As we look at the 2012 election in the rear view mirror, the nation’s attention now turns to the impact of the re-election of President Obama and the partisan leadership in the Congress. Last week, Americans kept in place a Democratic majority in the Senate as well as a Republican majority in the House of Representatives.
Essentially, the same partisan national leadership structure that existed prior to the election.
What will the election mean to our health care? It creates both certainty and uncertainty.
It seems certain that federal health care reform, the Affordable Care Act, will be implemented largely as promised. The so-called “Obamacare” has now survived both a significant legal challenge as well as a serious political challenge. The US Supreme Court’s ruling that the law is constitutional, and the re-election of the President, mean that the federal law will go into effect.
Most of the really big changes—including health-insurance exchanges and tax credits to help people buy coverage—won’t come into play until 2014. Still, the provisions going into effect in 2013, along with those that have already been introduced, can affect any changes consumers might want to make to their health coverage.
For example, the health-care law requires plans to provide easy-to-understand health insurance information. The summary is meant to be a simple, easy-to-read description of how a plan works, what it covers and doesn't cover—there is no fine print allowed. Every health plan must have one, allowing consumers to compare two different plans side by side.
These changes, and others, coupled with reforms already in effect (like dependent coverage which allows many adult children up to age 26 to remain on their parents' policies and the removal of limits on how much insurers will pay for care) will continue.
And states have to begin to build their health care marketplaces – known as health exchanges – places in where consumers can obtain their health insurance, if they can’t get it at work or through government programs (like Medicare).
But there will be uncertainty as well. The nation is heading for the so-called “fiscal cliff.” The fiscal cliff is the combination of expiring tax cuts and mandated $1.2 trillion cuts over ten years in federal spending – half from discretionary domestic spending and half from the militay.
In addition, tax cuts – largely enacted during the Bush years, but also including some passed during the Obama Administration – are set to expire, resulting in across the board tax hikes for all Americans.
Putting aside the issue of whether the reduction in the national debt is worth the trade-off of an economic contraction that would likely result from falling off the fiscal cliff, the deep cuts in the nation’s domestic spending would have a profound effect on the health care system.
The automatic cuts total around $110 billion for next year – $55 billion come from defense, $38 billion from non-defense spending and the rest from mandatory and Medicare provider cuts.
The public should know of the impact of these cuts. According to a September 2012 report issued by the White House, important programs are on the chopping block:
· Investment in cancer research. With domestic programs facing unprecedented cuts, lawmakers may consider cuts to funding for cancer research and prevention programs at the National Institutes of Health, National Cancer Institute and Centers for Disease Control and Prevention. The National Institutes of Health, which spends more than 80 percent of its research dollars in communities nationwide, is facing an estimated $2.5 billion cut in 2013. Cancer research could be cut by $400 million or more.
· Programs to prevent disease. Women’s access to breast and cervical cancer screening would also be hindered if mandatory budget cuts take effect. For example, the Centers for Disease Control and Prevention would take an 8.2 percent cut on Jan. 1. If the National Breast and Cervical Cancer Early Detection Program took a comparable cut, nearly 50,000 fewer low-income, uninsured and underinsured women would be screened for cancer next year.
The certainty of health care reform will pick up speed as its implementation moves forward. The uncertainty of the fiscal cliff will resolve itself soon – the certainty of how that plays out will be clear by early 2013.
Blair Horner is the Vice President for Advocacy for the American Cancer Society, Eastern Division. His commentary does not necessarily reflect the views of the American Cancer Society.
The views expressed by commentators are solely those of the authors. They do not reflect the views of this station or its management.