Friday, March 26, 2010

What the Passage of the Health Care Bills Means for Us

Here's the information that Involved Voters need to set the record straight on Health Care.

From 7th District Congressman Mark Schauer

"What does health insurance reform actually mean for me?"

  • This year, children with pre-existing conditions can no longer be denied health insurance coverage. Once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.
  • This year, health care plans will allow young people to remain on their parents' insurance policy up until their 26th birthday.
  • This year, insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage. This year, restrictive annual limits on coverage will be banned for certain plans. Under health insurance reform, Americans will be ensured access to the care they need.
  • This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary subsidized high-risk pool.
  • In the next fiscal year, the bill increases funding for community health centers, so they can treat nearly double the number of patients over the next five years.
  • This year, we'll also establish an independent commission to advise on how best to build the health care workforce and increase the number of nurses, doctors and other professionals to meet our country's needs. Going forward, we will provide $1.5 billion in funding to support the next generation of doctors, nurses and other primary care practitioners -- on top of a $500 million investment from the American Recovery and Reinvestment Act.

Health insurance reform will also curb some of the worst insurance industry practices and strengthen consumer protections:

  • This year, this bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.
  • This year, discrimination based on salary will be outlawed. New group health plans will be prohibited from establishing any eligibility rules for health care coverage that discriminate in favor of higher-wage employees.
  • Beginning this fiscal year, this bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance companies.
  • Starting January 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services. Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services. Any insurers who don't meet those thresholds will be required to provide rebates to their policyholders.
  • Starting in 2011, this bill helps states require insurance companies to submit justification for requested premium increases. Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance exchanges.

Reform immediately begins to lower health care costs for American families and small businesses:

  • This year, small businesses that choose to offer coverage will begin to receive tax credits of up to 35 percent of premiums to help make employee coverage more affordable.
  • This year, new private plans will be required to provide free preventive care: no co-payments and no deductibles for preventive services. And beginning January 1, 2011, Medicare will do the same.
  • This year, this bill will provide help for early retirees by creating a temporary re-insurance program to help offset the costs of expensive premiums for employers and retirees age 55-64.

This year, this bill starts to close the Medicare Part D 'donut hole' by providing a $250 rebate to Medicare beneficiaries who hit the gap in prescription drug coverage. And beginning in 2011, the bill institutes a 50% discount on prescription drugs in the 'donut hole.'

If you already knew all of this, congratulations on being exceptionally well-informed. If this is not at all like what you've been hearing from "The Party of NO," perhaps you've been the victim of a misinformation campaign. Whatever the case, now you know. So, please share the good news!

Monday, March 22, 2010

Three Cheers for Mark Schauer - and Us!

Our 7th District Congressman, Mark Schauer, continued his excellent work on behalf of constituents and the State of Michigan by voting for health care reform last night. (Please see my previous posts and for information about how the legislation will benefit us.)

This was a gutsy vote on Schauer's part. He's already been targeted by big-money, special interests who want to replace him with someone who will dance to their tune.

We are lucky to have a Representative who works as hard and has as much integrity as Mark Schauer. So, it's up to us Involved Voters to make sure Mark gets re-elected.

Sunday, March 7, 2010

Isn't it about time?!

A year's worth of discussing, ideas, formulating legislation and debating; two health care reform bills, one passed by the House and one passed by the Senate with 60 out of 100 votes - more than a simple majority. Now it's time to wrap things up and give all of us who have been waiting (not always patiently) what we want.

Here's what the "reconciliation process", otherwise known as a majority vote on the budget-related elements of health care reform with debate but without filibustering, will deliver for us:

Hold Insurance Companies Accountable:
  • Eliminate lifetime limits and restrictive annual limits on benefits in all new plans;
  • Prohibit rescissions of health insurance policies in all individual plans;
  • Prohibit pre-existing condition exclusions for children in all new plans;
  • Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs;
  • Establish a process for the annual review of unreasonable increases in premiums, requiring State insurance commissioners to work with the HHS Secretary and States.

Protect Consumers:

  • Provide grants to States to support health insurance consumer assistance and ombudsman programs to help consumers;
  • Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions;
  • Require all insurance plans to use uniform coverage documents so consumers can make easy comparisons when shopping for health insurance;
  • Establish an internet portal to assist Americans in identifying coverage options;
  • Prohibit insurers from discriminating in favor of highly compensated employees by charging them lower premiums.

Ensure Affordable Choices and Quality Care:

  • Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;
  • Create a temporary re-insurance program for early retirees;
  • Require new plans to cover an enrollee’s dependent children until age 26;
  • Require new plans to cover preventive services and immunizations without cost-sharing;
  • Offer tax credits to small businesses to purchase coverage;
  • Facilitate administrative simplification to lower health system costs.
The Republican's in Congress want to trash all these gains and start over! After a year of working to get this far! As an Involved Voter, ask yourself: Who are they working for?