FARMINGTON — Health care reform and how it affects local hospitals and businesses was the topic for the Franklin County Chamber of Commerce’s business breakfast series Wednesday.

When Franklin Community Health Network decided in December to invite David Winslow from the Maine Hospital Association to speak on the topic, it didn’t know he would be speaking just days after the national bill was signed into law, Winslow said. He explained how the MHA works with the state’s 39 hospitals and advocates for health care.

His take on the health care reform bill: some positives, some negatives but mostly a lot of unanswered questions, he said, referring to a New York Times article.

“It has hospital boards scratching their heads,” he said.

Some of the obvious and often quoted aspects of the plan include requiring most Americans to have health care with lower premiums for some people although maybe not covering as many people as was initially thought, he told the small group.

The plan expands eligibility for Medicaid, something Maine already does well compared to other states; prevents insurance companies from dropping someone due to pre-existing conditions; allows children up to age 26 to be covered on family policies, fills gaps in Medicaid prescription coverage; and gives small businesses tax credits of up 35 percent on premiums, he said.

Some of the pluses that he foresees for hospitals include stable health insurance for more people and additional matching Medicaid money going to the states. The federal government now matches 66 percent of each dollar for Medicaid payments with one-third paid by the state. The increase within the reform bill brings that ratio up to 75 percent from the government, 25 percent from the state.

Although there is a time limit on this measure, he doesn’t see it going away once in place, he said.

Winslow sees a significant redirection of Medicare reimbursements, perhaps additional government control or more standardization, raising the question of the future of the commercial insurance market as possible negative aspects for hospitals.

The unknowns include the logistics of how to implement the 2,700-page, $940 billion in changes and other unanswered questions with start dates a few years from now, he said.

A huge health care issue facing Maine is a shortage of medical personnel, not only doctors but also pharmacists and nurses, he said.

“Maine is competing with other states,” he said of the effort to increase professionals.

Larger hospitals have stepped up their in-state medical education policies. Interns from Boston are spending two-year residencies here in an effort to lure them to stay.

Another issue raised was whether the health care reform law provides funds for preventive medicine.

“Reform is not enough. We’re going to have to be healthy,” Winslow agreed, but whether there are funds for prevention within those 2,700 pages is one of the unanswered questions.

In comparison to other states, Maine has already accomplished many improvements in health care, he said noting the difference he’s seen in just eight years with the hospital association. Whether that parlays to a reward that can be used for other things like paying off hospitals money that is owed instead of expanding coverage may be where government control filters in, he said. The government could regulate the allotment of money to another state where Medicare is not so readily available and people are uninsured.

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