With or without health care reform and 30 million newly-insured Americans, everyone agrees we need more primary care physicians, more physician assistants, and more skilled health care workers. Everyone seems to agree there should be a coordinated effort to identify locations where there are doctor shortages and come up with ways to train and hire health care workers around the country.  But the politics of health care reform is preventing this from happening.

The Affordable Care Act calls for the creation of a commission to guide the country in matching the supply of health-care workers with needs. A commission of health care experts was appointed more than 8 months ago -but they have been unable to start their work because Congress has withheld funding.

The Washington Post reported:

The group cannot convene, converse or hire staff because $3 million that it needs for its initial year has been blocked by two partisan wars on Capitol Hill — strife over the federal budget and Republicans’ disdain for the health-care changes that Democrats muscled into law 14 months ago.

The National Health Care Workforce Commission is intended as an ongoing brain trust to focus new energy on solving an old problem that will become increasingly severe. The law says the new commission will analyze primary-care shortages and propose innovations for the government — and medical schools — to help produce the doctors and other health workers the nation needs.

Proponents of the workforce commission say they were surprised that Republicans have balked, because there has, in the past, been little ideological schism over the need to bolster the supply of primary care — doctors, nurses, physicians assistants and others.

The Republican strategy to kill the Affordable Care Act (Obamacare) could have some unintended consequences. The House recently approved a bill (HR1) that would bar using government appropriated funds to pay workers or contractors to implement any part of the Affordable Care Act. The Congressional Budget Office (CBO) studied the likely effects of de-funding health care reform and its cost to the government.

De-funding any and all parts of the Affordable Care Act would mean states would not be provided money to develop insurance exchanges that would enroll people in health insurance plans starting in 2014. It would also kill the already implemented Pre-existing Condition Insurance Plan that is available to people who have been turned down by insurance companies.

But the Republican bill would also affect ongoing programs such as Medicare Advantage and Medicare Part D drug plans. The CBO  report said the funding ban would prevent Medicare from establishing contracts to administer its Part D drug program, as well as its Medicare Advantage program.  All Medicare Advantage and Part D contracts expire on December 31, 2011. According to the CBO, since Medicare funding comes under the Affordable Care Act, contracts to pay insurance companies to manage Medicare Advantage and Part D would be banned under HR1. That would cause quite a bit of chaos for the eleven million people enrolled in Medicare Advantage and the 30 million or so with Part D drug coverage.

So it looks like Republican efforts to stop health care reform with a broad brush would kill things they hate, but also important programs that currently exist. Fortunately, the House of Representatives can come up with crazy bills and approve them until the cows come home.  The same or similar bills must be approved by the senate, and then they have to be signed by the President.  So Medicare Advantage and Part D are safe for now.

Kaiser Health News reports that 600,000 young adults took advantage of a provision in the Affordable Care Act that allows people under 26 to remain on their parents’ employer health insurance.

Wellpoint, the largest health insurer in the country, got 280,000 new clients as a result of the Affordable Care Act. Aetna added close to 100,000; Kaiser Permanente, about 90,000 new clients.

Here are excerpts from the Kaiser Heath News article:

Under the health law, health plans and employers must offer coverage to enrollees’ adult children until age 26 even if the young adult no longer lives with his or her parents, is not a dependent on a parent’s tax return, or is no longer a student.

According to the federal estimates, adding young adult coverage is likely to increase average family premiums by about 1 percent.

People in their 20s have the highest uninsured rate of any age group—about 30 percent, federal data show. Two factors are largely behind this: Young adults are most likely to work for employers that don’t provide coverage and young adults don’t understand the need for health insurance.

The federal government added 280,000 people to its insurance rolls because of the dependent coverage, said a spokeswoman for the Office of Personnel Management.

Before the federal law was passed, many insurers dropped coverage of children either at age 18 or 21 or when the children graduated from college. More than half the states required coverage to continue until at least age 25, but those laws often had several restrictions.

The full article can be read here:  http://www.kaiserhealthnews.org/stories/2011/may/01/young-adult-health-insurance-coverage.aspx?referrer=search