, and they will be able to stay on their parents' policies until they reach 26.
- In a small business "bonus" move, small businesses offering coverage to employees will be able to collect tax credits of as much as 50% of premium costs.
- Senior citizens who don't fall into the prime coverage category will get $250 to help pay bills as part of the Medicare Part D prescription drug coverage plan.
- Those with pre-existing health conditions will be eligible for a new, temporary national high-risk insurance plan.

Future changes that will take effect in 2014 include:

- Most U.S. residents will be required by law to get health insurance or be fined.
- Subsidies will be available to make policy purchase affordable for everyone that has previously struggled to get health care and has likely gone without.
- "Exchanges" that connect individuals and small businesses to health insurance will open.
- The most popular piece of the health care reform bill -- its ban on denying insurance coverage due to pre-existing health conditions -- will spring into action.

Despite the landmark movements of the past few months, Fox News reports that in the day before President Obama is set to sign the bill, state lawmakers and attorneys general are already gearing up for a full-scale battle against it, proving that the health care reform war has simply switched venues and will continue to be an issue in the coming years before its full implementation.

On Monday morning, Virginia Attorney General Ken Cuccinelli announced he would file a legal challenge the second Obama's ink hit the paper; Florida Attorney General Bill McCollum also stated that he and prosecutors from nine other states will file a lawsuit to "protect the right" of the American people from the negative impact of the bill. As he said late Sunday, "If the president signs this bill into law, we will file a lawsuit to protect the rights and interests of American citizens."

All totaled, Attorneys General in 12 states are arming themselves with information that supports the unconstitutionality of the health care reform bill and more could follow, working their way up to the U.S. Supreme Court. Those opposing Attorneys General hail from Florida, Virginia, Texas, Alabama, Nebraska, Oklahoma, Pennsylvania, Washington, Utah, South Carolina, North Dakota and South Dakota.

Small business expert and Aol contributor Steve Strauss agrees that the recently passed health care plan is not ideal, but that what currently exists in the U.S. is much worse. He cites statistics that particularly point to the new plan being smart for small businesses and entrepreneurs: 49% of businesses with 3-9 employees -- which describes a majority of small businesses -- offered any kind of health insurance to their employees in 2008, which is almost 10% less than 10 years ago; 29% of employees at businesses with less than 25 employees were uninsured in 2007. Strauss thus sees that recent developments in affordable health insurance are a huge factor for a previously under-represented segment of the population.

Still, Strauss does agree with many naysayers that health care changes will likely not have much effect on small business overall. Those with fewer than 50 employees will not be forced to get coverage, even though they may anyway, simply because it provides a more affordable option than is currently available and is wrapped up in many incentives.

As a side effect, Strauss also sees the new bill as a potential boost for small businesses trying to grow; employees will feel compelled to change jobs and link up with smaller firms because these firms would have health coverage, or the individuals would be able to get affordable coverage themselves through "exchanges." It could also encourage many entrepreneurs to go out on their own and capitalize on new, creative business ideas. Employees staying at dissatisfying jobs simply for the benefit of health insurance will dissipate.

Tom Galluci of Lazard Capital sees both confusion and the continuation of debate to be a natural part of the process of bill passage. He says, "The long period of time between the passage and implementation of the bill inherently lends itself to some level of uncertainty. The debate around health care will persist even after this legislation is behind us ... Depending on how the political winds blow for the next two years and whether government budget deficits grow or narrow, changes to the legislation are possible." Basically, the effects of specific bills are always hard to predict, so long-term analysis at this stage will not necessarily be fruitful or accurate; those opposing the bill before it takes true shape could be on shaky ground.

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