As I travel around our Senate District recently no topic has sparked more debate than passage of historic health care reform.

The long awaited (and much maligned) law brings needed relief to those without insurance and to those facing double digit increases in insurance premiums. The non-partisan Congressional Budget Office estimates 32 million uninsured people will be covered as a result of the new law. Over the next ten years the law will cost $938 billion paid for through savings, new taxes and fees.

Most constituents are relieved the bill finally passed. Citizens with no health insurance can expect, by the end of the summer, to find affordable coverage through the state’s high risk pool (HIRSP).

The new law brings $5 billion into state-run high risk pools to make insurance more affordable. In Wisconsin, rates for HIRSP are expected to drop in April and again this summer. If you found the high risk pool too expensive, please consider giving it another look. If you need assistance applying for coverage, please contact my office.

People with insurance coverage through a large company will see very little change. There are new rules insurance companies must follow, but many large companies are self insured and follow federal rules that remain the same.

For those on Medicare, the prescription drug ‘doughnut hole’ gap in coverage gradually begins to close. Seniors who fall into the hole will receive a $250 payment this year and 50% discount in some drug costs next year. Preventive care will now be covered by Medicare. The federal government will also rein excessive profits in the Medicare Advantage plans. Incentives and changes in payments to doctors and hospitals begin to slow the growth of medical care over the next ten years.

Insurance companies will follow a host of new rules including; banning pre-existing conditions, lifetime limits on policies, and the horrid practice of bouncing people off coverage if they get sick.  Parents will be allowed to cover their adult children up to age 26 on the parents’ plan. If these provisions sound familiar, they were passed, in some form, when the Governor signed my six point health plan into law last June. The state law – allowing coverage of adult children up to age 27 – remains in effect.

The most dysfunctional part of our health insurance system affects small business and the self employed. More than half of the 46 million Americans uninsured own or work in a small business or are self employed.  They will see the biggest effects of health care reform. Finding health insurance will be both easier and less expensive.

Immediately, small businesses that provide health insurance will qualify for tax credits for the premiums they pay for their employees. Companies that pay retirees health care will also be eligible for assistance.

In 2014, states will set up health exchanges – or one-stop shops – for small businesses and the self employed to find and compare affordable coverage. This is an idea I mentioned many times in this column. Four years is a long time to wait so I will soon introduce a bill to create this type of exchange right away in Wisconsin.

There is no free lunch and we can’t cover 32 million uninsured people without paying for it. Critics complain about paying for the plan. The plan includes taxes on drug and insurance companies. People who make over $200,000 will see less than a slight increase in payroll tax.

And eight years from now the plan will tax ‘Cadillac’ health plans (worth over $27,500). 

People don’t want Congress to add to the deficit but they agree our current health care system is unsustainable. Nevertheless, much of the criticism of the plan involves taxes.

Everyone agrees change must happen but worry when it does happen.

“Change is never easy,” President Obama said last week in Iowa, “But it’s always possible. It comes not from the halls of power, but from the hearts of our people. Amid setbacks, it requires perseverance. Amid calls for delay, it requires the fierce urgency of now. In the face of unrelenting cynicism, it requires unyielding hope.”