Healthcare Reform Passes: Now What?

The healthcare reform bill passed narrowly by the House of Representatives yesterday will eventually expand health coverage to tens of millions of uninsured Americans, creating both "opportunity and risk" for the ambulatory surgery industry, according to Marian Lowe, executive director of the ASC Advocacy Committee.

By requiring most U.S. citizens and legal residents to have health insurance or face a tax penalty, Ms. Lowe notes that the legislation will eventually increase the number of people with some form of coverage, creating "significant business opportunities" for ASCs. However, one of the ways the legislation achieves this goal is by expanding the Medicaid rolls to 133% of the federal poverty level. "That's something providers will want to keep an eye on," she says.

Expanding the insurance rolls will most likely have a positive impact on hospitals that have not been able to collect on indigent care in the past. But with the coverage provisions not kicking in until 2014, neither hospitals nor ASCs are likely to see an immediate increase in insured patients, says Robert I. Field, JD, MPH, PhD, professor of health management and policy at Drexel University School of Public Health in Philadelphia, Pa.

The reform bill "will have no immediate effect on people under Medicare and people with employment-based insurance," says Dr. Field. He adds that healthcare facilities may see more 20-something patients who will be eligible to join their parents' policies in 6 months, but this age group is less likely have surgery.

Ms. Lowe points to 2 specific provisions in the bill that would have a direct impact on the ASC industry: