Days after the legislation commonly known as the health care reform act was signed in March, some of the hospitals overseen by Gene Diamond received phone calls from people asking when they could come in for their free health care.
In the just more than six months since the signing of the Affordable Care Act, millions of dollars have been spent and new policies implemented with the idea of giving all Americans better access to health care. The full impact of the legislation won't be fully known until at least 2014, when the implementation timeline of the bill is completed, but in weeks the impact of the bill so far will have a very real measure in the form of November midterm election. The success of the health care reform act so far, and on the upcoming election, depends on whom you ask.
For Diamond, the regional CEO of the Sisters of St. Francis Health Services Inc., the past six months have been confusing and frustrating, evidenced by callers who wanted free health care. Diamond said his system took at look at where it would need to be financially in four years and determined the system would have to be making money on Medicare patients by that time, and estimated having to have a 3 to 5 percent cost reduction in each of the next four years.
"It's a tremendous struggle," he said. "We're trying to regionalize, but that's not enough. We're scratching our heads, even pounding our heads against the wall to figure out how to do this."
That's a totally different position from the one taken by U.S. Rep. Pete Visclosky, D-Ind. who voted in favor of the legislation in March and stands by his vote as he runs for re-election. Before the bill, he said constituents were regularly coming into his Merrillville office asking for assistance with their health care.
"That's part of the reason why I voted for the bill. You should not be coming to your congressman's office for health care help," he said, acknowledging there was anger over the bill, which he believes has dissipated but not fully evaporated.
Samuel Flint, a health policy expert and associate director of the School of Public and Environmental Affairs at Indiana University Northwest, said six months after the bill's signing Americans are as divided as they were when the legislation was introduced. He said it is a very real possibility that the elections will be affected by that division.
"We want instant mashed potatoes, instant coffee and instant health care reform," Flint said. "The next big story in health care will be the election. If the Republicans take the House of Representatives and the Senate, almost certainly there will be a repealed bill in some sort, that will then be vetoed by the president. The (Republicans) said they would stop appropriations, and I would take them at their word."
In September, the GOP revealed its agenda for the next Congress. Called "A Pledge to America," the document has a section on health care that explicitly states the goal of repealing the "job-killing health care law" and replacing it with other reforms.
Mark Leyva, the Republican running against Visclosky, agrees with his fellow Republicans and believes the six-month-old legislation does nothing to reform health care and is better labeled as a tax increase than a reform bill.
"... If this bill is not repealed, it would be totally devastating to senior citizens and (create) further job loss," he said.
But Denise Dillard, vice president of government and external affairs at Methodist Hospitals, doesn't see health care reform in terms that black and white. She sees the process did not go as smoothly or bipartisan as Americans hoped and believes a lot of the angst people are feeling is caused by the lack of economic recovery.
"There are two ways to look at it. Yes, there will be some immediate loss and changes, but also the opportunity to get citizens of Northwest Indiana the best care from a wellness standpoint," Dillard said. "How many people will flip because of a lack of understanding of 'How will (health care reform) be better for me?'"
Flint believes what happens in the election will depend on just that aspect. "There are good things happening, but are they happening to enough people?"