Times Union – Albany, New York
Panel: Lots to learn about health reform
Experts say more people will receive care, but cost controls seem elusive
If it's any indication of the complexity of the health reform law passed by Congress, three expert panelists tapped to explain its implications in New York admitted there was much they didn't know and plenty that nobody knows.
The Rockefeller Institute of Government hosted a forum Tuesday called "How will New York Implement Health Reform." Overall, the three panelists agreed that reform provides an opportunity improve health care and insure more people, but said the reform law did not do enough to contain rising health costs and said many people will remain uninsured.
"There will still be many people left behind," said Dr. James Knickman, president of the New York State Health Foundation.
The reform law requires Americans to buy health insurance or pay a penalty. For residents who cannot afford insurance, the reform legislation expands free public plans like Medicaid to more people and will offer subsidies for private plans on health insurance exchanges.
Knickman estimated only 100,000 more New Yorkers will qualify for expanded Medicaid -- a small number because the state already eased income requirements for the plan, which insures the poor and disabled.
Nearly 1 million state residents will be eligible for subsidized plans on the insurance exchange, Knickman said. The plans will most likely provide only basic coverage and lack the rich benefits the state requires employer-based commercial health plans to offer, he said.
Knickman said he believes about 1.1 million more residents will be covered by insurance, leaving more than 1 million without coverage. The uninsured pool includes 400,000 illegal immigrants, thousands of people eligible for Medicaid who do not enroll, and people who refuse insurance and pay the penalty.
Robert Doar, commissioner of the New York City's Human Resources Administration, warned that the state's decentralized system for public health programs could make implementing reform more difficult.
New York City and counties enroll Medicaid participants and each region sets requirements. He asked if the system will continue, whether local administrations will take on the health care exchanges and who will design the rules, regulations and eligibility guidelines.
"We need a lead state agency," Doar said.
Congress proposed a four-year period to phase in national health reform, but did not set aside money for implementation, the speakers said.
Assemblyman Joseph D. Morelle, D-Rochester, chairman of the Assembly standing committee on insurance, predicted the federal government will pay because the success of the initiative is at stake.
