America's health care system is home to the world's best providers, greatest doctors, and most advanced research and development.  But rising costs are hurting families, burdening small businesses, and making us less competitive in a global economy.  We have the most expensive care in the world – but we're not the healthiest as a result. 

After nearly a century of trying, and after more than a year of extensive debate, our country now has health care reform that brings down costs for Orange County families and small businesses, expands coverage to millions of Americans, and ends the worst practices of insurance companies. Our community will begin to see significant benefits take effect in 2010, with other important reforms following shortly after.

Here are some of the immediate changes you and your families can expect:

Reduced health care costs for Orange County families and small businesses: 

• In 2010, small businesses that choose to offer coverage will begin to receive tax credits of up to 35 percent of premiums to help make employee coverage more affordable.
• In 2010, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary high-risk pool.
• This bill starts to close the Medicare Part D donut hole in 2010 by providing a $250 rebate to Medicare beneficiaries who hit the gap in prescription drug coverage.  And beginning in 2011, the bill institutes a 50% discount on prescription drugs in the donut hole.
• Starting this year, new private plans will be required to provide free preventive care: no co-payments and no deductibles for preventive services.  And beginning January 1, 2011, Medicare will do the same.
• In 2010, this bill will provide help for early retirees by creating a temporary re-insurance program to help offset the costs of expensive premiums for employers and retirees age 55-64.

Expanded coverage for Californians in our community and across the state:

• This year, children with pre-existing conditions can no longer be denied health insurance coverage.  The bill outlaws that practice for new health plans as well as grandfathered group plans.  Moving forward, no insurance company can deny a child coverage based on his or her health.
• This year, new health care plans and select grandfathered plans will allow young people to remain on their parents’ insurance policy up until their 26^th birthday. 
• This year, insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage.  This year, restrictive annual limits on coverage will be banned for new plans and grandfathered group health plans.  Under health reform, Americans will be ensured access to the care they need.
• The bill increases funding for community health centers so that nearly double the number of patients can be treated in their community health centers over the next 5 years.  The funding begins in the next fiscal year.
• The health reform bill will increase the number of primary care doctors, nurses, nurse practitioners and physician assistants through new investments.  This funding takes effect in the next fiscal year.

An end to some of the worst insurance industry practices and stronger consumer protections:

• Beginning this year, this bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.
• Starting January 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services.  Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services.  Any insurers who don’t meet those thresholds will be required to provide rebates to their policyholders.
• This year, discrimination based on salary will be outlawed.  New group health plans will be prohibited from establishing any eligibility rules for health care coverage that discriminate in favor of higher-wage employees.
• This bill holds insurance companies accountable for unreasonable rate hikes.  Starting in 2011, it helps states require insurance companies to submit justification for requested premium increases.  Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance exchanges.
• Beginning this fiscal year, this bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance companies.

Moving forward, I will continue to meet with constituents, small business owners, consumers, doctors, nurses, and other health care providers to hear about what works – and what doesn't work – in our current system.  You can share your thoughts with me by calling my district office at (714) 621-0102 or my Washington, D.C. office at (202) 225-2965.  You can also send me an e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .