Sen. Brown defends rule requiring health insurance

1/3/2011

Sen. Sherrod Brown (D., Ohio), who answered health-care-reform questions from a crowd gathered for his first appearance of 2011, said those with insurance end up paying the tab for those without coverage through higher health-care costs.

The requirement to have health insurance, which many Republicans initially supported and is being challenged in many states as unconstitutional, is part of federal health-care reform passed last year.

"Maybe it's not ideal -- it's certainly not communism," said Mr. Brown, who voted for the reform measure and wrote part of the law. "It's the best way for the most people in the country."

Mr. Brown was at Monroe Street United Methodist Church Sunday to discuss some of the changes that will affect Medicare recipients.

Among the crowd of more than 50 was Cathy Allen of Marblehead, a 47-year-old who is self-employed and had been unable to get any insurance coverage for most of eight years because she has lupus, a chronic autoimmune disorder.

Ms. Allen, who has had only two minor lupus flare-ups in the last 20 years, said she knew getting coverage with a pre-existing condition would be difficult when she established a consulting business.

But, she said, she was unable to get even a plan that excluded lupus. Now she qualifies for a high-risk pool program and pays Medical Mutual of Ohio premiums of $293 a month. She has a $2,500 annual deductible and $30 co-payments.

"I am very grateful," said Ms. Allen, who recently received her first mammogram and gets other preventive care. "I couldn't be more grateful."

Although Mr. Brown answered questions about a variety of reform topics Sunday, he had come to Toledo to highlight some changes in Medicare that started this year.

Closing the so-called doughnut hole -- a Medicare Part D coverage gap requiring recipients to pay for prescriptions after the coverage limit is reached until the catastrophic threshold kicks in -- is one aspect being addressed in reform.

More than 100,000 Ohioans fell into the doughnut hole last year, although they had to continue paying premiums, according to Mr. Brown.

Between 2012 and 2020, progressive steps will be taken to close that gap created when a prescription benefit was added to Medicare in 2006.

Until then, qualifying Medicare recipients in the doughnut hole this year will get a 50 percent discount on brand-name prescription medications.

Last year, qualifying Medicare recipients received a tax-free, one-time $250 rebate after reaching the doughnut hole.

Plus, annual wellness checkups, colonoscopies, and other preventive screenings now are free for Medicare recipients under health-care reform.

Mr. Brown said that will benefit about 1.8 million Ohioans.

Previously, seniors in Medicare had to pay 20 percent of the cost of many preventive screenings.

Prevention is one aspect of health-care reform especially favored by Rebecca Liebes, health and wellness director at the Area Office on Aging of Northwestern Ohio Inc.

It's much cheaper to prevent ailments through screenings, good nutrition, and other measures than to deal with a disease, she told the crowd.

Not everyone gathered Sunday, however, agreed with health-care reform.

Some questioned Mr. Brown about whether health-care costs will go up anyhow, resulting in little financial benefit for Medicare recipients and others.

If the federal government had done nothing, Mr. Brown maintained, health-care costs would have continued to climb and fewer people would have coverage. Even Medicare still is far from perfect, he said.

Contact Julie M. McKinnon at: jmckinnon@theblade.com or 419-724-6087.