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Focus Now Shifts to Implementation Process

Now that Congress has approved healthcare reform, the nation's health system will undertake the broadest changes in more than four decades. After spending months in...
March 25, 2001

Now that Congress has approved healthcare reform, the nation's health system will undertake the broadest changes in more than four decades. After spending months in disputes with insurers, officials in the Obama administration now must get the industry's cooperation in order to begin implementing the reforms.

Health insurers see the implementation process as allowing them to influence the reforms to the system. The most far-reaching changes, the new exchanges that states will set up to sell insurance and subsidies to help consumers acquire coverage, do not take effect until 2014; some provisions become effective within six months. Donna Shalala, a former Health and Human Services secretary, said that implementing the reforms will be difficult. The office of chief administrator for the Centers for Medicare and Medicaid has not been occupied for more than three years, and the legislation will add 16 million people to Medicaid rolls and reduce payments to health providers under the Medicare program by more than $400 billion. Other changes will need to be implemented.

Carriers will be offering input to the process. "Insurers are nervous and want to make sure they are able to provide input," said Sandy Praeger, the Kansas Insurance Commissioner who chairs the group's health committee. "They recognize this is not business as usual." Cigna Corporation's Vice President of Public Policy, G. William Hoagland, said "Healthcare reform is not over simply because the president signs this bill," adding other measures in the future such as appropriations or authorization bills could address some of the cost-savings measures it says are needed to contain premium increases.

Government Focus Turns to Implementation (Wall Street Journal 3/23/10)