As we have traveled around the state for the last several years discussing health reform, again and again we hear from people frightened of losing their insurance coverage. The problem is that many of these folks have been diagnosed with a medical condition that brands them as uninsurable for life. In 2014 that worry will go away.

Currently, if you are diagnosed with a medical condition and seek insurance coverage you can be turned away or charged thousands of dollars per month for a policy. Health reform put some immediate changes in place as stop gaps for people with these so called pre-existing conditions. New money expanded our state’s high risk pool, called Inclusive Health, which gives people with pre-existing conditions a new coverage option. Young people can now stay on a parent’s insurance plan until age 26. This helps bridge potential gaps in coverage. For someone with a pre-existing condition such a gap can prove financially catastrophic. Children can no longer be denied coverage due to a pre-existing condition. And, starting in 2014, insurers will not be allowed to charge more or deny coverage due to a previous medical diagnosis.

Who will this help? Families took a close look and determined that more than 2 million North Carolinians will get a new sense of security from reform. Nearly one-in-four people in almost every county have been diagnosed with a pre-existing condition. In Wake County, 186,800 people have faced such a diagnosis. In Mecklenburg it’s 190,700. In Robeson County more than 30 percent of the population lives with a pre-existing condition.

These numbers are conservative. This report only shows people diagnosed with or treated for a specific set of medical conditions in 2009. That means the uninsured or those with problems accessing the health care system are undercounted. But this report does show the dramatic scope of the problem in our state. And it shows the tremendous relief health reform will bring to millions of families when it is fully implemented in 2014.

During the debate over health reform one of the primary criticisms of the Affordable Care Act was that it created uncertainty and stifled long-term investment, especially in the health care sector. While it was probably exaggerated, it’s true that hospitals and insurers and drug companies didn’t entirely know what to expect. Now everything has changed.

The U.S. Supreme Court has upheld the law as constitutional. A wide range of businesses, both in and out of the health care market, now understand what is required of them. They are making future decisions and investments based on health reform. Entrepreneurs are eyeing new opportunities. State governments are establishing new information technology infrastrustures. Insurance companies are thinking about how to compete on cost and quality instead of cherry picking the healthiest customers or paring down policies until nothing is covered. Hospitals are looking to increase efficiency and shift from traditional fee-for-service systems. It is an exciting time.

But there is one problem. Opponents of health reform continue threatening a full repeal of the law. This is frightening to organizations that are shifting toward providing better care at lower costs. Many of these models depend on implementation of the ACA. Health reform is funding new models of care. It is investing to strengthen the safety net. And the health care sector is depending on 32 million more Americans gaining access to affordable health insurance.

Many businesses were just waiting for a Supreme Court ruling to move forward. Now there are politicians saying that organizations should wait until November. After that, who knows?

And there is evidence that the ridiculous lies told about health reform are hurting business. Realtors are struggling every day to dispel the myth that middle class home owners will pay a tax on real estate transfers.

The Affordable Care Act is law. The Supreme Court has ruled. Let’s move forward and stop playing silly political games. Perpetuating lies and uncertainty only hurt the families and businesses of our state and slow the economic recovery.

If you read the news lately you might think that Sen. Phil Berger has taken the approach of South Carolina or Louisiana in rejecting a state-based health benefits exchange. As a reminder, an exchange is an organization that will allow individuals to shop for insurance in a standardized, understandable way and purchase policies at group rates. Each state can set up its own exchange, have the federal government set up an exchange on its behalf, or establish a partnership exchange between the feds and the state.

As another reminder, the NC Institute of Medicine convened meetings among stakeholders of every stripe to discuss how an exchange should be structured. That group came to a general consensus about legislation where everyone got something but no one got everything they wanted.

Blue Cross and Blue Shield of North Carolina had its friends (Reps. Brubaker and Dockham) ignore the IOM recommendations and file a bill that gave the state’s largest insurer everything it wanted. (The North Carolina Medical Society also had some input on the bill.) The House moved the legislation along despite objections from a wide range of organizations that the bill was fatally flawed and probably not compliant with federal regulations.

Then this clunker landed in the Senate. The Senate took a short look and many folks concluded that this thing needed a serious overhaul. But with budget writing and other priorities there was not much time to fix the broken bill sent from the House. So Berger wisely took a pass.

The situation was similar in the short session. Remaking the legislation was a steep climb and then there was a looming Supreme Court decision that could have scrapped any effort the Senate exerted by throwing out the Affordable Care Act. Again the Senate took a pass and again it was a reasonable thing to do.

So here we are. While it’s true that it would be extraordinarily difficult to get things up and going by 2014 — and the state has to pass a spot check by the feds in January — we can still have a state-based exchange. It may be that the feds run parts of our exchange in 2014 and the state takes over the entire operation in 2015. To some people that may sound like a federal takeover of our exchange. To me it sounds like semantics. In a few years North Carolina will likely have its own exchange operated by the state.

And if it takes a few years to get a state-based exchange don’t blame the Senate. The House could have passed a bill based on the NC Institute of Medicine recommendations within a few weeks and with nearly universal approval and praise. Instead they (Republicans and Democrats) allowed a few powerful interest groups to kill the entire enterprise.

We will get another shot at this. We still have the consensus recommendations. Let’s get those negotiated provisions enacted into law and move on.

Here is the first page of a letter sent to one of our North Carolina friends from WellPath explaining that the Affordable Care Act requires insurance companies to spend a certain percentage of premiums on health care. (You can click on the letter to get a better look.) As the letter notes, “No more than 15 percent of premiums may be spent on administrative costs such as salaries, sales, and advertising.” When those limits are exceeded then rebates are due. This is another important consumer protection provided by reform.

While Rep. Renee Ellmers wins the contest for most lies told per minute about the Affordable Care Act, Kissell should be honored for flipping and flopping more than any other member of Congress when it comes to his votes and views on health reform.

Kissell, of course, justified his vote against health reform by misrepresenting the measures in the law aimed at curbing Medicare fraud. Then things got interesting.

In 2011 Kissell said that he opposed repealing the Affordable Care Act and even voted against repeal. As recently as June 27, 2012, he was celebrating new funds flowing to Cabarrus Community Health Centers. He even had the gall to claim credit for securing the grant. This money is from a provision in the ACA that expands community health centers. That means Kissell voted against funding for Cabarrus Community Health Centers.

Now we come to yesterday’s vote. After saying that he opposes full repeal, and after taking credit for ACA funding of community health centers, Kissell changed course and voted for full repeal of health reform. That would mean snatching back the grant he recently took credit for.

Obviously, the Congressman’s contortions are due to the redrawing of his district lines. And even with his new stance he is unlikely to win reelection. And if this is his last year of service it will be sad that a career that began with such promise ended with such pretense.