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Affordable Care Act can do a lot of good

On the very first day he could, last Jan. 5, the ultra-rightist House Majority Leader Eric Cantor, R-Va., introduced his repeal of the "job-killing" Affordable Care Act. The House swiftly passed it along party lines. The Democratic Senate blocked it.

Nearly nine months later, this is all the new Republican majority has done on health care and patient protection. This conforms to a century of Republicanism.

While so-called Obamacare is a disappointment, the administration and many states like New York are working to squeeze what good they can out of it as the nation waits to see how the U.S. Supreme Court will rule on the sweeping law.

For instance, the president's aides announced last week that by March 2012, all health insurers will be compelled to outline on just four pages what their plans will or won't do. This will be a relief to AARP customers who are deluged with scores of pages of plan "explanations" that are totally confusing and sometimes, to be polite, inaccurate.

New York will apply for $4.5 million in federal aid to help develop programs to review and publicize changes in health insurance premiums. The Affordable Care Act has already sent $1 million to New York to help the state beef up its premium review processes.

The State Legislature gave the Insurance Department power to review and confirm rates just 14 months ago. So far, the department's influence on restraining rate hikes has been modest. In 2010, rates went up between 12 percent and 17 percent. So far this year, they are about 8 percent to 10 percent.

The Paterson and Cuomo administrations also received Affordable Care Act money to help design health insurance exchanges that must take effect at the end of next year. Kansas and a few other states have, for weird ideological reasons, returned $90 million to the Obama administration saying they want no part of these exchanges.

The Cuomo administration is crafting a new bill on insurance exchanges for the Legislature to consider in the 2012 session. Many insurance economists believe such electronic insurance exchanges will work best if the Obama mandate that all Americans buy health insurance survives review by the Supreme Court. Without a mandate, they believe, only the sick will buy insurance, driving up premiums.

The bet here is the high court will disallow the mandate, but the rest of the law will survive.

In New York, the state administration's goal is not to create a mass single pool to bargain for better rates, but to make benefit package offerings more transparent and reliable for those who will buy. So this can help consumers whether the mandate exists or not.

Just how tough New York or any state gets with health insurance companies depends on state law and the passion of the governor. As noted here before, Andrew Cuomo's record on health insurance firms is mixed. And Albany is awash with industry lobbyists and money. As a result, New York's health insurance rates are the fourth highest in the country.

Despite its drawbacks, the Affordable Care Act has done and can do a lot of good. Medicare clients can get wellness exams without co-pays. Americans now have freedom from worry about lifetime limits on coverage. The law has funded state programs to keep customers from being ripped off. No child can be denied coverage because of a pre-existing condition, a provision that will be extended to all in 2014.

Unfortunately, the law does nothing to slow down the biggest driver of costs: prescription drugs. Obama in 2009 gave that industry total amnesty as a "thank you" for its lavish gifts to his Senate and presidential campaigns.


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