Questions Mount As Health Law Rolls Out : Shots - Health News In a few months the federal law overhauling the nation's health system will be a year old. As House Republicans push for a repeal vote, NPR's Julie Rovner answers questions about how the law works.
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Questions Mount As Health Law Rolls Out

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Questions Mount As Health Law Rolls Out

Questions Mount As Health Law Rolls Out

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ROBERT SIEGEL, Host:

As expected, the House of Representatives has voted to repeal the health care law. The vote comes after two days of debate in which Republicans, one by one, took the floor to push for repeal.

SIEGEL: I think it's time we return this House to the people and we can start by repealing the job-killing, socialistic, and out-of-touch health care bill.

MELISSA BLOCK, Host:

Democrats spent the day defending the law. Here's G.K. Butterfield, Democrat of North Carolina.

SIEGEL: Mr. Speaker, I urge my Republican colleagues to stop playing politics with health care. Open your eyes and see the pain of America's working families.

SIEGEL: The repeal effort is headed nowhere, since the Senate is not likely to support it and the president has vowed to veto it. Nonetheless, during the debate, we've been hearing once again the major differences between supporters and opponents of the law, and it can be hard to make sense of it all.

BLOCK: So we've asked you to send us your questions. And here to help us answer some of them now is NPR health policy correspondent Julie Rovner. Hey, Julie.

JULIE ROVNER: Hey, Melissa.

BLOCK: And let's get started with, by far the most-asked question has to do with the Republican mantra that the health care law is job-killing. And in fact that is the title of the repeal legislation: Repealing the Job-Killing Health Care Law Act. A lot of our listeners, Julie, want to know, is the law in fact job-killing?

ROVNER: Now, the CBO also said that there would be a reduction perhaps in low-wage workers because of the law, but they said that that would be small in all likelihood. And that's something that other analysts have agreed with.

BLOCK: Let's move on to a question from Dane Schumacher(ph) of Huntsville, Arkansas. He writes this. He says he's a full-time farmer there. He says he lives off the proceeds from farm sales and he earns less than $15,000 a year. And this is what he wants to know: Will I be required to purchase health insurance? If so, how in the world does the government expect me to afford to do so?

ROVNER: Well, in a word: No. People who earn less than 133 percent of poverty, and that's about $14,400 this year, will get Medicaid coverage which costs them nothing. Now, that's a big change. It used to be that to get Medicaid, you had to not only be poor but fit into a certain category. You had to be a child, or blind, or disabled. Under this new law, you simply will have to be low-income. So starting in 2014, if you are low-income you will be eligible for Medicaid.

BLOCK: But what if, say, he were over that threshold even by just by a little bit, would he have to buy health insurance then?

ROVNER: Also, if the lowest cost insurance policy would require you to pay more than eight percent of your income, you're also exempt from the mandate. So if you don't earn very much money but it's still too much to be on Medicaid, you will not have to buy health insurance under this law.

BLOCK: Julie, we got a question from listener Theresa Stallman West(ph) from Los Angeles. Here it is: A friend of mine works for a law firm in New York City. The owners of the law firm said that when the new health care law takes effect, they will just refuse to provide health insurance for their employees and accept the government's fine for not providing it. They said this will be cheaper than actually providing the required health insurance. And she wants to know, if this is true, wouldn't all companies do this?

ROVNER: The other thing we know is that people have surveyed businesses who say they - most of them plan to continue to offer insurance. It's a way to recruit and retain workers.

BLOCK: In a way, Julie, does this question spool back to the question about is the bill job-killing? Because you do hear about businesses who say if the threshold is 50 workers, I'm not going to hire that - 51st worker. I'm going to keep under that threshold so that I don't face this situation.

ROVNER: Well, that is one concern but also if they decide that it's cheaper to pay the penalty, not provide the health insurance, put the workers in the exchanges, then they could hire more people.

BLOCK: Julie, we have time for one last question and this one is from Dave Manley of Boston. Why does most of the current law not go into effect for several years? If the purpose of the bill is to expand and improve health care in the U.S. and reduce its cost, he wants to know, why the multi-year rollout?

ROVNER: And that's why I think you've been hearing about a lot of these, you know, benefits that are already in effect about keeping kids on their parents' plans until they're 26, or the closing the Medicare drug benefit donut hole; things that are in effect now, because these big benefits are not going to go into effect until 2014.

BLOCK: Thanks to all our listeners for sending in questions. And Julie answers some more of them at NPR's health blog. You can find that at npr.org. Julie Rovner, thanks so much.

ROVNER: You're so welcome.

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