Health Care Reform Basics Explained

The family issues activist group MomsRising met with HHS Secretary Kathleen Sebelius in a web chat recently to ask questions that they had gathered from their million-plus membership of mothers. Since I've questioned MomsRising's tactics in the past, I was curious to see how this chat would go. It's certainly an important topic: a HealthDay/Harris Poll of 2,100-plus Americans, released today, showed that many are deeply confused about what changes to expect from the Affordable Care Act that passed in March.

Actress Fran Dreschler, who survived uterine cancer and now works to improve cancer awareness among women through her website Cancer Schmancer, joined Sebelius and MomsRising's National Campaign Director Donna Norton in the web chat.

It was an odd collection of personalities: the articulate, calm Sebelius; the passionate and occasionally off-topic Dreschler; and the smiling, friendly Norton, who wore a MomsRising T-shirt (as MomsRising representatives do when meeting publicly with government officials, a habit that I dislike) in contrast to the smartly-dressed Sebelius and Dreschler.

The web chat touched on some changes coming in 2014 (the health insurance exchange), but focused on what will change in 2010. Changes to expect this year include:

• preventative care coverage without out-of-pocket costs to the consumer 
• new insurance pools for people denied coverage due to pre-existing conditions
• expanded health care coverage for adults up to age 26
• elimination of annual caps on insurance coverage for individuals

Sebelius, Norton, and Dreschler also discussed more innovative disease-prevention strategies included in the bill, such as calorie labeling on menu items in fast food restaurants. I was glad to see MomsRising lead a substantive discussion of health care reform.

A timeline of when various benefits will begin is available on the new healthcare.gov site, which also has an interactive section that lists health insurance options for different groups of people.

It's unclear to me whether health insurance will become less complicated under the new law. Billing paperwork from health care insurers and providers is currently so complex and error-prone that Quicken has developed Health Expense Tracker software that interacts electronically with certain health insurance companies to help consumers keep track of everything. The 1996 HIPAA bill was designed (in part) to reduce and streamline insurance paperwork; instead, it has increased it.

On the other hand, the Affordable Care Act offers Americans assurances that their medical expenses will be covered more fairly. To pay for this, the bill is structured to provide financial incentives for insurers (and other organizations) to focus on preventing disease, rather than dropping patients when their diseases become too expensive. With more than half of all U.S. bankruptcies caused by unpaid medical expenses, it's about time for the change.

Making Politics Palatable to Moms

A while ago, I signed up to receive emails from the political group MomsRising. The organization advocates for progressive, family-friendly policies such as paid family leave, expanded health care coverage for children, and better-quality child care options. I support these causes, but I was hesitant to join MomsRising because they are linked to MoveOn.org.

I remember well when MoveOn ran a notorious full-page ad in the New York Times in 2007 that criticized the war in Iraq by making fun of General Petraeus' name. I am constantly telling my children not to tease other people (or each other), but MoveOn had no problem with name-calling. Should an organization that uses ridicule to advance its objectives provide political leadership to mothers?

And what does it mean, exactly, to organize mothers into a political entity advocating for improvements in child health and other family-friendly causes? Are American mothers that cohesive ideologically - or that easily lead? If they are, I'm not sure I want them to be.

When MomsRising - or other political or social organizations - send emails summarizing an issue and include a simple "click here to send a letter to your senator" button, I get a bit suspicious. If I take the time to do some research, the topic is inevitably more complex than it first appears. Furthermore, MomsRising tries to make political involvement fun, such as decorating a onesie to send to local politicians, or dressing in a superhero cape to advocate for health care reform - an approach akin to making smiley-faces out of your child's vegetables in order to persuade her to eat them. They forget that mothers are adults, not children.

I'd like to see less drama and more thoughtfulness from an organization that advocates for mothers and families, particularly if they're going to talk about such a fraught issue as health care reform. Moms (and Dads) need to flex their critical thinking skills. It's following without thinking, believing rumors and hearsay about health and health care instead of facts and reports, that gets everyone in trouble in the first place.