Results tagged “health reform” from EdLabor Journal

As mentioned yesterday, a provision of the Affordable Care Act banning lifetime limits on health care coverage goes into effect next week, on September 23rd.

A lifetime limit on coverage is a cap on how much an insurer will pay for any one policy.  When medical bills exceed this cap, which is often the case when a person is diagnosed with a serious or chronic illness, insurers can stick the patient with the rest of the bill. Over 90% of individual health insurance policies have lifetime benefit limits, but such practices will be prohibited under the health reform law. A recent NPR piece explained this important change:

“Among the new provisions of the health law that take effect later this month is a ban on something most people don't even know they have — a lifetime limit on benefits covered by their health insurance.

“Starting late next week, new health plans or plans that are renewed, won't be able to cap the dollar amount of benefits they cover. No more yearly caps either, though those limits will be phased out over three years, disappearing entirely in 2014.

“The change apply even to health plans that don't have to abide by some new rules because they were ‘grandfathered’ under the health law.”
…

“Until now, many people with expensive chronic conditions simply considered it their lot in life to have to change jobs every couple of years in order to maintain coverage.

“Take Edward Burke, of Palm Harbor, Florida. Burke, who has hemophilia, and has ‘capped out,’ as those with chronic conditions call it, twice in the past seven years. ‘I would have capped out four or five times,’ he says, but for the fact that the industry he works in, home health care, had been going through a series of mergers and acquisitions. So every time his company was bought and changed names, he was lucky enough to start with new health insurance — and a new lifetime limit.

“Burke estimates he spends about $900,000 per year on factor VIII, which replaces a clotting factor he lacks. That makes chewing through a lifetime limit of even several million dollars a matter of when, not if.”

As the ban on lifetime limits goes into effect for health plan years beginning on or after September 23, 2010, people like Edward Burke will not have to struggle to maintain coverage any longer.

Both the New York Times and the Washington Post highlighted the looming deficit problems for states and localities and how it could mean a loss of nearly 300,000 teachers' jobs nationwide.

In the New York Times editorial, Saving the Teachers, they say:

Last year’s $100 billion education stimulus plan insulated the public schools from the worst of the recession and saved an estimated 300,000 jobs. With the economy still lagging and states forced to slash their budgets, Congress must act again to prevent a wave of teacher layoffs that could damage the fragile recovery and hobble the school reform effort for years to come.

In March, Representative George Miller, a Democrat of California, introduced a jobs bill that included a $23 billion school rescue plan. Senator Tom Harkin, a Democrat of Iowa, has since introduced a similar plan fashioned as an emergency spending bill. The House version is the better of the two.

The need for a second school stimulus plan was underscored on Monday by a new analysis from the American Association of School Administrators, which reported that cash-strapped districts were prepared to cut as many 275,000 jobs in the 2010-2011 school year.

The loss of that many paychecks — and the resulting decline in consumer spending — could kill off still more jobs in the communities where teachers and other school employees live.

(emphasis added)

Harold Meyerson wrote about the school recession in the Washington Post:

The worst recession since the 1930s is clobbering the nation's schools.

In Indiana and Arizona, the legislatures have eliminated free all-day kindergarten. In Kansas, some school districts have gone to four-day weeks. In New Jersey, 60 percent of school districts are reducing their course offerings. In Albuquerque, the number of school district employees is down 10 percent. In the D.C. suburbs, Maryland's Prince George's and Virginia's Prince William counties have increased their class sizes.

The Local Jobs for America Act allocates $23 billion this year to help states support 250,000 education jobs. And it does a lot more for local communities like funding for firefighters and police.

On this blog, we have highlighted many of the benefits to all Americans under the new health reform law. Today the New York Times joins in, highlighting another key change, free preventative care under new plans. The new health reform law requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles.

As the New York Times reports:

The new law also aims eventually to improve health insurance for everyone. By now you have probably read or heard about big changes like the rules that will require insurers to cover everyone who applies, regardless of health status, and forbid them from dropping people when they get sick.

You may not yet be aware, though, of another notable improvement to insurance, a change that could save a consumer or family hundreds of dollars a year. Under the new law, insurers must offer preventive services — like immunizations, cancer screenings and checkups — to consumers as part of the insurance policy, at no additional out-of-pocket charge.

The idea is that healthy Americans will be less costly Americans.

“This is transformative,” says Helen Darling, president of the National Business Group on Health, a nonprofit organization for large employers. “We’re moving from an insurance model that was based on treating illness and injury, to a model that’s focused on improving an individual’s health and identifying risk factors.”

The trend toward offering free preventive care has been gaining steam for a decade among large companies that provide employee health benefits. “Employers recognize that if they want to control costs, they have to persuade their workers to be healthier, including their children,” Ms. Darling said.

Three out of four large companies now offer free preventive health services to their workers, according to a 2009 survey by Mercer, a benefits consulting firm. Smaller employers, though, and individual health plans have been less likely to offer free care of any type.

Learn more about the new health reform law and how all Americans will benefit. Also, see this PDF for more information about preventing disease and improving the public's health.

This year, President Obama and a Democratic-led Congress have:

ALLOWED EXTENDED COVERAGE UNTIL AGE 26 THROUGH YOUR PARENTS: Reform allows you to stay on your parents’ health care plans until your 26th birthday (PDF). Between now and 2014, this only applies if your employer doesn’t offer you coverage. Beginning in 2014, it applies to all young people, even if you get insurance through your job. This will help to cover the one in three young adults who are uninsured.

LOWERED YOUR COSTS WITH FREE PREVENTATIVE CARE FOR BETTER HEALTH: Reform means free preventive care to all people insured under new plans (PDF), and invests in preventing illness and disease instead of just treating them when it’s too late and costs more. Simple prevention can stop a small health problem from getting worse as you get older.

GIVEN YOU NEW PATIENTS’ RIGHTS THAT SAVE YOU MONEY: This year, reform eliminates lifetime limits on how much insurance companies cover if you get sick, and tightly restricts yearly limits (PDF). In 2014, reform caps what insurance companies can force you to pay in co‐pays & deductibles, bans "gender rating" that allows women to be charged more for the same coverage, and bans new group plans from having eligibility requirements that have the effect of discriminating in favor of higher wage employees—who tend not be younger workers.

GIVEN YOU SECURITY THAT YOUR  HEALTH CARE IS NOT TIED TO A JOB: Reform means affordable health insurance is available to those without job‐based coverage, starting in 2014, and provides substantial premium assistance (PDF) to those who still can’t afford it. Young adults are just starting jobs and careers, and often don’t have access to job‐based coverage. Even when they do, they often can’t afford health insurance—or must endure a waiting period as a new employee.

ENSURE YOU HAVE HEALTH CARE WHEN YOU NEED IT MOST – WHEN YOU'RE SICK: You can no longer be dropped from your plan if you get sick. If you have a “pre‐existing condition,” beginning in 2014, you can no longer be denied coverage or charged higher rates (PDF) —and between now and 2014, you can enter an interim high‐risk pool to get insurance. This year, discrimination is banned for children under age 19 who have pre-existing conditions.

PROVIDED YOU A CHOICE OF COMPETITIVE PRICES AND PLANS: Reform creates Health Insurance Exchanges, or marketplaces (PDF), you can shop in if you don’t get insurance through your job. Starting in 2014, you get the benefits of group purchasing power like big businesses have.7

MADE IT EASY WITH ONE-STOP SHOPPING: Insurance "Exchanges" or marketplaces will allow you to simply and easily compare prices and health plans online (PDF) and choose what’s right for you. The typical young adult risks losing coverage when you change jobs, move, or hold a part‐time or temporary job. Under reform, it doesn’t matter.

PAID FOR REFORM SO YOUR GENERATION’S NOT STUCK WITH THE BILL: Health insurance reform is actually projected to lower the deficit by $1.3 trillion (PDF) over the next two decades. It lowers health care costs over the long term—so it makes sense it lowers the cost to taxpayers.

Yesterday, the House approved legislation that makes key improvements to the historic health reform law, and makes the single largest investment in college aid ever, at no additional cost to taxpayers.

The legislation makes health care even more affordable for the middle class, lowers prescription drug costs for seniors by closing the “donut hole” over time, reduces the deficit and strips out special deals that favored one state over another. The bill also makes the most sweeping changes to our federal student loan program in a generation.

This morning, the Speaker of the House enrolled the bill. The package will now go to President Obama’s desk for his signature. Below are some photos of the enrollment ceremony as well as a few of a surprise birthday cake for Speaker Pelosi on her birthday.

The New York Times highlights the important of including the Student Aid and Fiscal Responsibility Act in the budget reconciliation package passed by the House last night to getting both health insurance reform and the federal student loan reform done.

The New York Times says:

Lots of Democrats can point to lots of different moments when they think the health care bill was brought back from the brink of collapse.

But for a number of senior House Democrats, the crucial turning point was a meeting the night of March 9 in the offices of Speaker Nancy Pelosi. It was supposed to be a strategy session with Senate Democratic leaders about the budget reconciliation procedure that Democrats were planning to use to make final changes to the health care bill and push them through the Senate on a simple majority vote.

Instead, the session focused entirely on the question of whether to include another of President Obama’s top legislative priorities — a sweeping overhaul of federal student loan programs — in the reconciliation package.

The budget resolution approved by Congress last spring provided for completing both major health care legislation and major education legislation through reconciliation, which adjusts federal policy to meet specific goals for reducing the deficit.

A trio of House leaders — Representatives James E. Clyburn, the Democratic whip; George Miller, the chairman of the Education and Labor Committee; and Xavier Becerra of California, the vice chairman of the Democratic caucus — argued strenuously in favor of including the education proposal.

...

Although overshadowed by the larger health care fight, the inclusion of the education bill may have been a decisive factor, especially at a time when House Democrats were exceedingly distrustful of their Senate colleagues and were essentially being forced against their better judgment to approve the Senate’s health care bill as the base law to which they would later make changes.

The student loan overhaul was very popular in the House. And because it would save tens of billions of taxpayer dollars by ending subsidies to private commercial banks, it offered a purely populist message at a time when public anger at Wall Street is running high and many liberals were disappointed that the health care bill would not include a public option, or government-run insurance plan.

Mr. Clyburn, who as the whip is the party’s main vote-counter, argued forcefully that the student loan measure would help generate support for the health care package.

...

For some Democrats, the student loan plan is the hidden triumph in the health care fight, and the late-night meeting earlier this month was the crucial moment. “It was an fascinating conversation about what the Democratic Party represented,” one Democrat said.

“Members of Congress have a clear choice,” Mr. Miller said in a floor speech on Sunday night. We can side with the American people by making health insurance and college more affordable and accessible, while creating millions of jobs and reducing the deficit. Or we can side with the insurance companies and the banks. That’s it. That’s the choice. I’m siding with the American people.”

Learn more about the Student Aid and Fiscal Responsibility Act.

Rep. Rob Andrews was on Fox News this morning talking about the health care summit at the White House tomorrow.

In the New York Times editorial this morning, Don't Give Up Now, the editorial board argues that:

Congress is achingly close to passing legislation that would cover most uninsured Americans and provide much more security for all Americans — guaranteeing that if they lose their jobs they will be able to buy affordable policies and can’t be denied coverage because of pre-existing conditions.

If the Democrats quit now, so close to the goal line, the opportunity for large-scale reform could be lost for years. Meanwhile, the number of uninsured, currently more than 46 million, will keep going up and the cost of health care will continue to soar.

Chairman Miller made the same point in his op-ed, health insurance reform remains critical to economic growth. "Health care costs are unsustainable; they’re still crushing families, small businesses and large companies. When people lose their jobs they lose their health insurance. People with jobs and who want coverage but find out they have a pre-existing condition still can’t get coverage. Businesses large and small come before Congress every day and tell us how they’re going to have to drop coverage for their employees or go out of business."

And Americans know this intuitively. A new poll by Kaiser Family Foundation found that although Americans are divided about health insurance reform proposals overall, they become more supportive when told about key provisions. The poll concluded that "majorities reported feeling more favorable toward the legislation after learning about key elements such as the availability of tax credits for small businesses, the creation of health insurance exchanges, the inability of insurers to deny people coverage because of pre-existing conditions and the move to close the Medicare drug benefit’s 'doughnut hole.'”

Both the Senate and House bills include all the above provisions and many more to ensure affordability for the middle class, accountability for insurance companies, and accessibility for all Americans. Learn more about the House's Affordable Health Care for America Act.

For the past year, the Democrats have been working tirelessly to reform health insurance yet, the GOP struggles for consensus on health care according to a report on NPR today.

“But there’s just one problem, says health policy analyst Len Nichols of the nonpartisan New America Foundation. If you take most of the ideas that Republicans are shopping around at the moment, ‘then we’re back to policy that, frankly, was rejected by Republicans when they had a majority”

Meanwhile Democrats in the House and the Senate have each produced legislation that will:

• Ensure that 30 to 35 million Americans will have health insurance coverage.
• Prevent insurance companies from discriminating or charging more because of a preexisting condition.
• Prevent insurance companies from dropping coverage during life-saving treatment.
• Ensure that laid-off workers won't lose insurance.
• Eliminate annual or lifetime caps on coverage.
  

Chairman Miller and House Leaders are committed to crafting the strongest final bill possible for American families.

In September a survey of business leaders by Business Forward found that:

Nearly 90% of those polled cite health care costs as a major concern, more than cite taxes, government regulation, labor costs or energy costs.

Without reform, 86% of those polled believe that health care costs will continue to rise in the next five years, and 55% believe it will go up "a lot." If costs continue to rise as expected, nearly 9 out of 10 business leaders expect to raise their employees' deductibles and copayments. Nearly 8 out of 10 expect to cut benefits. And nearly one in three expects to lay off employees.

Moderate think-tank, Third Way, released a report today entitled 12 Ways Health Reform Will Tackle Runaway Costs. By looking at both the House and Senate bills, they were able to conclude that there would be significant savings for businesses and workers under these reforms.

For American employers and workers:

Over the next 15 years, American businesses would collectively spend $637 billion less on their share of health insurance premiums, and their workers would save a collective $177 billion under the Senate bill. For a typical business with 500 employees, the cost of coverage would be $2.5 million less than it would be otherwise over 15 years. In other words, these reforms will slow the annual growth rate of costs for job-based health care coverage over the next decade and a half from a projected increase of 5.8% to 5.0% per person. For American businesses, these savings will translate directly into higher wages for workers, more money to expand and invest, and a greater ability to succeed in a fiercely competitive global marketplace. For workers, these savings will lead to coverage that is more stable and more secure.

Savings from Reform: 2010 through 2024

	Projected total spending	Projected spending under reform	Total projected reductions in spending from reform
Aggregate spending on employer share of premiums for job-based coverage	$14.55 trillion	$13.91 trillion	$637 billion
Aggregate employee share of premiums for job-based coverage	$4.04 trillion	$3.86 trillion	$177 billion
500-person employer offering coverage	$56.4 million	$53.9 million	$2.5 million

We encourage you to read the report as well as learn about the cost of inaction and how health insurance reform helps small businesses.

The USA Today has a column by Steven Findlay, a senior health policy analyst at Consumers Union (of Consumer Reports fame), that busts 4 of the most common myths about health insurance reform now before Congress.

He says:

1. It's not a government takeover of health care.
2. It's highly unlikely that your existing coverage is going to cost more under this legislation than it would otherwise over the next 10 years.
3. Relatedly, the legislation is not going to bust the budget.
4. Medicare is not being sacrificed on the altar of coverage expansions for the under-65 folks.

H.R. 3962, the Affordable Health Care for America Act, is a uniquely American solution to ensuring affordability for the middle class, accountability for insurance companies, and accessibility for all Americans.

Hallmarks of this reform are increasing choice for consumers and competition for insurance companies, reducing the deficit and ensuring the solvency of Medicare and Medicaid while improving the quality of care for every American.

We encourage you to read the entire USA Today column, learn more about the Affordable Health Care for America Act, and educate yourself on some of the other myths surrounding this reform effort.

A report by the General Accountability Office today says that it found "extraordinary price increases" in brand-name drugs. Those increases put an additional burden on sick and struggling families.

According to Reuters:

Prices for hundreds of brand-name drugs have soared since the beginning of the decade, especially those that treat depression, infections and heart disease, according to a U.S. government report on Monday.

The nonpartisan General Accountability Office said it found "extraordinary price increases" for 321 brand-name drugs, with prices jumping by 100 percent to 499 percent -- and in a few cases by more than 1,000 percent.

The number of drug price increases more than doubled from 2000 to 2008 with most drugs maintaining their higher prices over time, the investigative arm of Congress said.

The Affordable Health Care for America Act has multiple provisions to protect consumers and taxpayers from rapid drug price increase.

For consumers, the Affordable Health Care for America Act:

• closes the Part D donut hole by $500 in 2010 and eliminates the donut hole entirely by 2019. This protects seniors by ending the gaps in coverage that force them to pay the full cost of their drugs. For patients who are able to switch to lower-cost generic drugs, H.R. 3962 clarifies that Part D plans can offer a free generic prescription fill when a Part D enrollee switches to the generic.
• requires the Secretary of the Department of Health and Human Services (HHS) to negotiate with Part D manufacturers for lower prices, providing new leverage to help control Part D drug price increases.
• requires new transparency in drug pricing for plans in the Exchange that use pharmaceutical benefit managers (PBMs). This will reduce waste, fraud, and abuse and give patients more information about drug prices and spending.

For taxpayers, the Affordable Health Care for America Act:

• expands and increases the Medicaid drug rebate, which requires that manufacturers pay a rebate to cover cost increases that exceed the inflation rate. These payments will protect taxpayers from price increases that occur before or after the health care reform legislation goes into effect.
• contains new Part D rebates that help cut the cost of providing drugs for dually eligible and low-income enrollees. These Part D rebates are based on the Medicaid rebates. They will save taxpayers billions of dollars each year.

These reforms of health insurance are only a few of the many benefits for consumers and taxpayers. We encourage you to read the GAO report, learn more about how H.R. 3962 controls drug prices and improves Medicare Part D, or more about H.R. 3926, the Affordable Health Care for America Act.

With the goal of a final bill that ensures affordability for the middle class, accountability for insurance companies, and accessibility for all Americans, Chairman George Miller has been working with House Leadership and the chairs of the Ways and Means Committee and the Energy and Commerce Committee to craft final health insurance reform legislation.

Never before have we as a nation been this close to ensuring that every American has access to quality and affordable health insurance coverage.  The House and the Senate have each produced legislation that will:

• Ensure that 30 to 35 million Americans will have health insurance coverage.
• Prevent insurance companies from discriminating or charging more because of a preexisting condition.
• Prevent insurance companies from dropping coverage during life-saving treatment.
• Ensure that laid-off workers won't lose insurance.
• Eliminate annual or lifetime caps on coverage.
  

Chairman Miller and House Leaders are committed to crafting the strongest final bill possible for American families.


Watch Chairman Miller discuss health reform on the Ed Show (MSNBC) on January 5:



Read more about the impact of health reform:

• News of the Day: If health care bill passes, some changes would start fast
• News of the Day: Sick, without a safety net
  

Read more about the House's Affordable Health Care for America Act

Rep. George Miller, Chairman of the Education and Labor Committee, delivers his comments during the floor debate on H.R. 3962, the Affordable Health Care For America Act on November 7, 2009.



Rep. George Miller, Chairman of the Education and Labor Committee, delivers a rebuttal to the proposed Republican amendment during the floor debate on H.R. 3962, the Affordable Health Care For America Act, on November 7, 2009.

Big news yesterday as the nation's largest senior citizen group AND the nation's largest organization of doctors both offered support for the Affordable Health Care for America Act.

The Los Angeles Times reports:

The [AARP], which has been pushing for a health overhaul for more than a year, had withheld a formal endorsement of any of the healthcare bills being developed by congressional Democrats.

That endorsement was followed by an announcement at about 10 a.m. Pacific time from the American Medical Assn. in which the nation's largest doctors group voiced its support for the measure.

AARP Executive Vice President Nancy LeaMond said today that the group saw the House Democratic bill as the most promising proposal.

...

The AMA's support for the House bill comes ahead of a critical policymaking meeting of its House of Delegates in Houston that begins Saturday. The organization is being asked by some constituencies, at the eleventh hour, to back away from supporting healthcare reform.

"These bills go far beyond what is necessary to fix what is broken with our healthcare system, and they grant the federal government considerable new powers and authority, which could ultimately amount to a complete government takeover of healthcare, and which is anathema to doctors and patients," reads a resolution introduced by the American Assn. of Neurological Surgeons, the American Society of General Surgeons and the American Academy of Facial Plastic and Reconstructive Surgery. The resolution was also supported by AMA delegations from Georgia and Washington, D.C.

Learn why these groups and many, many others support the Affordable Health Care for America Act at our clearinghouse page.

Ezra Klein at the Washington Post passes along a new academic paper by MIT health economist Jon Gruber. Mr. Gruber has looked at the health care proposals being considered by Congress and has found that the reforms will lower insurance premiums.

One of those states is Massachusetts, which passed health-care reform similar to the one contemplated at the federal level in mid-2006. The major aspects of this reform took place in 2007, notably the introduction of large subsidies for low-income populations, a merged nongroup and small group insurance market, and a mandate on individuals to purchase health insurance. And the results have been an enormous reduction in the cost of nongroup insurance in the state: The average individual premium in the state fell from $8,537 at the end of 2006 to $5,143 in mid-2009, a 40 percent reduction, while the rest of the nation was seeing a 14 percent increase.

You can read the rest of Mr. Gruber's paper here.(MS Word document)

The New York Times ran an editorial on Saturday discussing individual mandates and affordability. It covers the key areas of:

• Why is a mandate necessary? [Those without coverage drive up costs for those with coverage]
  
• Will premiums go up or down? [They would go down]
  
• Will there be help? [Yes]
  
• What's affordable? [The House bill provides affordability tax credits for families of 4 up to $88,000]
• Has it been tried? [Yes, successfully]
  
• Which version is more affordable? [The House bill]
  

See the editorial for a complete explanation of how this would work and how it would improve access to quality, stable, affordable health care.

In another column today, E.J. Dionne correctly points out that, while the mandates and subsidies don't start until 2013, there are 14 benefits that start immediately.

That's why the most important document House Democrats released when they unveiled their bill last week was a list of 14 benefits that would be created immediately.

These include insurance reforms to ban lifetime limits on coverage and an end to "rescissions," under which insurers abruptly nullify patients' policies after they file claims. One of the most popular reforms in the bill -- barring insurers from denying coverage to those with pre-existing conditions -- wouldn't take effect until later. So the House bill creates an interim high-risk pool to help those who need coverage in the meantime.

There are also particular benefits for Medicare recipients, including an immediate reduction in drug costs, and a very popular provision that would allow parents to keep their children on the family health plan through age 26.

Especially important are new investments in community health centers and in efforts to increase the number of primary care doctors. As millions more people get access to decent care, the system will have to provide more doctors, nurses and facilities to treat them.

"People will be excited about 2013," said Rep. George Miller, chairman of the House Education and Labor Committee, which shares jurisdiction on the health-care bill. "But there are enough benefits between now and then to keep them engaged and to keep them favorably disposed."

Learn more about the Affordable Health Care for America Act [H.R. 3962] and how reform will slow the growth in out-of-control costs, introduce competition into the health care marketplace to keep coverage affordable and insurers honest, protect people’s choices of doctors and health plans, and assure all Americans access to quality, stable, affordable health care.

This morning, Rep. George Miller published an op-ed in the Vacaville Reporter about the need for affordable health care for everyone. Below it is excerpted in its entirety.

Readers of this paper will know that, for much of this year, Congress and President Obama have grappled with one of the most important and complicated issues affecting our nation's economy and our community: health insurance reform.

I am proud to announce that on Thursday we introduced revised legislation that addresses many concerns raised about reform and brings us closer than ever to delivering on the long-held promise of quality and affordable health care for each of us.

I am a principal co-author of the bill.

Since three House committees passed a bill this summer, we have worked hard to incorporate changes and improvements suggested by people from across the political spectrum. Our revised bill directly addresses the needs of American families. It will:

• Not increase the deficit.
• Curb out-of-control costs that are bankrupting families and employers.
• Strengthen Medicare for seniors, in part by closing the prescription drug "donut hole" and by making the program sustainable for years to come.
• Protect people against discriminatory insurance company practices. We eliminate so-called "pre-existing" condition denials, stop insurance companies from dropping coverage if you get sick, and establish yearly caps on what you will pay out-of-pocket.
• Keep premiums affordable and insurance companies honest by ensuring competition in the health care marketplace through inclusion of a public consumer option. People in California will be able to choose from multiple private options, such as Blue Shield, Kaiser Permanente and others, or choose a public plan that offers the best quality at the best price -- just as they do on Expedia.
• Offer affordability credits to ensure that low-income and middle-class families can pay for coverage, and ensure that small businesses can actually help cover their employees.

One of the biggest concerns I heard throughout this process was about the bill's cost. Let me be clear: Our reforms are fully paid for and will not increase the federal deficit. In fact, our revised bill will reduce the deficit by at least $30 billion over the next 10 years.

The nonpartisan Congressional Budget Office estimates the cost of our reforms at $894 billion. More than half of this cost will be offset through a combination of savings generated by making Medicare and Medi-Cal more efficient and implementing new technology, but we do not cut services for seniors or low-income individuals. We improve care for people served by these critical programs.

The rest of the bill's costs are paid for by a surcharge on the wealthiest 0.3 percent of U.S. households-- married couples earning over $1 million dollars and individuals earning more than half a million dollars annually.

For the past 70 years, Americans have battled hard for the right to quality, affordable health care. While we still have hard work ahead, next week the House will vote on our truly historic legislation and get us closer than ever to achieving what generations of Americans have been fighting for.

For the first time in U.S. history, all Americans would have access to quality, affordable health care under updated health insurance reform legislation passed by the House on November 7, 2009, by a vote of 220-215.

The Affordable Health Care for America Act [H.R. 3962], which blends and updates the three versions of previous bills passed by the House committees of jurisdiction in July, embodies President Obama’s key goals for health reform. It will slow the growth in out-of-control costs, introduce competition into the health care marketplace to keep coverage affordable and insurers honest, protect people’s choices of doctors and health plans, and assure all Americans access to quality, stable, affordable health care.

The key components of the Affordable health Care for America Act include:

Increasing choice and competition. The bill will protect and improve consumers’ choices.

• If people like their current plans, they will be able to keep them.
• For individuals who aren’t currently covered by their employer, and some small businesses, the proposal will establish a new Health Insurance Exchange where consumers can comparison shop from a menu of affordable, quality health care options that will include private plans, health co-ops, and a new public health insurance option. The public health insurance option will play on a level playing field with private insurers, spurring additional competition.
• This Exchange will create competition based on quality and price that leads to better coverage and care. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. The legislation will ensure that Americans have portable, secure health care coverage – so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the Exchange will have a plan that includes standardized, comprehensive and quality health care benefits.
• It will end increases in premiums or denials of care based on pre-existing conditions, race, or gender, and strictly limit age rating.
• The proposal will also eliminate co-pays for preventive care, and cap out-of-pocket expensesto protects every American from bankruptcy.

Improving quality of care for every American. The legislation will ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental, hearing and vision benefits.
• Provides better preventive and wellness care. Every health care plan offered through the exchange and by employers after a grace period will cover preventive care at no cost to the patient.
• Increases the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid and closes the Medicare Part D ‘donut hole’ so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. The bill will ensure that individuals, employers, and the federal government share responsibility for a quality and affordable health care system.

• Employers can continue offering coverage to workers, and those who choose not to offer coverage contribute a fee of eight percent of payroll.
• All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income, subject to a hardship exemption.
• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. The legislation will put the interests of consumers first, protect them from problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.

• Provides transparency in plans in the Health Exchange so that consumers have the clear, complete information, in plain English, needed to select the plan that best meets their needs.
• Establishes consumer advocacy offices as part of the Exchange in order to protect consumers, answer questions, and assist with any problems related to their plans.
• Simplifies paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer friendly system.
• Increases funding of efforts to reduce waste, fraud and abuse; creates enhanced oversight of Medicare and Medicaid programs.

Reducing the deficit and ensuring the solvency of Medicare and Medicaid. The legislation will be entirely paid for – it will not add a dime to the deficit. It will also put Medicare and Medicaid on the path to a more fiscally sound future, so seniors and low-income Americans can continue to receive the quality health care benefits for years to come.

• Pays for the entire cost of the legislation though a combination of savings achieved by making Medicare and Medicaid more efficient – without cutting seniors’ benefits in any way – and  revenue generated from placing a surcharge the top 0.3 percent of all households in the U.S.(married couples with adjusted gross income of over $1,000,000) and other tax measures.
• The Congressional Budget estimates the bill will reduce the deficit by at least $100 billion over ten years.
• Estimates also show the bill will slow the rate of growth of the Medicare program from 6.6 percent annually to 5.3 percent annually.

Our health insurance reform effort is about two things: making insurance secure and affordable to those who have it, and ensuring access to affordable, quality coverage for those who don’t.

Too many Americans have to fight with insurance companies over basic care -- being excluded for pre-existing conditions, facing outrageous medical bills, or appealing again and again to have a much-needed procedure approved.  If you have had trouble with your insurance company, I’d like to hear about it.  This is too important, and we're too close to the finish line, to falter now -- your stories will help me make the case for real health insurance reform.


We have proposed specific and important insurance reforms to:  

• Guarantee that you will not be denied coverage based on a so-called pre-existing condition
• Limit out-of-pocket expenses to protect families from medical-related bankruptcy
• Make your insurance policy transparent so you know what you’re paying for
• Prevent insurance companies from dropping coverage when you get sick
• Prevent insurance companies from charging people different rates based on gender, health status, or occupation.

 
Our reforms would guarantee that your medical care is decided by you and your doctor, not insurance companies.  That’s the way it ought to be.