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What's next for covering health reform: Laura Meckler

Laura MecklerLaura Meckler is a staff reporter for The Wall Street Journal, based in Washington, D.C., where she covers the White House with a focus on domestic policy. She came to the Journal from The Associated Press Washington bureau, where she covered health care, social policy and politics. Before that, she covered state government in Columbus, Ohio. She got her start covering everything from schools and cops to the annual Pro Football Hall of Fame festival at The Repository in Canton, Ohio, about 50 miles south of her hometown of Cleveland. Meckler graduated from Washington University in St. Louis in 1990. She was a Nieman fellow at Harvard University in 2003-04, and in 1999, she won the Livingston Award for National Reporting, a prize given to journalists under age 35, for her coverage of organ donation and transplantation issues.

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By Laura Meckler
Staff reporter
The Wall Street Journal

Implementing the program: States will be responsible for setting up exchanges where people can buy coverage starting in 2014. What does your state need to do to get ready for this?

Enrollment: Medicaid, the health program for the poor, generally has a very poor track record of getting all the people who are eligible for coverage enrolled. This will also be a challenge with the expanded program that kicks in 2014. How well has your state done in reaching out to eligible families in past years? If the state has a poor track record, what - if anything - are officials and activists considering to do a better job with this next, much bigger and more complicated, round?

Community health centers: One of the underpublicized provisions of the new law would give a lot more money to nonprofit community health centers. Look at one of these centers to show how they are providing front-line care, and investigate whether they are likely to see more funding.

Small business: Many small businesses have opposed the bill, but they are eligible for tax credits if they offer insurance this year. Look at a small business that is eligible and see if they plan to offer coverage.

Medicare cuts: The health bill cuts Medicare reimbursement rates for many health care providers. One worth looking at is Medicare Advantage, the private managed care program that is offered in some parts of the country. Experts say these plans are, on average, overpaid by about 14 percent, and their rates will be cut by the new law starting next year. Insurers predict this will prompt companies to pull out of certain communities where it is more expensive to provide care. Is yours one of them?

20-somethings: Find some 20-somethings who will be newly subject to the individual mandate (starting in 2014) and see what they think. Are they resentful that they will have to buy insurance, or excited that they may get help paying premiums?

Legal challenges: More than a dozen states are challenging the new law, saying it's unconstitutional to require people to buy insurance. If your state is one of them, look at the political dynamics that prompted such a suit, as well as perhaps local views about whether it might succeed. National experts are generally skeptical that these suits will succeed in the courtroom, but they may succeed in getting a lot of press for the people who file them.