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DECATUR — In the wake of the passage of historic health care legislation, health institutions, businesses and individuals nationwide have spent time reacting to what changes to the current system might mean for them. Locally, health care leaders said that at this point, they can see benefits and drawbacks to the bill’s many provisions.

Barbara Dunn, chief executive officer of the Community Health Improvement Center, said that overall, she believes the changes likely will have a positive impact on patients and providers.

“In terms of the health care bill overall, obviously, there are going to be a considerable number of people who are going to be covered by some type of insurance, which will certainly work in our favor and presumably any of the other local providers’, as far as the number of people who are insured,” she said.

Dunn cited a few anticipated short-term effects of the bill, such as the ability of children to remain insured by parents’ policies until they are 26, the elimination and regulation of lifetime and annual caps on insurance coverage and the closure of Medicare prescription drug coverage gaps, as tangible benefits to communities.

“There will be some additional money that’s going into expanding community health centers and, in some cases, opening new ones in parts of the country where there are not any,” Dunn said of the bill’s promise to help grow centers such as CHIC.

“I think that, overall, it’s good,” she said, adding that she also is pleased to see an emphasis on preventive care, dental and mental health issues and chronic disease management included in the legislation.

But even as a supporter of many aspects of the bill, Dunn said there is no question that as its impact evolves, some tweaking or changing will be necessary.

“I think in the minds of many people, there’s cost: the cost to individual taxpayers and individual employers and how does it all fit into the system,” she said, adding that these issues will take time to understand and work through.

Dunn said she hopes people will put in the time and effort to understand the legislation and not form their opinions solely on the long, polarizing debate that preceded its passage.

“You just wish that people would really take a step back and take a deep breath and see if it’s going to work,” she said. “I think it’s exciting. I think it’s challenging and, hopefully, people will work together.”

Jerry Andrews, administrator of the Macon County Health Department, said he personally also sees the legislation as something positive.

“First of all, I’m glad they finally passed it,” he said. “Everything wasn’t perfect in it; we all understand that.”

Overall, one main benefit of the bill is that it is expected to help millions of uninsured individuals access health insurance and routine medical care, Andrews said.

“By the time they go, they’re sicker,” he said of those without insurance in the current system. “And it’s more difficult to get treatment if you’re sicker.”

Andrews also cited provisions to recruit and train additional health care personnel as a benefit.

“If we can get people trained and working, then we’re going to have people able to see a doctor or physician assistant, nurse practitioner or a nurse,” Andrews said. “They’re going to be able to get in much easier than they had in the past.”

Andrews, too, said the tangible effects of recent health care legislation will take time to develop and understand.

“There’s a lot of stuff that I don’t really understand that much, unfortunately,” Andrews said. “Over the years, I probably will, but it’s brand-new, and it’s hard to understand it all.”

Area hospitals also will be among those affected by the legislation. St. Mary’s Hospital administrators declined to comment on its anticipated effects.

“I’m really plus, minus on this thing,” said Ken Smithmier, Decatur Memorial Hospital president and CEO, citing aspects of the recent bill he thinks will create benefits and setbacks for the people and industries involved.

Smithmier said he has long supported the elimination of pre-existing conditions as grounds to deny coverage and, along with that provision, the “individual mandate,” a requirement that individuals purchase health insurance.

But among the provisions he had hoped would be included in the bill were ways to address medical malpractice issues and slow the growth of health care spending, he said.

Another issue of concern is that Medicare reimbursement rates are expected to decline further, he said. If Medicare reimbursements are left as they are in the bill, payments to DMH will be reduced by $63 million over a 10-year period, which would mean serious ramifications for the hospital and community, Smithmier said, citing calculations done by the Illinois Hospital Association.

Projected amounts the hospital will gain through newly insured individuals are just speculative, he said.

“There is no reason whatsoever to believe government cost estimates of anything,” Smithmier said.

DMH will continue to remain cautious about expenses and conserve as much money as possible, as it has done over the past two years, Smithmier said.

He added that hospital leadership already has fielded many questions from employees about the effects of the bill, but only time will yield those answers.

“This is a bill with so many ramifications to it,” he said. “You’re just not going to have a clear-cut, broad-based map of the impact of it this quickly.”

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