All this talk of President Obama's upcoming health care summit has moms worried about how health care reform legislation will affect our kids' coverage. And it's no wonder: Because no one knows whether Congress will be able to agree on a final bill, getting straight answers about whether the line to see our pediatrician will get longer or if costs will go up has been nearly impossible—until now!
We asked the head of a leading group of physicians what we can expect from a health care reform bill. You can bet that our brief conversation with her was more helpful than several hours of Internet searching on the topic...
According to Dr. Lori Heim, President of the American Academy of Family Physicians, passage of a health care reform bill this year is highly probably; in fact, the issue is "how, not if." Here, she explains which changes moms can expect in terms of their children's coverage and benefits under a health care reform bill.
CafeMom: If a health care reform bill is passed this year, what will change when I take my kids to the doctor?
Dr. Heim: Certainly health care reform legislation can change in the next several months. However, the House and the Senate each have passed their own health care reform bills. Whether they will agree on legislation that melds the two versions into a final bill is yet to be seen. However, under the two proposals now before Congress:
Will my kids be denied certain benefits or care that they have had before?
Dr. Heim: The legislation sets a minimum of benefits that all plans must have. That's a plus for most people. Depending on the health insurance you have or choose to buy, your children will have at least the same benefits and could have more benefits. Both the House and Senate bills create different categories of health insurance, but the basic plans must provide coverage for:
Will I be responsible for any additional costs?
Dr. Heim: Not likely. In the House bill, you would have no cost-sharing—such as deductibles or copayments—for preventive services such as well-child checkups or immunizations, vision, or hearing care.
And, if health care reform passes, your insurance premium is likely to go down. That's because the legislation requires that everyone have health insurance. This means the insurance companies' risk is spread out among more people, so each individual person's premium will go down. That's why it's important to have the individual mandate that all people have insurance. Spreading the risk among both the healthy and those who get sick keeps the premiums down.
Don't miss Part 2 of our conversation with Dr. Heim tomorrow, in which she addresses what moms can expect when they take their kids to the pediatrician if a health care reform bill is passed.