By James Rincon

Pflag Reporter

More than two weeks after America’s health care system was overhauled by Congress, it seems most of the Pflugerville community has yet to feel any impact from the historic legislation.

Experts in health and insurance industries said they anticipate some substantial changes to their practices as more of the bill’s policies are implemented, but for now, everyone from local business owners to health care district directors are playing the waiting game.

“I haven’t taken the time to look into the 2,000 or so pages of the bill, but from what I’ve heard and what other business owners have told me, I don’t think I will be affected,” said Jean Garlic, owner of Wordyisms in Pflugerville and member of the Pflugerville’s Downtown Association.

Garlic’s business has eight employees, putting it among the larger employers in the Downtown Association. Under the bill originally passed in the Senate, employers with 50 employees or fewer are exempt from the new requirement for small businesses to provide coverage for its workers.

Although most of Pflugerville’s employers will be exempt from the bill’s mandates, Michelle Hussey, president of Integrity Network Insurance Group in Pflugerville, will feel the bill’s affects as an insurance provider.

“It’s a bit of a double-edged sword really. It’s great in the sense that insurance companies will no longer be able to drop a client because of health conditions, but obviously the quality of care is going to go down, and the insurance premiums are going to go up,” Hussey said.

She anticipates the influx in Americans who can access health care through the new individual insurance requirement will spread health care professionals thin, as a shortage existed before the legislation.

“Everybody has to have insurance, and we’re sort of pinched for health care as we speak,” Hussey said.

As for the rise in premiums, Travis County residents have been subsiding care for the uninsured long before the recent overhaul.

“[In a 2008 study] we figured out that an insurance policy that covers a family of four, $1,500 of that premium is going to subsidize the care of the uninsured. So we’re all paying for it. It’s going to get passed along somehow,” said Stacy Wilson, government relations director for Travis County’s healthcare district Central Health.

For those who do see their monthly payments go up, it will be difficult to see exactly where that extra money is being spent said Wilson.

“We’re thinking that we’re still going to have some folks that are not going to have access to coverage, either because they’re really the poorest of the poor which means they don’t have to file a federal income tax return. They’re not subject to the individual mandate so they may remain uncovered,” Wilson said. “We’re not really sure what it’s going to look like. There’s still a lot of rulemaking to happen, there is still a lot of regulatory pieces that are going to have to be implemented by the state of Texas and we’re just not really sure what that’s going to look like. We still think that there is going to be an absolute need for the services of the district funds because we still think that there are going to be people who for one reason or another aren’t required to or can’t get access to coverage.”

Although the Health Care bill is putting the federal government’s foot down on what democrats and republicans agreed were shady practices by insurance companies, the sheer increase in people who will need to buy insurance because of the bill means good business for Hussey.

“The bill that was passed really kind of opened everything up. And truthfully it would really be the wiser for people to get health insurance before 2014 so they’re not pulled into the government programs and told what kind of coverage they’re going to get,” she said.

As for Central Health’s clientele, whose care is paid for primarily through property taxes, more people with coverage may mean less emergency room visits and fewer tabs to be picked up by the county.

“Federal health reform does provide for an expansion of Medicaid up to 133 percent of the federal poverty level starting in 2014. There are also both individual and employer mandates for people to either have coverage or offer coverage,” Wilson said. “We’re very excited about the opportunity, that the expansions both through the exchanges and through Medicaid are going to bring.”

Many of the historic legislations changes, like those to Medicaid, won’t be implemented until 2014 or even 2020. Given the complexity of the bill, incremental implementations over the next 10 years means most of its affects are still left to foggy speculation.

The problem is that, one, the penalties for those mandates aren’t very stringent, and number two, there are a lot of people and a lot of businesses that are exempt from those penalties.”

“I really foresee that it will make people more aware of the type of coverage they need to have, compared to what the government is going to provide,” Hussey said. “If anything it will give them food for thought.”

jrincon@pflugervillepflag.com