The basic idea of health care reform is to lower costs. Health care reform does this in several ways.

First, because people without health insurance drive up the cost of insurance, health care reform is massively expanding the pool of those with health insurance. Medicaid expansion, the personal responsibility mandate, coverage of young adults on their parents plan and coverage of those with pre-existing conditions are the major ways health care reform expands coverage. Health care reform also provides tax credits for small businesses and subsidies to low- and moderate-income people to help them buy health insurance.

Second, health care reform puts new limits on health insurance companies. Health insurance companies are now required to spend at least 80 percent of the money they collect in premiums on actual health care or rebate money to their customers.

Third, health care reform provides new ways to buy private health insurance. The new Health Insurance Marketplace (formerly called a Health Benefits Exchange) allows small businesses and individuals to enjoy group buying power when they buy health insurance.

Fourth, health care reform provides better information. Insurance information will now be easier to understand and the new Health Insurance Marketplace puts health insurance plans into platinum, gold, silver and bronze categories to ease shopping and make “apples to apples” comparisons of plans doable.

Fifth, health care reform uses a “community rating” method to set health insurance rates that shares health expenses more evenly over the entire population.

Finally, health care reform stresses efficiencies in the health care delivery system to achieve long term cost savings. Wellness and prevention benefits are now stressed. The government is looking at better ways to pay for health care to encourage long-term health. And the government is funding pilot projects and research to find better ways to provide health care.

Some of these proposals have already been implemented but most will take effect January 1, 2014.

People can begin signing up for health insurance on the new Health Insurance Marketplace as of October 1, 2013. The website is healthcare.gov and the phone number is 1-800-318-2596. You can create an account now to be ready on October 1.

The Fredericksburg Chapter of Virginia Organizing is sponsoring an Educational Forum on health care reform on Monday, September 23, from 7:00 to 9:00 p.m. at the Central Rappahannock Regional Library Headquarters Auditorium, 1201 Caroline Street in downtown Fredericksburg. Everyone is welcome.

http://www.youtube.com/watch?v=zsqu_Ce8qec&feature=youtu.be is a very good 45-minute video that explains the key aspects of health care reform quickly and concisely.

The next regular meeting of the MIRC (Medicaid Innovation and Reform Commission; the group that will decide if Virginia expands Medicaid) is Monday, October 21 at 1:00 p.m. in Senate Room B of the General Assembly Building in downtown Richmond. The MIRC has said that it will hold a public hearing during the month of September but no such hearing has been scheduled.

Health care reform requires all employers to provide a notice about health care reform to their employees by October 1, 2013. Two draft notices (one if you offer insurance, one if you don't) are available at: http://www.dol.gov/ebsa/healthreform/.