FOR IMMEDIATE RELEASE: Sunday, March  21, 2010                 
MEDIA CONTACT:
STEVEN ENGELHARDT (314) 504-4029

Historic Healthcare Reform Bill Will Have Huge Positive Impact in

Missouri’s 1st Congressional District

Clay Says Landmark Legislation Will Improve Coverage, Strengthen Medicare, End Worst Insurance Company Abuses and Reduce the Deficit

-WASHINGTON, DC – Congressman Wm. Lacy Clay (D) Missouri, praised today’s passage of historic health insurance reform legislation that was approved in the U.S. House by a vote of 219 – 210.  The legislation, which was championed by President Obama and the House Democratic Leadership, will improve healthcare coverage for millions, cover millions of uninsured Americans, and will end the worst abuses by insurance companies.

“This legislation will have a huge positive impact for my constituents,” said the Congressman.  “It will immediately improve coverage for everyone who has health insurance, strengthen Medicare for all seniors, cover thousands of uninsured residents and reduce the deficit in the long run,” said Mr. Clay. 

“This plan also ends gender-based discrimination by stopping insurance companies from charging women more than men for the very same coverage. It controls costs and reduces the deficit.  According to the non-partisan Congressional Budget Office, this reform package will save taxpayers $138 billion over the next ten years, and over $1.2 trillion over the next twenty years,” said the Congressman. 

“Finally, this bill will give average Americans the same health insurance choices that Members of Congress and federal employees have.  I’m very proud that we have done the right thing for everyone who has health insurance, and for the millions who still need it.”

Here is a summary of key benefits and immediate improvements in healthcare coverage provide by this historic legislation:

Positive Impact in Missouri’s 1st Congressional District

- Improves coverage for 331,000 1st District residents who have health insurance by ending cancellations when you get sick and banning discrimination because of pre-existing conditions;

- Gives tax credits to 168,000 families and 15,200 small businesses to help them afford coverage;
 
- Strengthens Medicare for 96,000 seniors, including closing the donut hole;
 
- Extends health insurance coverage to 42,000 uninsured residents;

- Guarantees coverage for 10,000 residents with pre-existing conditions;

-Protects 1,400 families who were at risk of medical bankruptcies;

-Allows 47,000 young adults to obtain coverage on their parents' insurance plans;

-Provide millions in new funding for community health centers.

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Key provisions that will take effect immediately

SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to    35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010.        (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)

BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand-name drugs in the donut hole; also completely closes the donut hole by 2020.)

FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

HELP FOR EARLY RETIREES—Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment

ENDS RESCISSIONS—Bans insurance companies from dropping people from coverage when they get sick. Effective 6 months after enactment.

NO DISCRIMINATION AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS—Prohibits health insurers from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)

BANS LIFETIME LIMITS ON COVERAGE—Prohibits health insurance companies from placing lifetime caps on coverage. Effective 6 months after enactment.

BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)

FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS—Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)

NEW, INDEPENDENT APPEALS PROCESS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.

ENSURING VALUE FOR PREMIUM PAYMENTS—Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool. Effective 90 days after enactment.

EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.

COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.

INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

PROHIBITING DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

HEALTH INSURANCE CONSUMER INFORMATION—Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.

CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

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