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What we don’t know

What’s known about the landmark health insurance reform bill signed into law this week by President Barack Obama can-and soon will-fill volumes. We know, for instance, that it will extend coverage to roughly 32 million Americans who today lack health insurance.

We also know that pre-existing medical conditions no longer will be the basis for insurers to deny coverage; nor will companies be able to set lifetime benefit caps or drop individuals when they file claims.

Further, the new law clearly means that workers will not lose coverage if they lose their jobs. And companies with more than 50 employees will face fines if they do not offer health insurance to those on the payroll.

But what’s not known about the new law is equally voluminous. Some of the biggest questions:

  • How much will this measure, pegged at $938 billion over 10 years, truly cost the taxpayers?
  • How accurate is the Congressional Budget Office estimate that it will reduce the federal deficit by $143 billion over the same period?
  • What will be the long-term impact? Firms with 50 or fewer employees are exempt from the penalties faced by companies that do not provide affordable health coverage to workers. Those with no more than 25 could get a tax credit to help them provide the benefit. Will the overall effect be less hiring?

Plenty of people in this debate insist they know the answers to such questions. In truth, no one does.

Republicans on Capitol Hill, who predict that the law will be a disaster, can trumpet the fact that they voted against it. But they bear some responsibility.

For years, Americans have shown strong support for greater access to health insurance and many other elements of the Democrats’ reform measure. When the Republicans held power, they could have made health insurance reform a top priority; they did not.

While some now are rallying around the notion of repeal, fiscal accountability might be the real battle ahead.

As he signed the law, the president trumpeted "the core principle that everybody should have some basic security when it comes to their health care."

Another core principle should be responsibility for the financial commitments we make.

3/26/10 (c) 2010 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or e-mail rbj@rbj.net.

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