Health-care changes coming, businesses told

By Valerie Baldowski


A health-care expert has told members of Henry County's business community that -- as a result of national health-care reform -- they will be able to get additional tax credits; that insurance companies can no longer deny health-care coverage to children with pre-existing conditions, and that college students can remain on their parents' health-care plans longer.

Patricia Ketsche, from the Institute of Health Administration for Georgia State University's Robinson College of Business, presented that information during a speech entitled, "Beyond the Politics: The Who, What, When & How of Health Care Reform." She was addressing the Henry County Chamber of Commerce, Thursday, in McDonough.

"I'm sure you've heard about this, no cancellations anymore, no lifetime coverage limits, or no pre-existing conditions for children, starting this year," said Ketsche. "It's not only that you can't exclude a specific condition, you can't decline the coverage," she added.

A level of tax credits, Ketsche said, will be provided to small businesses with 25 or fewer employees, who have average wages less than $50,000. The credits will be offered to help employers offset some of the costs of providing health coverage.

"The full tax credit, which is 35 percent of the cost of a plan, is available to firms with 10 or fewer, and average wages of less than $35,000," she said.

Ketsche reminded those in attendance that the changes will take place over a period of several years, through 2015, but there are changes scheduled to be in place this year. "The first one is a high-risk pool," she explained. Beginning in June, the federal government will establish a "high-risk pool" for individuals who have been rejected by private insurers, she said. The pool, to be made available to Georgia residents, will give them the opportunity to buy health insurance.

"A lot of states have high-risk pools now," Ketsche said. "What that means is, if you try and buy insurance, and you get turned down because you have a pre-existing condition, you can go to the high-risk pool, and you can buy insurance.

"Usually, it's at 150 percent of the standard premium," she said. "It lets people who are very sick have a way to buy insurance that they can't do now."

The federally-subsidized insurance will cover those individuals until 2014, she continued. She said the provision that prohibits insurance companies from denying health coverage for children with pre-existing conditions, is expected to go into effect in September, but that some larger insurance companies are incorporating the requirement into their policies now.

Additionally, she said, group health coverage on a parent's plan will become available for anyone up to age 26, if the dependent does not have their own health insurance coverage. Usually, dependents are dropped from their parents' plan at age 19, unless they are a full-time student. If they are full-time, they are typically allowed to stay on their parents' plan until age 23. The change will take effect Sept. 23, she said. "Some big employers are saying go ahead and do it now," she added.

Ketsche presented information some may not have been aware of previously, said Kay Pippin, Henry County Chamber of Commerce president. "All of this is a big education process for all of us," she said. "We're going to have to learn more ourselves. We're going to have to be good consumers in this process."

After the presentation, others also responded. Gwendolyn Parks, an oncology and palliative care certified nurse for Sacred Journey Hospice in McDonough, said: "I thought it was absolutely wonderful, very informative. I Iiked it best because it was no politics involved. It was just the facts of what to do ... That's it."

Eddie Ausband, managing partner for Revanta Financial Group, LLC, in Stockbridge, said there was much information to consider. "I'm kind of on both sides of the health-care reform," he said, "one, as a consumer, and one, as a broker. My reaction is probably much like most others ... It is highly technical, it is complicated, it is going to be phased in over the next four or five years and beyond."

Ausband, whose company has about 20 employees, said he is worried that health-are care reform will experience the same difficulties as the Social Security program.

"My biggest concern is that it's a major undertaking by the federal government, kind of akin to running Social Security, and we all know there are issues there," he said.