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Health care lobbyist sees big changes ahead
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MONROE - To better understand health care reform and how it would impact local businesses, Monroe Clinic on Wednesday hosted national health care industry lobbyist Paul Lee to provide his perspective to local businesses owners, managers and representatives from area organizations.

Lee is a founding partner and oversees the Washington, D.C. office of Strategic Health Care.

By 2014, states are required to implement state-based American Benefit Exchanges and Small Business Health Options Program (SHOP). That means that more consumers can obtain health care insurance, allowing them to compare benefits and prices, and choose a plan that best suits their needs.

Small businesses with up to 100 employees can pool together to buy insurance, Lee said. Employers will be able to go online and shop for private insurance companies.

There would be criteria for qualified health plans including marketing requirements; ensuring a sufficient choice of providers, meeting clinical quality measures; and using a uniform enrollment form.

While the federal government is working on guidelines for American Benefit Exchanges and SHOP Exchanges, the state has the option to develop their own guidelines.

Lee said that while officials are currently working on providing standards for the SHOP Exchanges, the information should ultimately be standardized and easy-to-understand - allowing companies to more easily compare and purchase health care coverage. This also reduces the administrative hassle small businesses are facing.

He said there is a need for reform in health care, due to spending growth that is unsustainable; a broken delivery and insurance system; and the fact that many patients simply can't afford care.

There also has been an increase in enrollment for national programs like Medicare and Medicaid, he said. Enrollment in Medicare has grown by 32.5 percent from 1995 to 2010. Medicaid and Children's Health Insurance Programs provide coverage for 53.6 million as of 2008; with a projection of 60.4 million being covered by the end of 2010.

Lee said that employer-sponsored plans provide coverage for over 162.1 million, a decrease of 7.3 million in 2008. And while 86 percent of people are insured, there are still 25 million underinsured Americans.

According to OpenSecrets.org, his firm's total lobbying income for 2010 exceeded $5.8 million.