Will insurance premiums go up or down when reform is fully implemented?
It depends on who’s buying the coverage. People purchasing individual insurance may indeed face a higher cost when exchanges are launched four years from now. But they will receive much better benefits coverage, Duke’s Taylor says. Those already in large employer plans may not see much change beyond the current climb in their premiums related to rising medical costs, not reform, says Collins of the Commonwealth Fund.
Will illegal immigrants be given the opportunity to buy health insurance in the new exchanges?
Illegal immigrants will be barred both from getting subsidies to buy coverage and from participating in the new insurance exchanges that will begin in 2014, even if they pay the entire cost out of their own pocket. Undocumented immigrants will continue to get care at some community clinics and will still be able to receive emergency medical treatment at hospital ERs.
Does reform represent a government takeover of the health care system?
Certainly government will have a bigger role under reform. The law provides a large expansion of Medicaid, a government insurance program for the poor and disabled. And there is more government regulation of insurance in general. “It’s a remarkable expansion of federal power,” Moffit says. Still, it’s not a government-run system. The private insurance market will be preserved in the new insurance exchanges, and large employers will continue to run their own health plans. “People will have more protections,”says Collins of the Commonwealth Fund.