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So, What's In the Reconciliation Bill?

Tuesday, March 23rd, 2010

The President signed the Senate health care bill into law at noon today.

This year, over 4 million small businesses will get tax credits worth up to 35% of their health care costs. This year, seniors will get $250 towards closing their coverage donut hole. This year, young Americans will be able to stay on their parent’s insurance plan until they are 26. This year, lifetime caps on benefits will be a thing of the past. And this year, the people with pre-existing conditions who can’t get health care now at any price will be able to buy into high-risk pools until the exchanges are set up in 2014.

But we are not done. Right after the House passed the health care bill on Sunday, they passed a package of improvements that now head to the Senate for an up-or-down vote.

The fixes heading to the Senate are mostly focused on making health care affordable to middle class families.

First, the package vastly improves the excise tax on “Cadillac” insurance plans, raising the threshold at which a plan will be affected to $10,200 for individual plans and $27,500 for family coverage. It also delays the implementation of the tax until 2018. As a result, the burden on middle tax families will be dramatically reduced.

To make up for the loss in revenue, the fixes broaden the Medicare payroll tax on on rich investors, taxing net investment income for those who make more than $250,000 per year.

And second, the package increases the subsidies available in the exchanges for middle class families and lowers their cost sharing. With the package, a lower percentage of a family’s income will be spent on health care costs – both premiums and out of pocket.

And there are more provisions in the package that would help broad swaths of the American public:

  • The package fully closes the donut hole for seniors over time
  • It freezes Medicare Advantage overpayments to private insurers and requires private insurers to pay 85% of money in to benefits in Medicare Advantage, to match the levels for all insurance plans in the health care bill
  • It strikes the deals Senators like Ben Nelson received and replaces them with increased Medicaid funding to all states
  • And it funds student loans for millions of young Americans

The Senate, after a string of favorable parliamentary rulings, is expected to take up the improvements under budget reconciliation rules today, with the goal of a final vote at the end of this week before the Easter recess.

*This post originally appeared in Health Care For America Now on March 23, 2010. Reprinted with permission.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

What Health Reform Will Do for America - Two Examples

Friday, March 19th, 2010

Two headlines today highlight glaring problems in our health care system that would be fixed if health reform passes.

First, from Pennsylvania, the New York Times headlines “Big Insurance Rate Increase for Pennsylvania Poor”:

Facing a sharp rise in costs, Pennsylvania has almost doubled the monthly bill for a state health insurance program for poor people who do not qualify for Medicaid and are on a waiting list for a less costly option.

On March 1, the cost of the plan rose to about $600 a month, up from $313 a month, for the roughly 2,400 state residents on the waiting list.

Established in 2002, Pennsylvania’s state insurance program, called AdultBasic, covers adults ages 19 to 65 with incomes lower than twice the federal poverty level, or about $21,672 for a single person, at a cost to participants of about $36 per month. About 39,000 people are enrolled in AdultBasic.

About 390,000 other people are on a waiting list to join the AdultBasic program. While they wait, the state gives them the option to pay for the same insurance at a higher rate. It is the cost for members of the waiting list that rose on March 1 to about $600 a month.

Health reform solves this problem.

For families who make 133% of the Federal Poverty Level or less – about $24,000 per year – health reform would allow them to get on Medicaid. Those families who make more than that – up to 400% of the FPL or about $73,000 per year – will be able to purchase heavily subsidized insurance in the Exchanges.

For families making between 133% FPL and 200% FPL ($24,000 – $36,000 per year) – the people affected by Pennsylvania’s rate increase above – their average cost for insurance, both premiums and out of pocket, will be [pdf] around $63 per month for families at 133% up to $244 per month for families at 200%.

The next headline is from Kaiser Health News, “Drug Prices Rise For Seniors Who Reach Medicare Part D Coverage Gap”:

Seniors who hit the coverage gap in their Medicare prescription drug plans and must use their own money to buy drugs are facing price increases that are far outpacing inflation, a new study finds.

According to the Kaiser Family Foundation, prices paid by enrollees in standalone Part D plans who enter the coverage gap increased 5 percent or more since January 2009 for half of 10 brand-name drugs most commonly used by seniors. That’s almost twice the rate of inflation over the same period.

For example, the price of Actonel, a treatment for osteoporosis, increased 8 percent, from $91 per month in 2009 to $98 per month in 2010. Meanwhile, the prices for both Aricept, an Alzheimer’s medication, and Plavix, a drug used to prevent blood clots, both increased by 7 percent during the same period. Aricept’s prices rose from $184 to $198 while Plavix’s rose from $142 to $152. Lipitor, a cholesterol medication, was the only drug surveyed that decreased in price, from slightly more than $86 to just under $86 per month.

The rising prices are part of a longer is sufficient longer-term trend. Between January 2006 and January 2010, the analysis showed, prices of drugs bought by seniors who hit the coverage gap increased 20 to 25 percent for Lipitor, Plavix, Nexium, a drug for acid-reflux, and Lexapro, a medication for depression and anxiety; 39 percent for Actonel, and 41 percent for Aricept. Over the same period, inflation has increased 9.2 percent while prices for medical care have surged 16.1 percent.

Health reform solves this problem, too. Immediately after passage of the bill, seniors will get immediate relief that starts closing that coverage gap. The gap will be completely closed as health reform is implemented.

There are a few more noteworthy immediate affects of reform as well:

  • Prohibit pre-existing condition exclusions for children in all new plans;
  • Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool; (this will help with the Pennsylvania situation as well)
  • Prohibit dropping people from coverage when they get sick in all individual plans;
  • Offer tax credits to small businesses to purchase coverage;
  • Eliminate lifetime limits and restrictive annual limits on benefits in all plans;
  • Require plans to cover an enrollee’s dependent children until age 26;
  • Require new plans to cover preventive services and immunizations without cost-sharing;
  • Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions;
  • Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs.

Reform will also help people like 11-year-old Marcelas Owens, who’s mother died because she didn’t have insurance:

And Matt Masterson’s son, who’s pre-existing condition makes him virtually uninsurable, a near death sentence as soon as he’s kicked of his father’s insurance plan in a few years:

Finally, today, the House Energy and Commerce Committee came out with numbers on how reform will help people in every Congressional district.

The vote is coming in the House. It’s likely to take place this weekend. Without reform, none of these problems get solved, and the insurance companies will get to continue their business practices of denying care and carving out coverage while making record profits.

It’s time to for the House to decide, and you should pick up the phone and help them.

*This post originally appeared in Health Care For America Now on March 17, 2010. Reprinted with permission.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

Republicans Aren't Bringing a Health Reform Plan to the Summit Because They Don't Want to Reform Health Care

Wednesday, February 24th, 2010

Yesterday, Republican leaders finally confirmed that they weren’t going to bring a health care bill to the President’s summit tomorrow. Why? Because they don’t actually want to reform health care (emphasis added):

The Senate GOP leadership is brushing off Dan Pfeiffer’s demand this morning that Republicans clarify whether they’ll produce a bill in advance of the summit, and won’t put forth a “comprehensive proposal,” aides say.

This morning on the White House blog, Pfeiffer challenged GOP leaders to say whether they’d be bringing a bill to the summit. “The Senate Republicans have yet to post any kind of plan,” Pfeiffer wrote, adding that “we continue to await word from them.”

Asked for comment, a senior Senate GOP aide emailed:

We fundamentally disagree with a comprehensive proposal to reform health care. We think a step by step approach on areas where we agree is the best path forward. We will not be posting a comprehensive alternative to commence a staring contest.

Of course, health care advocates have known this all along. Republicans have no solutions to the crisis in our health care system because they don’t view it as a system in crisis.

However, the position that health care in this country doesn’t need fundamental reform is a dangerous position to take. Never mind that every day we go without reform, 6,821 more people lose their health insurance [pdf], 2,548 more people file for bankruptcy because they got sick, and 60 more people die [pdf] because they don’t have the coverage they need. Declaring that as a party Republicans “fundamentally disagree with a comprehensive proposal to reform health care” is radically out of step with the American people.

The latest Kaiser Health Tracking Poll is only the latest in a series showing the elements of health reform are popular:

Other parts of reform are really popular too, like the public option.

And majorities want comprehensive health reform passed:

And even more will be disappointed or angry if reform doesn’t pass:

If Republicans think going with nothing is going to win them broad support, they haven’t been reading their polling.

Democrats need to work to make sure the reform that passes works for everyone in America and has the popular elements in it – they must pass health care that works for us and pass it now. Today, we’re helping to put in 1 million messages to Congress to send them that message, and Melanie’s March is arriving in DC to a huge rally with Senators attending the summit, so we’ll get to tell that message to these Senators in person.

Getting health reform done right is more than good policy for the country, it’s popular, too. And it will show America that Democrats won’t accept the party of NO’s strategy.

*This post originally appeared in Health Care For America Now on February 24, 2010. Reprinted with permission.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

Aetna Cuts 600,000 Lives for Profit

Thursday, December 10th, 2009

Aetna announced that it will deliberately cut 600,000 people from its insurance rolls to raise its profits next year:

In a third-quarter earnings conference call in late October, officials at Aetna announced that in an effort to improve on a less-than-anticipated profit margin in 2009, they would be raising prices on their consumers in 2010. The insurance giant predicted that the company would subsequently lose between 300,000 and 350,000 members next year from its national account as well as another 300,000 from smaller group accounts.

Aetna’s decision to downsize the number of clients in favor of higher premiums is, as one industry analyst told American Medical News, a “pretty candid” admission. It also reflects the major concerns offered by health care reform proponents and supporters of a public option for insurance coverage, who insist that the private health insurance industry is too consumed with the bottom line. A government-run plan would operate solely off its members’ premiums.

Aetna is saying they want to make more money on each person they insure to please Wall Street, so they are raising prices. It doesn’t matter to them if this action causes them to lose some less profitable customers, customers that actually use their health care benefits. In fact, they welcome it. They are more than happy to let these people be priced out of the market, go uninsured, go bankrupt, or lose their lives. These people are not bringing in enough money for Aetna, so Aetna would rather not have them as a customer.

Aetna is following the insurance company playbook as articulated last year by Wellpoint CEO Angela Braly when she said, “We will not sacrifice profitability for membership.” In other words, the insurance companies won’t sell health coverage to more people if it means they will make less money on each person.

They don’t care about coverage, they just care about profits. This is exactly why we must have a public health insurance option.

Health reform without a public option will not not work. The insurance industry playbook would still be on the table, and they would still find ways to cut people for more profit. Even with laws against insurance companies denying care, they would still find ways to do it.

The CBO confirms this with their analysis. Even with laws making it illegal for insurance companies to deny care, the CBO found that while the public option would keep down insurance premiums overall, it would attract less-profitable customers that the insurance companies don’t want and would refuse to insure.

There is no substitute for a public health insurance option that’s national and available everywhere on day one – no triggers. And indeed, the bill on the table in the Senate gets us there.

To those moderates who are holding out, don’t let the perfect be the enemy of the good. There may be some things in the Senate bill you don’t agree with, but that’s no reason to deny this country the reform it needs and wants. It’s time to allow this bill to come up for a fair, majority vote in the Senate.

*This post originally appeared in SEIU Blog on December 9, 2009. Reprinted with permission from the author.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

The Senate Has a Health Care Bill. What's in It?

Thursday, November 19th, 2009

Last night, the Senate unveiled their health care bill. You can read the full bill here [pdf], or the summery documents here.

On the whole, the Senate bill looks very much like the House health care bill. It ends insurance company abuses like denying care for those with pre-existing conditions and it sets benefit standards to make sure the coverage people receive – both on their own and through their employer – actually covers the care they need. It gives people the choice of a public health insurance option like the one in the HELP bill, though states would be able to opt-out of the public option if they passed a law saying so. And it sets up a health insurance “Exchange” that would provide tax credits (subsidies) to make health care affordable, as well as helping business afford health care for their employees.

On the budgetary front, the Senate bill would cost $849 billion over 10 years, and reduce the deficit by $127 billion over the same period. You can read the CBO’s projections on the bill here [pdf].

Of course, there are major differences. Igor Volsky at the Wonk Room has a handy comparison chart:

Senate Bill ($849 billion/10 years) House Bill ($894 billion/10 years)
Individual Mandate Yes, penalty of $750 by 2016 for those don’t purchase coverage. ($95 penalty in first year) Yes, penalty of 2.5% of income for those who remain uninsured
Employer Mandate Free rider provision. Employers would have to pay whichever is lower: $3,000 per every employee who receives a subsidy in the Exchange, or $750 for every employee (not just the subsidized worker). Yes, employers who don’t’ offer coverage would pay a fee equal to 8% of their payroll
Medicaid Expansion Up to 133% FPL. 100% federal funding for the first 3 years, then revert to Senate Finance language. Up to 150% FPL
Subsidies Between 133 – 400% FPL on sliding scale; spend 2%-9.8% of income on premiums Between 133 – 400% FPL on sliding scale; spend 2%-12% of income on premiums
Public Option National public plan, states can opt-out by 2014. Co-ops are also available. Yes, HHS secretary negotiates rates
Financing Excise tax on policies above $8,500 (individuals) and $23,000 (families), increases the payroll tax by .5% (increases to 1.95%) on individuals who earn more than $200,000 and families earning more than $250,000 a year, tax on insurers, pharmaceuticals, and medicare devices; Medicare savings 5.4% surtax on individuals earning > $500,000, couples earning more than $1 million; Medicare savings

The New York Times also has a great comparison.

Overall, the fact that Majority Leader Harry Reid did the right thing and listened to the American people by including things like a public health insurance option and a tax credit level that goes a long way towards making health care affordable means that this bill deserves a debate and a fair, majority up-or-down vote.

Republicans and the insurance companies will try to block this bill any way they can, even going so far as to recommend the Senate not even talk about this bill, let alone vote on it. These tactics only preserve the status quo. The American people deserve health care reform – reform that delivers affordable coverage, a choice of a public health insurance option, and fair financing – and this bill deserves a fair vote by the full Senate so it can meet the House bill in conference.

*This post originally appeared in Health Care for America Now on November 19, 2009. Reprinted with permission from the author.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

A Closer Look at the House Bill: Taking on the Insurance Industry

Friday, October 30th, 2009

Over the next few days, I’ll be taking a closer look at the provisions on the House health care bill – H.R. 3962, the Affordable Health Care for America Act. As was the case when the original tri-committee bill was released, the House committees have a ton of fact sheets on the bill that are required reading for folks looking to learn more.

Overall, the House bill is a bill that takes on the insurance industry. Here’s how:

A Public Health Insurance Option

First and foremost, the House bill creates a public health insurance option, available in the new health care marketplace called the “Exchange,” that would compete directly with private insurance. The public option won’t have to worry about profits or stockholders, and because it is run by HHS, it will have huge bargaining clout to get good rates from providers. Overall, while the public option in the House bill won’t save taxpayers as much money as a public option based on Medicare rates, it will still save money according to the CBO.

Because of all that savings, and because the public option will have a mandate to provide health care to people, not maximize profit, it will be a strong competitor to private insurance, keeping prices down and attracting customers. Private insurance will be forced to compete or face losing their most profitable customer base – the individuals and small group customers who are in the Exchange from the start.

Insurance Industry Regulations

The House bill puts new regulations on the insurance industry to curb their bad practices.

The practice of rescission – terminating someone’s insurance plan because they get sick – would be outlawed immediately. Similarly, as soon as this bill is signed, lifetime caps on insurance coverage would be outlawed.

After the Exchange is set up in 2013, all insurers, not just the ones in the Exchange, will be barred from denying care for pre-existing conditions, charging more if your are a woman or sick, or employing annual benefits caps. They will have to cap out-of-pocket expenses at a standard level, keep administrative costs down to below 15%, and publicly disclose and justify their rate increases.

Medicare beneficiaries and the unemployed will benefit as well, with overpayment to private companies through Medicare eliminated and COBRA coverage extended until the Exchange is set up.

Finally, the House bill will eliminate the anti-trust exemption on health insurance companies, making it possible to finally prosecute them for their monopolistic practices.

Immediate Relief

The House bill also provides immediate relief for people at the mercy of the insurance industry by setting up an interim high risk pool open to people who have been uninsured for at least a few months or who have been denied insurance because of pre-existing conditions.

Though clearly not a long term solution, the high-risk pool, combined with the COBRA extensions mentioned above, would get people out from the trap the insurance industry has put them in until full reforms kick in.

Taking on Drug Companies

The House bill also gives us significant savings from drug companies, which according to the Washington Post would amount to between $125 and $150 billion in cuts to their profits.

It does this by eliminating the donut hole which forces seniors to pay unaffordable prices for prescription drugs, starting immediately and completely closing the hole by 2019. It also requires the Secretary of HHS to negotiate for better drug prices for Medicare and Medicaid, and makes it easier for Medicare Part D to offer free generic prescription drugs to enrollees.

Of course, some issues, like biologics (new drugs exempted from generic competition), are still unresolved.

————————

There’s a lot to talk about in the House bill – employer responsibility, fair financing, a whole host of other reforms that take effect immediately. Over the next few days I’ll talk about those. However, the overall thrust of the bill is clear – it takes on the insurance industry for consumers, strengthening care for folks without insurance, on the individual market, in small and large businesses, and on Medicare and Medicaid.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared in Health Care for America Now on October 29, 2009. Reprinted with permission from the author.

What Today's Vote on the Public Option in the Senate Finance Committee Means

Wednesday, September 30th, 2009

Today, the Senate Finance Committee voted on two amendments from Senators Schumer and Rockefeller to add a public health insurance option to the Baucus Bill. Both of those amendments were defeated, 8-15 and 10-13 respectively.

In a long debate on the amendments, Senators spoke out vigorously in favor of the idea. Rockefeller exhorted his colleagues to consider the people of this country as they vote. Schumer asked why the insurance industry was afraid of a little competition. Cantwell, Menendez, Bingaman, Kerry, Bill Nelson, and Stabenow all made their cases and pushed back hard on the misinformation coming from the opposition. The intellectual and moral case for the public health insurance option was clear. And there were some pleasant surprises as Senator Wyden voted for both amendments, and Senators Bill Nelson and Carper voted for the Schumer amendment.

On the Rockefeller amendment, which would have created a public health insurance option based on Medicare, the roll call was:

Democrats

Max Baucus, MT – No
John D. Rockefeller IV, WV – Aye
Kent Conrad, ND – No
Jeff Bingaman, NM – Aye
John Kerry, MA – Aye
Blanche Lincoln, AR – No
Ron Wyden, OR – Aye
Charles Schumer, NY – Aye
Debbie Stabenow, MI – Aye
Maria Cantwell, WA – Aye
Bill Nelson, FL – No
Robert Menendez, NJ – Aye
Thomas Carper, DE – No

Republicans

Chuck Grassley, IA – No
Orrin Hatch, UT – No
Olympia Snowe, ME – No
Jon Kyl, AZ – No
Jim Bunning, KY – No
Mike Crapo, ID – No
Pat Roberts, KS – No
John Ensign, NV – No
Mike Enzi, WY – No
John Cornyn, TX – No

On the Schumer amendment, which would have created a “level playing field” public health insurance option, the roll call has:

Democrats

Max Baucus, MT – No
John D. Rockefeller IV, WV – Aye
Kent Conrad, ND – No
Jeff Bingaman, NM – Aye
John Kerry, MA – Aye
Blanche Lincoln, AR – No
Ron Wyden, OR – Aye
Charles Schumer, NY – Aye
Debbie Stabenow, MI – Aye
Maria Cantwell, WA – Aye
Bill Nelson, FL – Aye
Robert Menendez, NJ – Aye
Thomas Carper, DE – Aye

Republicans

Chuck Grassley, IA – No
Orrin Hatch, UT – No
Olympia Snowe, ME – No
Jon Kyl, AZ – No
Jim Bunning, KY – No
Mike Crapo, ID – No
Pat Roberts, KS – No
John Ensign, NV – No
Mike Enzi, WY – No
John Cornyn, TX – No

In the most conservative committee in the Senate, which is itself the most conservative house of Congress, a public health insurance option got the support of an overwhelming majority of the governing party. And as such, it sets the stage for the next step.

As has been reiterated over and over on this blog, the public health insurance option saves money and lowers costs, it’s the only way to hold insurance companies accountable, and it is overwhelmingly popular – both in Congress, where four out of five committees have already passed a public health insurance option, and with the American people, 77% of whom support the idea. The next time the public health insurance option will come up for consideration is when Harry Reid merges the Finance bill with the HELP bill. The above facts should be kept in mind during that process.

Today was the first step in building momentum for a public health insurance option in the Senate. Clearly, the idea has weight – even self-described moderates such as Bill Nelson and Tom Carper voted for it. As we move to the floor and into conference, with Schumer, Rockefeller, and other champions pledging support and whipping their colleagues, those numbers can and will continue to grow. As Schumer says, a public health insurance option will be in the bill President Obama signs into law. It’ll take work, but it can and will happen.

Chris Bowers has an update to our Senate whip count proving we have 51 votes in the Senate for a public health insurance option. Senator Harkin concurs. As today made clear, there will be surprises as this debate commences. Senators Wyden, Carper, and Nelson (FL) made clear that they support a public health insurance option, something that we didn’t know beforehand. Who knows what other surprises await us as the push continues.

Today was the first step. Today, Senators voted for the first time on the sole question of the public health insurance option, and a huge majority of Democrats supported it. There is no question that this was a big day for health reform, and it will shape the ground going forward.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared in Health Care for America Now on September 29, 2009. Reprinted with permission from the author.

Senator Kennedy - A Health Care Champion

Thursday, August 27th, 2009

Senator Kennedy’s legacy cannot be defined within one issue, no matter how important. But it would not be an understatement to say that his life’s work revolved around health care for all. He said so himself, calling it “the cause of [his] life” in a passionate Newsweek op-ed published just last month.

True to form, Kennedy turned his passion into real results. The list of health care legislative accomplishments he was part of is stunning. From the website set up by his family dedicated in his honor:

  • In 1966, Kennedy helped establish the community health center model in the United States. Community health centers are now serving 20 million low-income Americans around the country.
  • In 1985, Kennedy led the fight to enact COBRA, giving workers the ability to purchase health care through their employer after they have been let go from their job.
  • In 1996, Kennedy co-sponsored HIPPAA, which now ensures access to health care coverage for an estimated 25 million Americans who move from one job to another, are self-employed or have pre-existing medical conditions.
  • In 1997, Kennedy was instrumental in passing the CHIP program that gives health care to millions of children.
  • In 2006, Kennedy passed the Family Opportunity Act, which provides states with the opportunity to expand Medicaid coverage to children with special needs, giving low- and middle-income families with disabled children the opportunity to purchase health coverage under Medicaid.
  • From 1997-2008, Kennedy helped grant Massachusetts the Medicaid waivers it needed to pass its state health care reform plan.
  • In 2008, Kennedy enacted legislation to reform the inequities in the way mental health and substance use disorders are treated by the insurance industry, a 10 year battle.
  • And finally, in 2009 under his leadership and the leadership of his close friend, Senator Chris Dodd, Kennedy passed the Affordable Health Choices Act – which would give everyone in America a guarantee of quality, affordable health care – through the Senate committee he chaired, the Health, Education, Labor and Pensions (HELP) Committee. The bill awaits a vote by the Senate as the health reform process moves forward.

Senator Kennedy’s towering vision for health care was built on his numerous accomplishments. While there is sadness in knowing Senator Kennedy won’t be with us to see his life’s work completed, we will keep him in our thoughts as our fight continues and we finally achieve quality, affordable health care for all this year.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared on the Health Care for America NOW! Blog on August 27, 2009 and is reprinted here with permission from the author.

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What Health Reform Will do for You (and Why)

Thursday, August 6th, 2009

The central question on the American people’s minds right now about health reform seems to be, “What’s in it for me?” Though the cost of doing nothing, as the conservatives propose, is staggering, with the average family paying $10,000 more in premiums by 2019, people still need to understand what reform will do. And while many people have answered or attempted to answer that question, I thought it might be worth another shot. So here it is – a concise and explanatory answer to the question, “What will health reform do for me?”

The below is based on the House version of health care reform, HR 3200 – America’s Affordable Health Choices Act, which is the strongest bill being discussed to date. In short, it will provide a guarantee of quality, affordable health care to everyone.

 

If you receive health insurance from your employer (or your spouse’s or parent’s employer):

The big things will not change – you will keep your current health insurance, keep your current doctor, and keep your current benefits. All the health reform plans being proposed allow people to keep their health insurance if they want to, and that means keeping their current benefits and choice of doctor. So if you get your coverage through work, or if your spouse or parent covers you on their health insurance through work, these big pieces will not change unless you want them to.

Your health insurance will get better and more stable. Health reform gives your employer a strong incentive to retain your health insurance or make it better. They will have to offer you at least standard, comprehensive package of benefits and your employer will not be able to continue shifting additional costs of insurance to you – they will have to pay at least about 70% of the cost of your coverage.

Your health insurance will get cheaper. As the public health insurance option forces insurance companies to compete, prices of private health insurance will fall. Your costs, even if you keep your current health insurance plan, will go down.

If you lose your job, you will always be able to get affordable insurance. If for any reason you lose your job and your employer based coverage, you will be eligible for affordable health insurance that meets your needs, as described below, with the government helping you pick up the tab until you get back to work, and expenses will be capped to make sure you can’t go bankrupt due to medical costs. You will always have a guaranteed, affordable backup to rely on if you need it.

 

If you are employed but do not receive health care benefits from your employer:

Your employer will have to offer you good, affordable health insurance. Under the bill proposed by the House, employers will have to offer you health benefits. Those benefits need to meet a standard for coverage, so you can’t be offered sub-par insurance that doesn’t meet the needs of you and your family. And your employer will have to cover a large percentage of your health care costs (65% for families and 72% for individuals), ensuring insurance is affordable and your employer can’t shift more costs to you. Small businesses are exempt from this regulation.

If you work for a small business that is exempt from regulations asking employers to provide health benefits you will always be able to get affordable insurance. You will be eligible for affordable health insurance that meets your needs, as described below.

 

If you buy health insurance on your own, or if you or your family are uninsured:

You will be able to find coverage. You will have access to a new health insurance “exchange,” where both public and private health insurance will be offered. You will be able to compare these plans side-by-side and choose what’s right for you and your family. None of these plans will be able to reject your application for pre-existing conditions or for your gender. You will have guaranteed access to health insurance.

You will be able to afford coverage. Any health insurance plan in the exchange will be subsidized if you qualify. Subsidies will be available up to 400% of the federal poverty level, or $88,000 per year for a family of four. These subsidies will ensure that you will only pay a certain percentage of your income in health care costs (that percentage varies depending on how much you make). Bottom line: Health insurance through the exchange will be affordable to you.

You will save money. Even if you do not qualify for subsidies or choose the public health insurance option, competition from the public health insurance option will force prices for insurance to fall across the board.

Your coverage will be good coverage, stable and secure. All plans in the exchange will have to conform to federal regulations, making sure that the plan you purchase covers things that you and your family need – things like preventative medicine, regular checkups, and prescription drugs. And, under health reform, your health insurance company will no longer be able to deny you coverage or care for pre-existing conditions. Your insurance company will no longer be able to drop your coverage if you become sick, or charge you more if you’re a woman. There will be no more annual or lifetime caps on coverage, so you won’t be stuck with tens of thousands in uncovered medical bills. And if you pay your premiums, your insurance company won’t be able to reject a renewal of your insurance plan.

Your expenses will be capped. Deductibles, co-pays, premiums, and other expenses will be capped at a percentage of your income (between 1.5% and 11%, depending on how much you make), so you no longer face exorbitant health insurance costs.

 

If you are on Medicare or Medicaid:

Your health programs will not be touched. There will be no eligibility or benefit cuts to Medicare and Medicaid. Health reform will be financed partly by finding savings in these programs. These savings will come from eliminating portions of Medicare and Medicaid that are no longer needed once we’ve passed health care reform for everyone. For example, right now, Medicaid pays hospitals a reimbursement for people who come to the hospital without health insurance, and thus stick that hospital with the bill. Under health reform, most people will have health insurance, making these reimbursements unnecessary.

The Medicare “Donut Hole” will be closed. The “donut hole” in Medicare’s prescription drug program that leaves seniors with thousands of dollars in drug costs when their coverage runs out partway through the year will be gradually closed under health care reform.

 

Is this all paid for?

Yes. Health reform will be fully paid for, and will not increase the deficit. It will not increase your taxes, either. The House has proposed increasing taxes on those that make more than a quarter of a million dollars per year to pay for health reform. The middle class will not be affected.

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There is a short answer to the question of what health reform will do for you: Better coverage, lower costs, and the security of knowing you’re not at the mercy of private insurance anymore. This is what health care reform will do for you.

The cost of doing nothing – the conservative plan for health care – is staggering: The average family will pay $10,000 more in premiums by 2019 if nothing is done. We can not afford the conservative health care plan. We must reform health care now, for you and me and our families.

For a lot of you, this information is not news. However, you must know someone who needs to be educated. Copy and paste this post into an email and send it to someone who needs to know exactly how this bill works. Send around this link. Whatever you need to do, get that information out there. Fear can stop health care reform from happening, we need to fight back with the truth.

Jason Rosenbaum: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared on the Health Care for America NOW! Blog on August 4, 2009 and is reprinted here with permission from the author.

Washington Post Makes Up Competition In the Insurance Market

Thursday, June 18th, 2009

It’s amazing how far the conservative Washington Post editorial board will go to deny the fact. Here is the blatant falsehood from their editorial today (emphasis mine):

More disappointing was Mr. Obama’s restated commitment to a public health insurance option as part of the array of available plans. A public plan is not necessary to maintain a competitive market in health insurance, but including a public plan is almost certain to doom what Mr. Obama says are his hopes for a bipartisan agreement. Given the high stakes involved in an overhaul of this magnitude, it would be unfortunate indeed if health reform were to be a one-party endeavor.

Here you’ve got a conservative lie and a inside-the-Beltway platitude all rolled into one. Let’s take them piece by piece.

First, the Washington Post editorial board actually believes there is a competitive insurance market right now to maintain, and that a public plan isn’t necessary to keep that competition up?

Do the Washington Post editors read their own paper? Because they published a story via the Associated Press (now offline) on Health Care for America Now’s report showing there is no competition between health insurers. In most states, insurance markets are dominated by one or two insurers, and the Justice Department feels they are at risk for monopolies. That is not a “competitive market in health insurance.” Clearly, the Washington Post editorial board wants to deny the facts.

Or maybe they just want to keep the status quo. They imply by their word “maintain” that we have a market they like right now. Maybe the Washington Post editorial board wants to see the insurance industry continue raking in money hand-over-fist using their near-monopoly powers. Maybe that constitutes a competitive market in their minds.

Next, the Washington Post editorial board goes on to say they’d rather have a bipartisan health care plan than one with a public health insurance option to do important things like control costs and provide better health care. In other words, they’d rather see health reform in name only than health reform that actually means anything, another vote in favor of the status quo, where one American every 30 seconds files for bankruptcy due to high health care costs.

Robert Creamer has a bit of a history lesson on the fallacy of bipartisanship:

Of course you never heard a word about “bi-partisanship” from the insurance industry or Republicans when they passed the notorious “Medicare Part D” prescription drug plan in 2003. Back then, they froze Democrats out of all negotiations, and passed the bill on a 220 to 215 vote in the House (with only 16 Democrats voting yes). In fact, Medicare Part D would be their idea of a “good” health care “reform”: taxpayer subsidies for private insurers with no competition from a public plan. And if we went that route, the results of health care reform would look pretty much like the results of Part D as well – no cost control, giant gaps in coverage, and confusing options for consumers.

Now that the political tide has turned, and last year’s economic collapse has given voters a fresh lesson in the consequences of turning public policy over to corporate CEOs and insurance giants like AIG, the Republicans and insurance companies have had an eleventh-hour conversion to the benefits of “bipartisanship” when it comes to health care reform.

It’s no surprise then that in the current debate, the advocates of this position have made it clear that, to them, “bi-partisanship” means one thing: Americans should be denied the choice of a public health insurance option like Medicare. Their problem is that while a public health insurance option may not have bi-partisan support in Congress, it has big time bi-partisan support among the voters.

He also points out, a public health insurance plan has bipartisan support among the people, whether it has it in Congress or not:

A poll conducted earlier this year by the highly respected Lake Research Partners found that voters overwhelmingly want everyone to have a choice of private health insurance or a public health insurance plan (73%), while just 15% prefer everyone having private health insurance.

And the preference for a choice between public and private health insurance plans extends across all demographic and partisan groups, including Democrats (77%), Independents (79%) and Republicans (63%). So in fact, President Obama’s proposal that creates a choice of a public health insurance option is a bi-partisan plan – whether is has “bi-partisan” support in Congress or not.

The Obama plan for health care reform has massive bi-partisan support throughout the United States. Let’s get busy making sure that it becomes the law of the land whether the insurance companies and the Republicans in Congress support it or not.

It doesn’t matter if this thing is bipartisan, because just being bipartisan doesn’t mean it helps the American people. That’s the bottom line. It needs to be good for you and me. If Republicans want to play ball and pass something real, great. If they don’t, it’s more important to get health reform than to get a bipartisan bill. But of course, the beltway insiders at the Washington Post disagree.

Why don’t you take a moment and write them a letter to the editor. Explain how their facts are wrong and how their inside-the-beltway attitude is hurting this country in the fight for real health care reform. Email your letter to letters@washpost.com.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared in Health Care for America Now! on June 8, 2009. Re-printed with permission by the author.

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