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Health Care

 

 

 

The Congresswoman visits the Greater Lawrence Family Health Center

 

OVERVIEW

I know firsthand how being able to access affordable health care isn’t a political issue, but a deeply personal one for every family. My late husband Paul waged a long, courageous fight against cancer and during that time, our family had the benefit of excellent care from extraordinarily able and dedicated professionals. I understand the fear and helplessness so many feel when faced with an illness in their family. But I have also experienced the hope our health care system can offer and shudder to think what our experience might have been if our family had been uninsured. I believe that every American deserves access to the same level of high quality care that my family received. 

During the national debate over health care reform, I engaged in thousands of conversations with District residents and heard repeatedly that health care costs were hurting businesses and families across Massachusetts. Citizens and experts alike agreed that if left unchecked, health care costs were going to bankrupt our country.

I supported the Affordable Care Act (ACA), the landmark health care reform legislation signed into law by President Obama in 2010, because it was designed to improve the quality of our health care system, provide expanded access to care, and lower the cost of health insurance. This is an important piece of legislation that will continue to enact reforms as pieces come into effect in the years to come. The benefits of the ACA are continuing to become apparent and more than 8 million Americans signed up for health insurance through a health care exchange, many of whom had never had health insurance in the past.

Here are updated fact sheets about the Affordable Care Act: Click for ENGLISH or SPANISH

While I believe the law can continue to be improved, I do not support efforts to repeal the ACA.  Not only would repeal take away the many benefits of this law that are just beginning to go into effect, the non-partisan Congressional Budget Office estimated that repealing the Affordable Care Act would increase the deficit by $109 billion over the next decade, passing on more debt to our children and grandchildren.

 

THE AFFORDABLE CARE ACT (ACA)

The ACA aims to bring down health care costs for Massachusetts residents and small businesses; prohibit unfair insurance company practices, such as denials of coverage based on pre-existing conditions, rescissions of coverage, and annual limits on coverage; and strengthen Medicare by closing the donut hole, reducing the cost of preventative care, and adding years to Medicare’s solvency.

As with any undertaking of this magnitude, the Affordable Care Act is not perfect and I have consistently demonstrated an openness to making appropriate improvements. For example, I was one of the first Democrats to support repealing onerous 1099 reporting requirements to help small businesses, and I have voted for several changes that I thought helped refine and improve the law, including voting to repeal the medical device tax.

The ACA is being implemented in different stages over the course of the next several years and will help to improve the quality of care for all Americans while making reforms to our health care system that will reduce costs for families.

Since its enactment, the benefits of the new law have become increasingly apparent:

Since its enactment, the benefits of the new law have become increasingly apparent:

More than 8 million Americans signed up for health care in the ACA exchanges

Reports say hospitals will see reduced costs thanks to the ACA

The U.S. will get more insurers under the ACA

Millions of small businesses are receiving tax credits to provide insurance to their workers.

Recent college graduates who may not have access to insurance can remain on their parents’ health plans until the age of 26. In Massachusetts, over 9,800 young adults have insurance coverage under this provision. For example, I received an email from a District resident who told me that his 19 year old daughter is working two jobs and is now able to get health insurance because of the new health care reform law. 

Senior citizens who fall into the donut hole—4,800 of whom live in the District—are starting to see it closed and have already received checks to help them afford needed medications in the meantime.

Men and women have access to a number of free preventive services, like mammograms, and colonoscopies without being charged a deductible, co-pay, or coinsurance fee.

Insurance companies can no longer deny coverage to children with pre-existing conditions, cancel coverage when people get sick, and place limits on the amount of care people can get. Nationwide, up to 129 million Americans with pre-existing medical conditions would lose protections if this coverage is repealed.

Consumers have saved an estimated $2.1 billion on health insurance premiums since the passage of health care reform, thanks to provisions requiring that insurance companies must reveal how much they actually spend on health care and how much they spend on profits and administrative costs such as salaries and marketing. If insurers do not spend at least 80 percent (or 85 percent for the biggest insurers) of premium dollars on actual health care benefits and quality improvement measures, they must refund consumers the difference.

The Affordable Care Act also bettered Medicare by providing free preventative and wellness care, improving primary and coordinated care, enhancing nursing home care, and strengthening the Medicare trust fund, extending its solvency from 2017 to 2026. Beginning in January 2011, fifty million Medicare beneficiaries began to have free access to covered preventative services, such as high-blood-pressure screenings and cancer screenings, allowing doctors to better identify and treat health problems at earlier stages. Repealing the Affordable Care Act would eliminate these benefits for 1,104,483Medicare beneficiaries in Massachusetts and cause the Medicare hospital trust fund to become insolvent in just six years.

You can read more below about how the health care reform and the Affordable Care Act is working for you:

 

SMALL BUSINESSES

The Affordable Care Act (ACA) benefits small businesses with the creation of new insurance exchanges, tax credit subsidies and work place wellness programs.

CREATION OF INSURANCE EXCHANGES

Small businesses now have the option to purchase insurance through a new market, called the Small Business Health Options Program (or SHOP Exchange). The exchange is designed to offer individuals and small employers an easier way to compare and purchase plans. Employers may continue to purchase insurance through the market outside of the exchange, and the insurance reforms in the ACA will apply throughout both markets.

TAX CREDITS TO ASSIST IN THE COST OF HEALTH INSURANCE

Small businesses with fewer than 25 full time employees may be eligible for tax credits to assist in the cost of health insurance. To qualify, such businesses must have average annual wages below $50,000 and must pay at least half of the cost of their employee’s health insurance.

Eligible employers that purchase insurance through the SHOP exchange may receive a tax credit of up to 50% of the employer’s contribution toward insurance premiums. These employers may take the tax credit for up to two years. Tax-exempt small businesses meeting the requirements above may receive 35% of their contribution in the form of tax credits. The exact amount each small business receives in tax credits will depend on the number of employees and average wages. See if your small business qualifies.

GRANTS FOR WELLNESS PROGRAMS

Small businesses (with fewer than 100 employees who work 25 or more hours per week on average) that did not have a workplace wellness program in effect as of March 2010 are eligible for grants to start such programs.

 

COMMUNITY HEALTH CENTERS

Investments from the Affordable Care Act and the American Recovery and Reinvestment Act have led to the expansion of community health centers in Massachusetts and across the country.  This is good news for our district where we benefit from high quality care in Community Health Centers in Gardner, Fitchburg, Lowell and Lawrence.

According to the National Association of Community Health Centers, more than 22.3 million patients nationwide in 9,000 communities utilize the services of community health centers.

As health premiums continue to rise, the centers could see even more use by those unable to afford coverage; more than a third of those who currently use the centers are uninsured. Roughly 71 percent live in poverty and 92 percent are considered low income.

Find more information from the National Association of Community Health Centers visit: http://www.nachc.com/pressrelease-detail.cfm?PressReleaseID=795

Links to some Community Health Centers in the Third District:

 

WOMEN’S HEALTH CARE

Before health care reform, women on average paid higher premiums than men (a practice known as “gender rating”). A 25-year-old woman could pay up to 84% more than a man, even for a health plan that excluded maternity coverage.

More than 60% of health care plans charged a 40-year-old woman who doesn’t smoke more than a 40-year-old man who does. 

Further, before the passage of health reform, it was still legal in many states for insurance companies to deny a woman coverage if she had been the victim of domestic violence. 

I was proud to join my fellow women colleagues in raising these issues and others that specifically affect women during the debate over health care reform. 

During the national debate on health care reform, I served on the House Budget Committee, one of the committees responsible for reviewing the health care reform bill before it could become law. During our review, I introduced an amendment to prohibit insurance companies from denying full or partial coverage to women, including maternity coverage, for so-called “pre-existing conditions” such as domestic violence, pregnancy, or a medical history of cesarean sections. 

My Republican colleagues joined me in supporting this motion, acknowledging that my amendment was crafted “fairly” and “addresses a significant problem,” and would improve health care for women and families.  The motion passed unanimously.

Since the ACA was signed into law, I have been working with my colleagues to make sure that health insurance companies cover comprehensive preventative services for women without requiring patients to pay copayments. These services include annual well-woman preventive care visits, gestational diabetes screening and counseling and screening for domestic violence.

 

ADDITIONAL HEALTH CARE RESOURCES FOR MASSACHUSETTS RESIDENTS

 

HELPFUL PHONE NUMBERS

Marketplace Call Center: 1-800-318-2596 (The Call Center can also submit ‘casework’ if they cannot resolve your issue.)

Member Services Line: 877-623-6765

Call Center for Consumers with Cancelled Policies: 1-866-837-0677

New phone line for MA insurance offerings: 1-855-624-4584

Press Releases

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