The New Health Care Deal: What Does it Mean For You, UC Irvine?

The year-long partisan struggle over the health care reform bill, which was pronounced dead by some just a few months ago, was resuscitated and narrowly passed by a house vote of 219-212 on Sunday Mar. 21, 2010.

The effects on the nation are astronomical, but at a more micro-level, the bill will also have significant effects on the UC system.

The Patient Protection and Affordable Care Act intends to provide 32 million people with affordable health insurance and eliminate some of the crueler practices of health insurance companies including denying coverage due to pre-existing conditions and cancelling coverage due to illness.

According to a recent study from UCLA’s Center for Health Policy Research, an estimated 8.2 million Californians are uninsured compared to 6.7 million in the year 2007. This makes the Golden State a major benefactor of the new health care bill, potentially insuring up to five million Californians. For Daniel Jimenez, a pre-med biology major who graduated from UC Irvine in 2009, the passage of the health care bill is, “a step in the right direction,” and “given the state of the health care industry, something had to be done at this point.”

Within the vast California landscape of health care, the University of California is the fourth-largest health care distributor and trains over 12,000 health care practitioners a year through a network of academic medical schools and health profession schools.

Irvine is home to both a medical school and an executive MBA health care program. For Dr. Alpesh Amin, a graduate of the Paul Merage Executive MBA Healthcare program and the Professor and Interim Chair of the Department of Medicine at UCI, the bill represents a new set of exciting opportunities and complex logistical challenges.

“I think it is exciting because it is nice to be able to give folks that need health care the opportunity to actually get health care,” Amin said. “The challenging thing is that we have identified over the last several years that we really need to do a better job in terms of improving our health care delivery models.”

Dr. Amin shares the perspective of many wary citizens who wonder how the actual implementation of the ambitious bill will work.

To insure the proposed 32 million uninsured, the bill plans on expanding Medicaid with subsidized plans based on level of income and creating state health care exchanges that allow people to buy affordable health care insurance.

There will also be also be a mandate to purchase health insurance with a fine of 1 percent of income or $95 — whichever amount is greater.

However, these elements of the bill will not be enacted until 2014. The bill is filled with changes, but these three items alone will no doubt require monumental effort and planning.

Dr. Amin sees the passage of the health care bill as a chance to make health care delivery and teaching better here in California and the nation.

“There are opportunities as we continue to move forward toward a system that will hopefully value quality and value outcomes. We will hopefully be teaching and training as we develop systems that value that as opposed to just valuing productivity,” Amin said.

Some of the immediate effects of the bill include allowing parents to keep their child on their health care plan until the age of 26, removing a lifetime cap on coverage, the creation of a high-risk pool for people who have health conditions that have excluded them from coverage in the past and health insurance companies cannot deny health care coverage to children due to pre-existing conditions.

“I think that it is a victory for the American people,” said Assistant Vice Chancellor of Counseling and Health Services, Dr. Parham.

Dr. Parham runs UC Irvine’s Undergraduate Health Insurance Plan (USHIP). As of 2001, students pay into USHIP as part of their registration fee but can opt out of USHIP fees if they prove that they have equal or better health insurance outside of USHIP. Currently, around 60 percent of UC Irvine’s 22,000 undergraduate population are on the USHIP plan at about $75 per month – a comparatively low price for comprehensive health care at UC Irvine’s Student Health Center.

For the relatively low cost of health insurance and the convenience of the Student Health Center, Dr. Parham does not anticipate the bill to cause drastic changes to the cost of USHIP or number of students who use USHIP.

As a non-profit entity, USHIP can maintain competitively low prices while utilizing the specialists at UC Irvine Medical Center. Whether the health care bill will have a major impact on the student population remains to be seen but Dr. Parham wants all students to have health insurance wherever it may come from.

Along with the health care bill, the House also passed an amendments package, or “fixes” bill that went through the Senate reconciliation process that does only requires a 51-vote simple majority instead of the filibuster-proof 60 votes.

A student loan overhaul was included in the amendments package that was passed late last week.

The student loan overhaul cuts out private college loan companies that currently act as an intermediary between government money and students. According to the Congressional Budget Office (CBO), the reduction of fees that need to be paid to private banks will save the government $61 billion over 10 years – money that will be used to increase funding for Pell Grants.

Unfortunately, this is not as great a change as President Obama had originally outlined. The maximum Pell Grant allowance for next year will be $5,500 and will only be raised to $5,900 by 2019-20. With rising tuition fees at public universities, this increase hardly covers tuition expenses.

Furthermore, UC Irvine will most likely be unaffected by the loan overhaul because UC Irvine is already a direct lender. Acting Director of the Office of Financial Aid at UC Irvine Christopher Shultz, says that the loan overhaul is, “going to have a minimal impact.” He also added that the Pell Grant increases may be modest, but that, “anytime we can secure stable funding for some of these programs it is always good.”

For Daniel Jimenez, who just got accepted to Temple Medical School, the bill is not perfect but represents a step in the right direction. He hopes to one day get a chance to work in disadvantaged communities and like many other doctors, hope this bill will help them extend care to more people.

“Most doctors today look towards improving the welfare of their patients. They look out for their patients,” Jimenez said.