by Nick Delgado

Guam - Dozens of members in the island's medical community gathered to provide input and ask questions about the newly-passed health care reform law. And it seems there's still some confusion as to how the measure will impact the island.

Health care stakeholders, doctors and insurance companies raised concerns and questions over the implications of the newly-passed health reform law on Guam during last night's roundtable discussion. Senator Frank Aguon, Jr., said, "There's been a tremendous amount of concern over the last couple of weeks in terms of the impact of the federal health care reform law."

Members of the island's medical community presented major concerns during the health care reform discussion. Guam Medical Association president-elect Dr. Thomas Sheih was part of the few that expressed concerns with the disparity on the reimbursement of Medicaid and MIP. He said, "I think part of the misunderstanding is whether or not this bill is going to put a demise to the insurance industry on Guam, and we certainly don't want it to be seen as its going to be a demise but its going to have to see how see how it works out when the details comes out whether or not we opt-in or we opt-out."

The law states that the territories will continue to have flexibility in implementing Medicaid to meet local needs and the new funding puts the territories on a path to full parity. Each territory will have a one-time option to "opt-in" to state (or territory)-based insurance exchanges in 2014. If Guam opts-out of the insurance exchange, its share of funds will be allotted to Guam's Medicaid funding instead.

Also part of the concerns was the continuity of care requiring a physician to care for their patients, to include medical treatment at public facilities. Department of Public Health's Division of Senior Citizens employee Joleen Almandres admits some of the language in the measure calls for clarification, saying, "In 2010 the donut hole that exist in our plans here in Guam that if an individual hit the donut hole then they would be given a $250 rebate."

Almandres says Public Health is now providing counseling on the type of plans they offer as it relates to the health reform law. Some in the room even called the measure a "massive insurance reform law", which they need more time to review and digest. "It requires health plans in a state to except every employer and individual in the state that applies for coverage and renew or continue coverage at the option of the plan sponsor or the individual as applicable," noted Sen. Aguon.

Aguon, the chairman of the Legislative Committee on Health, who called for the roundtable, says he along with the medical community will continue to weigh the advantages and disadvantages of this new law. He will hold a follow-up roundtable meeting in about two months.