Health Care
The Affordable Care Act Resource Center
Congressman Tierney was pleased to support the Patient Protection and Affordable Care Act (PPACA), which was signed into law in 2010. This historic health insurance reform legislation is bringing about a significant improvement over the status-quo and is making unmistakable progress in the effort to make health care more accessible and affordable for all Americans.
Because of the Affordable Care Act (ACA):
- If you are a young adult, you can now stay on your parents' health plan until your 26th birthday, if you do not have coverage of your own.
- Your insurance company must now spend at least 80 percent of premiums on covering medical services - rather than administrative expenses, CEO pay, and profits, a provision I authored and fought for.
- If you are among 4 million eligible small businesses, you can receive tax credits to help you cover the cost of providing coverage to your employees.
- You or your child can no longer be denied coverage by an insurance company for having a “pre-existing condition.”
- Your insurance company can no longer place a lifetime limit on your coverage. Such limits have caused some families to declare bankruptcy.
- If you are a senior, you will now be receiving a 50% discount on brand-name drugs if you enter the Medicare Part D ‘donut hole' coverage gap - a discount that grows until the ‘donut hole' is closed in 2020.
- You can no longer be dropped from coverage by your insurance company simply because you get sick.
- Annual limits on your coverage are be completely eliminated by 2014.
- If you are in a new plan, you now have free coverage of key preventive services, such as immunizations, mammograms, and other cancer screenings.
- Your insurance company must now publish on the Internet detailed justifications for any premium increases they are seeking that are more than 10 percent.
Congressman Tierney believes that health insurance premiums Americans pay should be used to make people healthy, not wasted on unnecessary paperwork or excessive CEO pay. That's why he insisted that the 80/20 rule be included in the Affordable Care Act. This rule, also called the Medical Loss Ratio requires insurance companies to spend generally at least 80 cents of every dollar that Americans pay in premiums on health care versus CEO pay and bonuses and other administrative costs . If this requirement is not met, insurance companies must pay consumers a rebate. In 2012 alone, more than 12 million Americans, including 163,949 in Massachusetts, received more than $1 billion in rebate checks because of this provision.
As Democratic Leader Nancy Pelosi said in July 2013, “when Congress passed the Affordable Care Act, Democrats insisted on steps to improve the quality and affordability of health insurance nationwide. With the leadership of Congressman John Tierney, Democrats acted to ensure that Americans’ premium dollars are invested where they will do the most good – in the care of patients, not in the bottom lines of insurance companies. Today, a new report showed that competition will lower premiums by nearly 20 percent in the new health insurance marketplaces – more evidence that the law is a victory for the American people.”
Rep. George Miller, senior Democratic member of the House Education and the Workforce Committee said, "The health insurance premiums Americans pay should be used to make people healthy, not wasted on unnecessary paperwork or excessive CEO pay. At the insistence of Congressman Tierney and Democrats in Congress, this important principle is now the law of the land and millions of policyholders are receiving billions of dollars in rebates. Washington Republicans should drop their agenda to repeal these important patient protections and instead work with us to strengthen America's middle class."
To visit my Affordable Care Act Resource Center, click here.
Ensuring Health Care Benefits for Retirees
Congressman Tierney continues to be concerned about and outraged by companies that unfairly reduce the terms of retirees' health coverage by increasing premiums, co-payments, and deductibles, all of which result in a gradual elimination of employer-sponsored benefits.
In response, Congressman Tierney introduced the Earned Retiree Healthcare Benefits Protection Act (H.R. 2425), which would prohibit profitable companies from curtailing or eliminating benefits under their retiree health plans after a worker retires. Specifically, this legislation will:
1. Prohibit group health plans from making post-retirement reductions in retiree benefits;
2. Require plans to adopt provisions barring post-retirement cuts in retiree health benefits;
3. Require employers to restore benefits reduced after retirement; and
4. Provide an exemption for employers who are unable to restore benefits because they would experience substantial business hardship, as determined by the Secretary of Labor.
During the health insurance reform efforts, Congressman Tierney successfully secured certain principles of H.R. 2425 in the original House-passed version of health reform. Unfortunately, the Senate version, which ultimately became law, did not include these provision.. Nonetheless, the Congressman remains committed to this cause and is currently focusing on gaining support for H.R. 2425 in the 113th Congress. For more detailed information on this legislation, please visit THOMAS by clicking HERE.
While Democrats fight to preserve, protect and strengthen Medicare for our nation's seniors and future generations, the Republicans have resorted to supporting ending Medicare as we know it – and in April, they voted to do just that.
On April 10, 2014, House Republicans passed their budget proposal (H. Con. Res. 96) for FY 2015. Their budget would make major changes to Medicare. John adamantly opposed their plan, and here are just some of the reasons why:
First, the House Republican budget significantly cuts spending on Medicare by eliminating benefits and shifting costs to seniors and individuals with disabilities. These reductions in benefits and cost shifts affect both current and future Medicare beneficiaries. By 2050, the House Republican budget would cut Medicare nearly in half, corresponding to about $20 trillion in cuts in today's dollars, according to projections by the nonpartisan Congressional Budget Office (CBO) effectively shifting those costs to individuals.
Second, the House Republican budget ends traditional Medicare for individuals age 54 and younger. Seniors who become eligible for Medicare in 2024 would no longer be allowed to join the traditional Medicare program; instead, they would receive a federal contribution, sometimes called a "voucher" or "premium support," to use to purchase private insurance coverage. Over time, because of the higher cost of private plans and the reduced value of the federal contribution, beneficiaries would be forced to pay an ever-growing portion of their health care costs.
Finally, the House Republican budget would mean higher premiums charged for traditional Medicare. CBO projects the annual Part B premium will be $1,600 in 2020 under current law. If the Republican plan were in effect in 2020, the average Part B premium charged in that year across the country for the traditional Medicare option would be 50 percent higher, or $2,400 – an average increase of $800 to use traditional Medicare.
Instead, Congressman Tierney supports efforts to keep the Medicare Trust Fund solvent. He believes we need to support measures that lower costs for seniors and ensure that patients and their doctors – not insurance companies – make decisions about patient health. That’s why he supported the Affordable Care Act. Because of this law, millions of seniors have already saved an average of $1,209 per person on their prescription drugs. And millions more have received a free preventative screening appointment with their doctor.