Low-cost coverage in health plan not for all

It's an eagerly awaited early benefit of President Barack Obama's health care overhaul: low-cost medical coverage for Americans with health problems who can't get a private insurer to even take a look.

Starting in July, a special high-risk pool will offer coverage to uninsured people with pre-existing health conditions at a cost similar to what everyone else pays. It's the first test of whether the administration can deliver on Obama's vision within the budget Congress set.

But some vulnerable patients are probably going to feel a little cheated. Consider this coverage wrinkle:

Suppose your cancer is in remission. You had to quit your job while you were having chemotherapy, and your employer coverage ran out. You can't find a private insurer who'll take you, but you're lucky to live in a state that has its own high-risk pool. Still, you have to struggle to pay the premiums, well above standard insurance because sicker people are in the group. Yet as the federal program is designed, you wouldn't be able to switch over and take advantage of significant savings.

The reason: You have to be uninsured to qualify for the new plan.

"It's awkward," said John Rother, senior strategist for AARP, which supported the overhaul. "None of us would want to see the program lock people in to the more expensive existing coverage, but to switch over all those people would have definitely boosted the cost, and Congress was looking for ways to minimize it."

That means some 200,000 patients now enrolled in more than 30 state high-risk insurance pools will be stuck paying higher premiums. Many are on tight budgets, drawing down their savings and borrowing from family members.

Premiums in the new federal pool are expected to be 10 percent to 50 percent lower cost than current state rates, said Richard Popper, who directs Maryland's program. Co-payments and deductibles are also expected to be considerably lower. But the only way current beneficiaries could get the federal coverage would be to drop out of their state pool and go uninsured for six months.

Obama to promote health bill's business benefits

WASHINGTON - President Barack Obama is promoting his health care law's benefits for small businesses as he tries to rally public support for the massive overhaul.

During a speech Thursday in Portland, Maine - the second stop in a series of appearances to sell the reforms - Obama was to focus on the plan's short- and long-term impacts on small businesses, many of which have suffered during the economic downturn.

Under the plan, businesses with 25 or fewer employees with average annual wages of less than $50,000 will receive tax credits this year if they provide health care coverage to their workers. Those credits are expected to increase by 2014, with 3.6 million small businesses benefiting, according to Democrats.

Also starting in 2014, companies with up to 100 employees will be able to buy insurance through new state-based purchasing pools, or exchanges, with the goal of giving small businesses the same kind of purchasing power as employees at larger companies. Twenty-two million self-employed Americans will also be able to purchase insurance through the exchanges.

Overall, the 10-year, nearly $1 trillion overhaul Obama signed into law last week will extend coverage to 32 million people who are currently uninsured and will shape how almost every American receives and pays for medical treatment.

The law doesn't require businesses to offer insurance, but hits employers with 50 or more workers with an annual fee if the companies don't insure them and the government ends up subsidizing workers' coverage. Those fines have troubled critics of the overhaul, who argue that the increased costs could bankrupt companies already trying to recover from the recession.

Many Republicans are predicting that the overhaul will prove devastating in the November elections for Democrats who voted for it. Some in the GOP are calling for the revisions to be repealed.

But in Maine, Obama will be preaching to the choir in a state that has been a leader on health care reform, establishing programs to lower prescription drug costs and extend health insurance to the working poor.

After speaking in Maine, Obama planned to travel to Boston to attend two fundraisers for the Democratic National Committee.