Health Care

As Congress continues to debate our spending priorities for the coming years, Americans are very concerned about the impact our decisions will have on their health care options.  I will continue to advocate for access to affordable, quality care for all Americans and protection of Medicare and Medicaid beneficiaries from drastic cuts.

The Health Care Reform Law

In March of 2010, I voted to pass the Affordable Care Act, historic legislation overhauling our nation’s broken health-care system. Beginning on January 1, 2014, with commencement of the health care marketplace, 40 million Americans have access to coverage they could not previously afford, and up to 129 million Americans with pre-existing health conditions are no longer being denied coverage by insurers.

Since passage of the law, people in the Seventh District and around the country have already realized many benefits including:

• 12 million uninsured Americans gained coverage in 2014 - the first year ACA’s coverage provisions were in effect.
• 219,185 people in Indiana were covered through the health insurance marketplace as of February 2015.
• 87 percent of Hoosiers on the marketplace qualified for an average tax credit of $319 per month.
• 53 percent of Indiana Marketplace enrollees obtained coverage for $100 or less after any applicable tax credits in 2015, and 85 percent had the option of doing so.
• 254,127 Hoosiers with private insurance coverage benefited from $11,889,719 in refunds from insurance companies, for an average refund of $84 per family.

Open enrollment for 2016 coverage runs from November 1, 2015 to January 31, 2016.  If you need help searching for plans on the health insurance marketplace, you can learn more by:

• Visiting the online website at www.healthcare.gov
• Finding an In-Person Assister, also called a Navigator, by visiting https://localhelp.healthcare.gov/.
• Calling the 24-Hour Affordable Care Act Call Center at 800-318-2596.

Healthy Indiana Plan 2.0 and Medicaid Expansion in Indiana

Medicaid is an entitlement program that provides health coverage to low income Americans.  Prior to passage of the health reform law in 2010, eligibility for Medicaid was generally limited to low-income children, pregnant women, parents of dependent children, the elderly, and people with disabilities.  However, the new law allows other low-income individuals, such as childless adults to get coverage through Medicaid in states that expand the program—at no cost to the states through 2016. 

I worked hard to extend this important health coverage to vulnerable Hoosiers, many of whom have never been insured.  Unfortunately, Indiana has chosen not to expand traditional Medicaid and as a result Hoosiers will not have the same access to health coverage as people in our neighboring states, such as Kentucky.   However, with my support, our state received a waiver to pursue a limited expansion, the Healthy Indiana Plan 2.0.  The plan provides coverage to some low income individuals by requiring beneficiaries to pay a personal responsibility contribution and, under certain circumstances, requires copays.  Although it is not as ideal as traditional Medicaid, I was happy to support efforts to implement the Healthy Indiana Plan 2.0.  It offers full health benefits, including hospital services and mental health care. I will continue to work with community leaders to educate all Hoosiers to ensure that they receive the best benefits and health care possible.

Medicare and Protecting The Health of Our Seniors

Medicare is a federal insurance program that pays for covered health care services of qualified beneficiaries, including individuals 65 and older.  I have continuously fought to protect our seniors from the rising costs of health care.  As my colleagues and I continue to look for ways to make Medicare more efficient, I am committed to maintaining a high quality of care. 

Access to health services and prescription drugs through Medicare is only the first hurdle our seniors face as they deal with problems such as serious illnesses and living on fixed-incomes. The Affordable Care Act eased some of the burdens on seniors by helping seniors close the gap between coverage and out of pocket expenses for prescription drugs.  In Indiana, Medicare beneficiaries have already saved nearly $377,084,734 on prescription drugs.    In 2014 alone, 126,526 Hoosiers saved over $117,854,817, or an average of $931 per beneficiary.  Other ways our seniors are benefitting include:

• Reduced prescription drug costs.  In 2015, Medicare beneficiaries received a 55 percent discount on covered brand name drugs and a 35 percent discount on generic drugs to help ease out of pocket expenses.
• Free Medicare coverage of key preventive services, such as mammograms and colonoscopies, and annual wellness visits. 
• Additional savings, including stable and lower premiums and a lower deductible. 
• Extended solvency of the Medicare Trust Fund by nearly a decade.
• Reduced fraud and abuse that would have resulted in higher costs to seniors. The health law includes new technology and tougher screening procedures that have led to more than $27 billion being returned to the Medicare Trust Fund.