New health legislation was recently passed that improves health care for seniors, cracks down on the insurance companies, lets 63,000 Mainers get insurance coverage and improves coverage for those who already have it.

We don’t have to look any further than our own state to see what would happen if we did nothing to reform health care—huge premium increases like those that Anthem has demanded forcing more and more individuals and small businesses to go without coverage.

Here's what the health care reform legislation does:

Improves health care for 225,000 Maine seniors by closing the donut hole, reducing the price of prescription drugs and covering check ups

• In 2010, Medicare beneficiaries who go into the donut hole will receive a $250 rebate. After that they will receive a pharmaceutical manufacturers’ 50% discount on brand?name drugs, increasing to a 75% discount on brand?name and generic drugs to close the donut hole by 2020.)

• The legislation requires free annual checkups and no out of pocket expense for things like cancer and diabetes screening.
• AARP strongly supports this bill because they know it will be good for their members.

Strengthens Medicare and keeps it solvent

• The legislation will add nearly a decade to Medicare solvency.

Cracks down on the worst practices of the insurance industry like discrimination based on pre-existing conditions and cancelling your insurance policies after you get sick.

Makes it easier for small businesses and working Americans to afford health insurance and helps ensure that no one will go bankrupt because of medical expenses.

• Provides cost sharing assistance to working Americans to help them afford insurance.
• Creates the largest health car tax break in history to make it easier for small businesses and individuals to afford coverage.
• Lets individuals and small businesses buy coverage from an “exchange” so they can buy it the way big employers do.

Is fully paid for and reduces the deficit by $143 billion.

• Bill is paid for in part by cutting out waste, fraud, and abuse and asking wealthy Americans to pay their fare share of the Medicare tax.

Health care reform in Maine: by the numbers

• Improve coverage for 771,000 residents with health insurance.
• Give tax credits and other assistance to up to 359,000 families and 38,900 small businesses to help them afford coverage.
• Improve Medicare for 255,000 beneficiaries, including closing the donut hole.
• Extend coverage to 63,000 uninsured residents.
• Guarantee that 17,800 residents with pre-existing conditions can obtain coverage.
• Protect 1,400 families from bankruptcy due to unaffordable health care costs.
• Allow 90,000 young adults to obtain coverage on their parents’ insurance plans.
• Provide millions of dollars in new funding for 133 community health centers.
• Reduce the cost of uncompensated care for hospitals and other health care providers by $139 million annually.

Health care reform timeline

Provisions that take effect in the next 9 months

Starting Right Now...

• Small businesses will get a tax cut to help them pay for health insurance for their employees. Companies will get a credit up to 35 percent of the money they spend on premiums. Those credits will increase over time, eventually reaching 50 percent when the Insurance Exchanges go into effect. The full credit is available to small firms with 10 or fewer employees, and firms with up to 25 employees will qualify for a partial credit.
• The federal government will begin investing in community health centers to provide care to the people who need it most. In the next five years, $11 billion will be spent expanding access to health centers to 25 million more people in 10,000 communities.
• Any senior who is affected by the so-called “doughnut hole” will qualify for a $250 rebate to help them pay for their prescription medicines.

In 3 Months...

• People with pre-existing conditions will be able to get help with a special fund set up to cover the gap until the Insurance Exchanges are up and running.
• Retiree health plans qualify for a new federal reinsurance program for health plans covering early retirees (age 55-64) to bring down costs for businesses and lower premiums.

In 6 Months...

• All health plans will be prohibited from denying coverage or care to children because of “pre-existing conditions.” This protection will apply to everyone when the Insurance Exchanges are up and running.
• All health plans will be required to allow young adults to stay on their parents’ insurance until age 26.
• All new health plans will be required to provide free preventive care with no co-pays or deductibles.
• All health plans will be prohibited from cancelling coverage when a patient reaches a lifetime limit on coverage.
• All health plans will be prohibited from cancelling coverage if a patient gets sick or if they file too many claims.
• All new health plans will be required to allow consumers to appeal insurance company denials of coverage and get an independent review of their case.
• All new health plans will be required to let you pick your own primary care doctor. Women will also be allowed to visit their ob-gyn without getting permission from their insurance company first, and all patients will be guaranteed access to emergency care.

On January 1, 2011...

• All insurance plans will be required to spend at least 80-85 percent of their revenues on medical care. If they spend too much on wasteful overhead, like executive salaries and advertising, they will be required to give their customers a rebate. 

Read the Health Care Reform legislation:

• Text of the Amendment in the Nature of a Substitute
  • Section-by-Section of the Amendment in the Nature of a Substitute
• Text of the Senate Amendments to H.R. 3590 (Senate health bill)
• Text of the bill as reported (reported by the Budget Committee) 
  
  • H. Rept. 111-443: Budget Committee Report (Volume 1)
  • H. Rept. 111-443: Budget Committee Report (Volume 2)