The first wave of changes related to the federal health care reform law passed six months ago takes effect today.

But there won't be many noticeable differences -- at least yet, according to a local business leader, an insurance industry spokesman and medical officials.

The Patient Protection and Affordable Care Act, which Congress passed without Republican support, was signed by President Barack Obama on March 23. Full implementation is expected to take another eight years.

Benefits taking effect today include:

"¢ Young adults can stay on family health plans until they turn 26, regardless of college enrollment.

"¢ Free immunizations for children.

"¢ Children under 19 can no longer be denied coverage for pre-existing conditions.

"¢ New plans must have no cost to patients for preventive care such as mammograms and colonoscopies.

"¢ No lifetime limits on coverage.

"¢ Making it illegal for an insurer to rescind a customer's policy if he or she gets sick.

However, changes will be reflected

see reform on page 2

only in new or renewed policies after today. For most businesses, health plans for employees are renewed Jan. 1, which is when the new benefits would take effect.

That's also when health insurance rates could go up, Otsego County Chamber President and CEO Rob Robinson said.

How much of that increase is passed down to employees is subject to a lot of variables, including how good of a year a business has, he said.

And the state Department of Insurance has to sign off on any rate increase. With the trend of increasing health care costs, annual adjustments of insurance rates for employers, which often get passed to employees, are the norm, Robinson said.

"That's a ritual that goes every year nowadays," Robinson said.

He said insurance companies serving area employers would likely request an 18 percent to 20 percent increase, with the state knocking that down to about 12 to 13 percent. All of the increase would be related to health care reform, he said.

One of the state's major health insurance companies, MVP Health Care, gave a lower estimate of rate increases under the new regulations.

Rate increases directly from the PPACA are projected to be between 1 percent and 2 percent, MVP Health Care Director of Public and Community Relations Gary Hughes said.

"There are certainly other factors that affect rates," Hughes said.

Health care rates in recent years have increased 9 percent to 10 percent annually because of general inflation. There also may be state taxes and other state assessments that could calculate into higher rates next year, but New York has been ahead of the curve in terms of regulations, he added.

"In New York state, the number of changes that subscribers will see is a lot less than other parts of the country because for a number of years New York state has had a very strong consumer insurance law," Hughes said.

The company will comply with the new federal rules, he said.

"As a company we are prepared to implement the changes as set forth in the law," Hughes said.

But though the legislation is passed and signed, many regulations have yet to be developed.

"There is a lot of federal rulemaking that gets developed after the fact," Hughes said.

The medical director of Oneonta Community Health Center, which caters to the uninsured, welcomed the first phase of the federal health care reform.

"I look forward to the day when we can go out of business," Dr. Benjamin Friedell said.

That day is at least several years off, he added.

"I think (the first phase) should help decrease our numbers," Friedell said.

But he cautioned that a doctor shortage, especially in primary care, may be on the horizon.

"I have a concern that as we insure more and more people, we're going to put an increasing strain on our health care system," he said.

The president of the Bassett Healthcare Network, which includes Bassett Medical Center and A.O. Fox Memorial Hospital, said most of the early changes of the PPACA affect only insurance issues.

"The changes in the structure of the health system, accountable care organizations, bundling of payments, etc., will be under development in 2011 and 2012," Dr. William F. Streck said. "So, on the near horizon we see no major changes in inpatient or outpatient care that we provide. Payment reductions now being implemented by Medicare that are not part of the reform act will have an impact."

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