“But health reform is not only saving money – it’s saving lives.”

“In the richest nation in the world no insurance company will ever again put a price tag on a human life.”

Washington, D.C. – Senate Majority Leader Harry Reid spoke on the Senate floor today regarding Saturday’s anniversary of the Affordable Care Act. Below are his remarks as prepared for delivery:

Three years ago, President Barack Obama signed into law the greatest single step in generations toward ensuring access to quality, affordable healthcare for every American – the Affordable Care Act.

Millions of Americans are already benefitting from Obamacare. Insurance companies can no longer set arbitrary lifetime caps on benefits, putting millions of Americans one car accident or heart attack away from bankruptcy. Today children can no longer be denied insurance because they are born with a disease or a disability, a protection that will soon extend to all Americans. And soon being a woman will no longer be considered a pre-existing condition.

In less than a year, 129 million Americans with preexisting conditions such as high blood pressure or diabetes can rest assured they’ll have access to affordable insurance and life-saving care – regardless of their health or how much money they make.

In Nevada alone, tens of thousands of seniors have saved tens of millions of dollars on medicines because the Affordable Care Act closed the gap in prescription drug coverage.

But health reform is not only saving money – it’s saving lives.

Just ask 26-year-old Sarah Coffey, a native of Gardnerville, Nevada. Sarah was halfway through her first year of law school at the University of Connecticut when she was diagnosed with stage 4 Hodgkin’s disease.

Sarah had done everything right. When she enrolled at UConn, she bought the best student insurance plan money could buy and paid for it a year in advance. But her cancer – and the difficult treatment to fight it – made returning to school last fall impossible.

Since Sarah was no longer a student, she no longer qualified for student health insurance. And her policy was about to expire. Without an expensive bone marrow transplant, she might die.

Before the Affordable Care Act became law, Sarah would have been one of the tens of millions of Americans who desperately needed life-saving care, but didn’t have insurance to pay for it. Before the Affordable Care Act, Sarah might even have become one of the 45,000 Americans who died each year because they lacked health insurance.

But thanks to Obamacare, Sarah was able to sign on to her parents’ insurance plan. Sarah is one of 3.1 million young people – including 33,000 young Nevadans – who have benefited from a provision in the law that allows children to stay on their parents’ health plans until they are 26 years old.

And I’m pleased to report that Sarah’s story has a happy ending. She got the treatment she needed. Her most recent PET scan was clear. And Sarah plans to return to law school in September.

Sarah’s mother, Sue, sent me a letter in January. She wrote that Obamacare and the dedicated doctors at Stanford Hospital saved her daughter’s life.

This is the legacy of the landmark law: that no American will end up in an emergency room because he has no insurance, that no American will live in fear of losing her insurance because she loses her job and that in the richest nation in the world no insurance company will ever again put a price tag on a human life.

Thomas Jefferson wrote that, “The care of human life and happiness… is the first and only object of good government.” I am gratified that the Affordable Care Act meets that standard. And I am proud that this law, which we worked so hard to pass, is already ensuring the care of human life remains the first object of this government.

Starting today, critical women’s preventive health services will be available to women, free of co-pays or deductibles — a hard-fought benefit for women in Nevada and across the country that is long overdue.

Yet on the eve of the implementation of these historic benefits for women, my Republican colleagues were still trying to repeal the Affordable Care Act — the very law that offers these benefits along with many other crucial protections for women.

To read more, follow this link to the Huffington Post.

Congress Can’t Afford To Waste Time Refighting Old Battles And Should Renew Focus On Creating Jobs

Washington, D.C. – Nevada Senator Harry Reid spoke on the Senate floor today regarding the Supreme Court’s decision on the Affordable Care Act and Congress’ plan to refocus on creating jobs for the American people. Below are his remarks as prepared for delivery:

Yesterday the United States Supreme Court reaffirmed that no family should live one illness or accident away from bankruptcy.

The Court’s decision isn’t a victory for Democrats or for President Obama – it’s a true victory for the American people.

Let me give you a few reasons why.

Since President Obama signed the Affordable Care Act into law, more than 6 million young people have signed up for their parents’ health plans.

Because children can now stay on their parents’ insurance until they’re 26, no young person will have to defer his or her dreams to take a job that offers insurance.

Since health reform took effect, 5 million seniors have already saved about $600 each on prescription drugs. Millions more have gotten free wellness checks and cancer screenings.

That means millions of seniors have more money in their pockets for food, gas and the electric bill.

And, hundreds of thousands of businesses that already offer their employees health insurance are getting tax credits for doing the right thing.

Since Congress passed this law, insurance companies can no longer put profits ahead of people.

They can no longer discriminate against children with preexisting conditions.

They can no longer raise your rates for no reason.

They can no longer drop your coverage if you get sick.

Millions of Americans are already seeing the benefits of this law.

And soon, 30 million more who can’t afford health insurance will have access to reasonably priced insurance and quality care.

Here’s how it works. Each state will set up its own health insurance marketplace, called an exchange, which will offer a menu of private insurance plans from which people can choose.

Once these exchanges are in place, insurance companies will no longer be able to discriminate against any American with a preexisting health condition.

They won’t be able to deny you insurance because you’re sick.

They won’t be able to charge you more just because you’re a woman or because you don’t already have insurance.

And if you can’t afford the premiums, you’ll get a tax credit to help pay them.

But what if you’re one of the 250 million Americans who already has insurance? Nothing will change.

Nothing will change except that you’ll no longer have to worry that if you lose your job, you’ll lose your insurance.

Nothing will change except that if you get cancer or have a stroke, your insurance company won’t be allowed to deny life-saving care because you reach some arbitrary lifetime cap.

Nothing will change except that your checkups and preventive care will be free – a provision that’s already helped 54 million Americans with private insurance.

You’ll be able to keep your plan and keep your doctor. But now you – not the insurance company – will be in control.

And by August, almost 13 million people will get a rebate check from their insurance company because it spent too much on administrative costs and not enough on health care.

The Affordable Care Act is already helping millions of Americans – seniors on Medicare, children with heart conditions, students following their dreams.

And in the coming months many millions more will benefit from this law.

That’s doesn’t mean the law is perfect. Democrats have already shown we’re willing to work with Republicans to improve it.

But now that the Supreme Court has spoken, it’s time to renew our focus on the most pressing challenge facing this nation: the high unemployment rate.

Too many Americans are still struggling. And Congress can’t afford to waste time refighting old battles.

Now we need to work together to put Americans back to work.

Thanks to cooperation on both sides, I am glad to say the Senate will vote today on the transportation jobs bill conference report.

This package also includes an extension of student loan rates and flood insurance legislation.

Passing these three very important job-creating measures is a real accomplishment for Congress.

Extending the flood insurance program will allow millions of home closings to go forward at a time when our real estate market is just beginning to rebound.

Preventing interest rates from doubling on 7 million students was a major priority for Democrats and for President Obama.

And passing the two-year transportation bill will create or save 2.8 million American jobs – many of them in the hard-hit construction industry.

It will also restore millions of miles of crumbling roadways, railways and bridges.

This has been an incredibly productive week. And it tops off a fruitful session.

This month we passed a bipartisan farm bill that will give certainty to an agriculture industry that supports 16 million jobs.

I am optimistic the Senate will maintain a spirit of collaboration during the next work period, when we will consider a number of other job-creation measures.

I hope all my colleagues have a constructive week in their home states, and a safe and happy Fourth of July.

And I hope they come back rested and ready to work on in July, because we have a lot to get done next month to ensure this country’s economic future.

I look forward to taking on that challenge together.

“Today’s decision by the Supreme Court to uphold the Affordable Care Act is a win not only for the millions of Vermonters and other Americans who have long been victimized by a deeply flawed health care system, but for all Americans who will benefit as we continue to implement this landmark law.

“Over much of the last century, generation after generation has unsuccessfully grappled with how to answer complex and increasingly urgent questions about how to let every American have access to quality, affordable health insurance.  Out of control costs were eating our economy alive and forcing many employers to drop insurance for their workers.  The Affordable Care Act at last answered those questions.  Though no bill is perfect, these are good reforms, long needed by the American people, by American businesses and by the American economy.

“The nation and every American household now would be best served if this historic decision puts an end to the years of partisan attacks and obstruction of efforts to help the millions of Americans who have fallen through the cracks, and millions more who worry with good reason that they may fall through the cracks of our broken health insurance system.  The Court has spared the American people a return to those decades of spiraling problems and uncertainty that reached into every American household.

“The Court’s decision reaffirms what I have believed since the Senate debated and passed this law: Congress has the power under the Constitution and the Court’s own, long-standing precedent to protect Americans from abuses by health insurers and to help give all Americans with access to affordable health care, including some of the most vulnerable among us like children and older Americans.

“In passing the Affordable Care Act, Congress built on the cornerstones of modern America like Social Security, Medicare and Medicaid, to strengthen the Nation’s social safety net and help protect hardworking Americans.  I have served in the Senate for 37 years, through seven presidencies.  I am one of the few people in the Senate today who can say that I served alongside representatives who voted to create our nation’s Social Security system, voted for the G.I. bill, passed the Voting Rights Act, and created Medicare, Medicaid, and Head Start.  Congress has come together to refine the laws establishing these programs.  We should similarly come together to further improve the Affordable Care Act where needed.  It’s time to stop the political posturing.  Congress works best for the American people when we are able to come together to solve national problems.  America is stronger when we do.”

Statement Of Senator Max Baucus (D-Mt.)
Chairman, Senate Finance Committee

“This is a win for millions of American families, small businesses, and seniors who are getting more affordable health care, tax cuts, and protections from insurance company abuses thanks to this law.  Now it’s time to put politics aside.  We need to move forward and find ways to work together to put America back on track.”

Statement Of Senator Tom Harkin (D-Ia.)
Chairman, Senate HELP Committee

 “Today’s decision by the Supreme Court is a rigorous, resounding confirmation of the constitutionality of the Affordable Care Act.  It is great news for America’s families and businesses, and for our economy.  This decision keeps consumers, rather than insurance companies, in the driver’s seat, and protects the more than $1 trillion in deficit reduction included in the ACA. Today’s decision allows us to continue our work replacing the current sick care system with a genuine health care system – one focused on wellness, prevention, and public health, keeping people out of the hospital in the first place.

“I am heartened to see that the hundreds of millions of corporate dollars poured into the effort to kill the Affordable Care Act did not win. This law is a critical step in the right direction; I have likened it to a starter home, suitable for improvement.  I look forward to working with my colleagues to make sensible changes as we continue to implement the law.  I invite them to bring their tool kits, rather than their sledgehammers, so we can work together to improve the law.

“The choice is to go forward, or be dragged backward.  I believe the great majority of Americans want to go forward – and today the Supreme Court made clear what we have long known: that the opposition is standing on the wrong side of history.  Now let’s get back to work building a health care system that works not only for the healthy and wealthy, but for all Americans.”

Two years ago tomorrow, President Obama signed the Patient Protection and Affordable Care Act into law.

It was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every American – regardless of where they live or how much money they make.

Millions of Americans have already felt the benefits of this law.

Seniors are saving money on their prescriptions and checkups.

Insurance companies can no longer set arbitrary lifetime caps on benefits, putting millions of Americans one car accident or heart attack away from bankruptcy.

Children can no longer be denied insurance because they have a preexisting condition, a protection that will soon extend to all Americans.

And in two shorts years, virtually every man, woman and child in America will have access to health insurance they can afford and the vital care they need.

No longer will hundreds of millions of Americans live in fear of losing their insurance because they lose their job.

And no longer will tens of millions more rely on emergency room care – or go without care entirely – because they have no insurance at all.

Unfortunately, Republicans continue to target the rights and benefits guaranteed under this law.

If Republicans have their way, insurance companies will once again be allowed to deny care to a sick child because he or she has asthma or diabetes.

In Nevada, thousands of children with preexisting conditions would once again be at the whim of insurance companies that care more about making money than about making people better.

If Republicans have their way, young adults just out of college will be kicked off their parents’ insurance plans.

Almost 23,000 young adults in Nevada would once again have to defer their dreams to take jobs that offer health insurance – or else risk going without care.

If Republicans have their way, seniors will pay more for prescriptions and checkups.

More than 230,000 Nevada seniors would once again be forced to pay for wellness visits, cancer screenings and other preventive services.

And tens of thousands of seniors, who saved $12 million on prescription drugs last year, will once again be forced to choose between buying food and buying medicine.

If Republicans have their way, taxes will increase for small businesses. And so will the deficit.

Repealing health care reform would add $1.5 trillion to the federal debt.

But when Democrats undertook healthcare reform, it wasn’t just about saving money – it was about saving lives.

And while the numbers I’ve just discussed are very important, there is one number that matters more than all the others: 45,000.

That is the number of Americans who die every year because they lack health insurance.

That doesn’t include the tens of thousands more who are sick or dying because they have health insurance, but still can’t afford the care they need.

After the rest of the Affordable Care Act has taken effect over the next two years, no American will have to bear what President Lyndon Johnson called “the injustice which denies the miracle of healing to the old and to the poor.”

President Johnson knew that living in a country with the best medical care in the world doesn’t matter if you can’t access that care.

That’s why, almost 47 years ago, he signed Medicare into law.

On that day in July, President Johnson celebrated an American tradition that “calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.”

I am pleased to say the Affordable Care Act continues that tradition.

This law makes certain that the richest nation in the world never again turns its back on the despair, helplessness and suffering of the least among us.

And it guarantees that no insurance company will ever again put a price tag on a human life.

“This morning one of my friends said that passing the health care bill was a miracle in his life and his family’s life. Those are his words, not mine,” Nevada Sen. Harry Reid said today on the Senate Floor. “They could not find insurance for their child who developed diabetes. Because of the health care bill, that child is fully insured now. That’s what the health care bill is about.

“Hundreds of thousands of students have health insurance because their parents have health insurance. The IRS sent notices to 4.4 million small businesses in America to let them know that they may qualify for reduced insurance premiums. And exchanges are being set up in Nevada and across the country that will mean every American has access to insurance plans similar to the ones members of Congress have. The health care bill is a milestone in the history of this country.”

Reid said Republicans who want to repeal health care reform also want to strip away those benefits, which have proven popular with people in Nevada and across America. Their plan would put Americans’ care back in the hands of big insurance companies, whose only concern is their bottom line.

In addition to costing small businesses and middle-class families, repealing the Affordable Care Act would also balloon our deficit.  In fact, the Congressional Budget Office estimated the law will reduce this country’s debt by $1.3 trillion–a savings that would disappear if Republicans get their way.

• Improving Access to Care
• New, Draft Form W-2, and Another Assurance that Health Coverage is Not Taxable
• Helping 1,000 More Businesses Help Early Retirees
• Ensuring Access to Health Insurance for Children with Pre-Existing Conditions
• Putting Patients Back in Charge
• Improving Care and Preventing Abuse in Long-Term Care Facilities
• Legal Challenges to the Affordable Care Act
• Additional Information

Previous updates on health reform implementation and other information are available from the DPC. [DPC]

Improving Access to Care

Community Health Centers

The Affordable Care Act creates an expanded and sustained national investment in community health centers by providing $11 billion over five years to these critical health care providers. [P.L. 111-148; P.L. 111-152]  The country’s 1,250 community health centers provide quality health care to 20 million Americans without regard to a patient’s ability to pay or health insurance coverage. [National Association of Community Health Centers, accessed 8/23/10]  The Affordable Care Act’s investment in community health centers will allow them to nearly double the number of patients they serve.  By providing primary care and focusing on preventive services, health centers estimate they save our health care system $9.9 billion – $17.6 billion each year.

Recently, HHS announced awards of $727 million to 143 community health centers nationwide for construction and renovation projects that, when complete, will allow the health centers to provide care for an additional 745,000 patients. [HHS, 10/8/10]  Community health centers are a constant source of quality, affordable health care to millions of Americans, but especially during this economic downturn, health centers can be a critical source of care for those who have lost their health insurance, who are in between jobs, or who face other financial difficulties.

School-Based Health Centers

HHS and the Health Resources and Services Administrative (HRSA) also recently announced the availability of $100 million in funding for the construction and renovation of school-based health centers. [HRSA, 10/4/10]  The Affordable Care Act includes funding to assist school-based health centers in providing comprehensive and accessible preventive and primary health care services to medically-underserved children and families.  HRSA anticipates 200 grants will be awarded to construct, renovate, or purchase equipment in school-based health centers.  Grant applications are due December 1, 2010, and more information is available at Grants.gov. [Grants.gov, accessed 10/18/10]

New, Draft Form W-2, and Another Assurance that Health Coverage Is Not Taxable

To provide Americans with more information about the value of their health insurance, the Affordable Care Act requires employers to disclose the value of any employer-sponsored health insurance for each employee, on the employee’s annual Form W-2.  Despite an onslaught of rumors to the contrary, employer-sponsored health benefits are absolutelynottaxable, and the Affordable Care Act does not change the tax-free status of these benefits.  Reporting the cost of coverage will be optional in 2011, and, in 2012, all employers who offer health insurance will be required to report the value to each worker on their Form W-2.

Last week, the Internal Revenue Service (IRS) released a draft Form W-2 for 2011. [IRS, 10/12/10]  The new draft form looks a lot like the existing Form W-2, except that it includes a space for employers to report the cost of employer-sponsored health coverage. [IRS, undated]  And, the form itself clarifies that the cost is provided for information purposes only:

Cost of employer-sponsored health coverage (if provided by the employer).  The reporting in Box 12, using Code DD, of the cost of employer-sponsored health coverage is for information only.  The amount reported with Code DD is not taxable.

Helping 1,000 More Businesses Help Early Retirees

The Affordable Care Act creates a $5 billion Early Retiree Reinsurance Program to support employer health plans that provide coverage to retirees who are not yet eligible for Medicare, helping to protect access to coverage while reducing costs for employers and retirees. [P.L. 111-148; P.L. 111-152]  HHS recently announced that another 1,000 employers were accepted into the program, bringing the total number of participating employers to nearly 3,000. [HHS, 10/4/10]  Participating employers come from all 50 states and the District of Columbia, representing large and small businesses, state and local governments, educational institutions, non-profits, and unions.  A fact sheet explaining the program and a list of all participating employers in each state is available at HealthCare.gov and the list will be updated each week as new employers join the program.  Applications are still being accepted, and more information on the Early Retiree Reinsurance Programs is available at ERRP.gov.  This month, participating employers will begin to submit claims and receive reimbursement payments for qualifying expenses.

The Early Retiree Reinsurance Program is another bridge to the Health Insurance Exchanges and reformed health insurance markets effective in 2014, which will make it easier for earlier retirees to access affordable health insurance.  Skyrocketing health care costs have made it difficult for employers to continue to provide health benefits for employees and retirees, and this temporary program will provide financial assistance until 2014.  Earlier this year, a survey found that 76 percent of large employers that offer retiree benefits planned to pursue participation in the program, and that the average federal reimbursement for each early retiree will represent between 25 and 35 percent of each early retiree’s health care costs. [Hewitt Associates, 5/25/10]

Ensuring Access to Health Insurance for Children with Pre-Existing Conditions

On September 23, 2010, the six month anniversary of the enactment of the Affordable Care Act, the Patients’ Bill of Rights took effect.  One of the most critical protections included in the Patients’ Bill of Rights prohibits insurers from denying coverage to children who have pre-existing conditions, for all new plans and for existing plans in the group market.  Before enactment, insurers were free to deny health insurance to children who had a pre-existing condition, such as asthma, or could offer to cover the child but refuse to pay for any treatment related to the pre-existing condition.  The Affordable Care Act ended this practice, providing children and their parents the peace of mind that comes with knowing they can always access coverage.

Despite a March 29, 2010, letter in which AHIP expressed its commitment “to make pre-existing condition exclusions a thing of the past,” some health insurers are still choosing to deny coverage to children who need it by refusing to offer new “child-only” policies.  These types of policies are issued in the individual market and cover only children, not an entire family.  Last week, HHS Secretary Sebelius sent a letter to the National Association of Insurance Commissioners outlining efforts by HHS, working with states, to ensure that children with pre-existing conditions continue to have access to health insurance. [HHS, 10/13/10]  The letter clarifies a range of insurer practices related to child-only policies that are permissible under the Affordable Care Act and highlights answers to frequently asked questions, available online. [HHS, 10/13/10]  In addition, the letter outlines steps some states have taken and other states might consider, including the establishment of open enrollment periods, offering unsubsidized buy-in to a state’s Children’s Health Insurance Program (CHIP), and seeking coverage through existing state high-risk pools.  The Affordable Care Act also created the Pre-Existing Condition Insurance Plan (PCIP) which is available to eligible children and adults with pre-existing conditions who have been uninsured for at least six months.   Information is available at PCIP.gov.

Putting Patients Back in Charge

The Affordable Care Act protects consumers by ending some of the worst health insurance industry abuses.  One way the Affordable Care Act protects consumers and puts patients back in charge of their health care is by providing grants to states to establish or expand offices of health insurance consumer assistance or health insurance ombudsman programs. [P.L. 111-148; P.L. 111-152]  These independent offices will assist consumers with enrolling in coverage and with filing complaints and appeals, educate consumers on their rights and responsibilities, and collect, track, and quantify consumer problems and inquiries.

Earlier this year, HHS issued a grant notice, and on October 19, 2010, HHS announced awards of nearly $30 million for state consumer assistance programs. [HHS, 10/19/10]  Thirty-five states, four territories, and the District of Columbia applied for and received this funding.  More information about this grant program and summaries of how each grantee will use this new funding is available at HealthCare.gov. [HealthCare.gov, accessed 10/19/10; HealthCare.gov, accessed 10/19/10]

Improving Care and Preventing Abuse in Long-Term Care Facilities

In order to improve care and prevent abuse in long-term care facilities, the Affordable Care Act requires the Secretary of HHS to establish a nationwide program for national and state background checks on employees with direct access to patients at certain long-term supports and services facilities or providers. [P.L. 111-148; P.L. 111-152]  Earlier this month, HHS announced it had awarded $13 million to six states to design comprehensive applicant criminal background check programs for jobs involving direct patient care. [HHS, 10/6/10]  The Affordable Care Act provides a total of $160 million for the background check program, which should allow all states to participate.   Another round of grants is expected in the near future.

Legal Challenges to the Affordable Care Act

Since the Affordable Care Act became law, several state Attorneys General have filed lawsuits to challenge its constitutionality.  Opponents of health reform, having failed to prevent it from becoming law, are now taking their opposition to the courts.  But constitutional law scholars are confident these suits have no merit, and that, as President Reagan’s Solicitor General Charles Fried wrote, “the health care law’s enemies have no ally in the Constitution.” [DPC, 3/26/10; Boston Globe, 3/21/10]

On October 7, 2010, in the first substantive ruling on the individual responsibility policy, Judge George Caram Steeh of the U.S. District Court, Eastern District of Michigan, determined that the Affordable Care Act is constitutional.  In considering the Commerce Clause, Judge Steeh wrote:  “Far from ‘inactivity,’ by choosing to forgo insurance plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now through the purchase of insurance, collectively shifting billions of dollars, $43 billion in 2008, onto other market participants.” [Opinion available here]  In dismissing the lawsuit Judge Steeh concluded:  “The minimum coverage provision, which addresses economic decisions regarding health care services that everyone eventually, and inevitably, will need, is a reasonable means of effectuating Congress’s goal.”

On October 14, 2010, Judge Roger Vinson in Florida dismissed four of the six claims brought by several Republican Attorneys General and issued a procedural ruling allowing the two remaining claims to proceed. [Washington Post, 10/15/10]  The ruling does not address the merits of the constitutional claims raised by the suit, but allows the process to continue to a summary judgment hearing later this year.

Additional Information

The Democratic Policy Committee has released 13 previous updates on health reform implementation, available on the DPC website here.  In addition, DPC maintains a centralized listing of health reform implementation resources which is frequently updated and is available here.

Republican Repeal Costs $143 billion

Health Reform Reduces the Deficit

The nonpartisan Congressional Budget Office, the official scorekeeper of Congress, determined that the Affordable Care Act reduces the federal deficit by $143 billion over the first ten years of enactment. [CBO, 3/20/10]  The Affordable Care Act reduces the deficit while ensuring that 94 percent of Americans have health insurance and reducing the rate at which health care costs grow.

Republican Repeal Plan Increases the Deficit

Extrapolating from CBO’s estimate of the deficit savings resulting from the Affordable Care Act, repeal of health reform is likely to increase the deficit by $143 billion.

Republican Repeal Raises Drug Costs for Seniors

Health Reform Fills in the “Donut Hole”

More than 1.2 million Medicare beneficiaries who have entered the “donut hole” have received their $250 rebate checks, the first of the Affordable Care Act’s steps to completely fill in the “donut hole” by 2020. [HHS, 9/23/10]  Checks will continue to go out monthly for the rest of the year as beneficiaries enter the coverage gap. [White House, 6/8/10]  The $250 rebate check is tax-free and seniors do not need to do anything to receive it; Medicare automatically mails a check when the beneficiary reaches the “donut hole.” [Centers for Medicare & Medicaid Services, 5/10]  Seniors who do not receive Medicare Extra Help should expect their check in the mail within 45 days or less of hitting the coverage gap.  Information on the number of seniors in your state who may qualify for the rebate check is available from the DPC. [DPC, 6/22/10]

Beginning next year, Medicare beneficiaries who do not receive Medicare Extra Help will receive a 50 percent discount on brand-name drugs and biologics they purchase when they are in the coverage gap.  In addition to the discount, coverage in the “donut hole” will increase until 2020, when 75 percent coverage on all drugs purchased in the gap will completely fill in the “donut hole.”  More information on filling in the “donut hole” and other benefits of health reform for seniors is available from the DPC. [DPC, 6/10/10]

Republican Repeal Raises Drug Costs for Seniors

The Republican scheme to repeal health reform would deny seniors the $250 rebate check and rescind the 50 percent discount on brand-name drugs and biologics purchased in the “donut hole” next year to help them afford their medication.  The Republican plot to repeal reform would ensure the “donut hole” remains in place, rather than being closed by 2020 as under the health reform law.

Republican Repeal Revokes Tax Credits for Small Businesses

Health Reform Provides Small Business Health Insurance Tax Credits

The Affordable Care Act provides tax credits for up to 35 percent of premium costs for small businesses that offer coverage to their employees.  Effective this year, the full credit is available to firms with 10 or fewer employees and average annual wages of up to $25,000, while firms with up to 25 employees and average annual wages of up to $50,000 will also be eligible for a credit.  Beginning in 2014, tax credits are available for up to 50 percent of premium costs.  In April, the Internal Revenue Service began mailing postcards to more than four million small businesses and tax-exempt organizations that may be eligible for the credit, and provided answers to frequently asked questions about the credit. [IRS, 4/19/10; 5/5/10]  Information on the number of small businesses in your state who may qualify for the tax credit is available from the DPC. [DPC, 6/22/10]

Republican Repeal Plan Revokes Tax Credits for Small Businesses

The Republican scheme to repeal health reform would deny small businesses this tax credit, putting small business owners right back where they were before health reform was enacted, struggling to find affordable coverage options to offer their employees, or simply not offering coverage because affordable plans are unavailable.

Republican Repeal Rescinds Coverage for Young Adults

Health Reform Expands Coverage for Young Adults

The Affordable Care Act allows young adults to stay on their parents’ health insurance plan until their 26^th birthday.  Before passage of the new law, many plans dropped young adults from their parents’ policies at age 19 or upon graduation from high school or college. [National Conference of State Legislatures, 4/10]  Thirty percent of young adults age 19 through 29 are uninsured, the highest rate of any age group.  This provision is effective for all policies issued or renewed after September 23, 2010, and more than 65 insurance companies voluntarily started providing this coverage to young adults earlier this year, before the deadline. [The White House, 5/10/10]  Information on the number of young adults in your state who may benefit from this coverage extension is available from the DPC. [DPC, 6/22/10]

Republican Repeal Plan Rescinds Coverage Expansion for Young Adults

The Republican scheme to repeal health reform would revoke the new health insurance coverage options that health reform offers for young adults.  For young adults, especially new college graduates facing a challenging job market, the option to stay on a parent’s health insurance could be the only reasonably priced insurance option they have.  Without it, many will be forced to go uninsured.

Republican Repeal Revokes Coverage for Children with Pre-Existing Conditions

Health Reform Guarantees Coverage for Children with Pre-Existing Conditions

The Affordable Care Act prohibits health insurers from denying or excluding coverage of pre-existing conditions for children, effective for policies and plan years beginning on or after September 23, 2010, and applying to all group plans and all new plans in the individual market.  The Administration has worked with the health insurance industry, which has agreed to ensure that children with pre-existing conditions are not denied coverage. [HHS, 5/10/10]  This means that children, no matter their health status, and their parents will soon have the peace of mind that comes with knowing coverage of a child’s pre-existing condition cannot be denied.

Republican Repeal Plan Revokes Protections for Children

The Republican scheme to repeal health reform would revoke the protection children now have from having their health insurance coverage denied or limited due to a pre-existing condition.  The Republican effort to repeal reform gives insurance companies the freedom to deny coverage of a child’s pre-existing condition, including congenital conditions a child may have at birth.  No child should be denied health care for a condition they were born with, and every parent deserves the peace of mind that comes with knowing their child’s health care is covered.

Republican Repeal Revokes the Patients’ Bill of Rights

Health Reform Guarantees Patients’ Rights

The Affordable Care Act includes numerous consumer protections and a Patients’ Bill of Rights – provisions that Senate Democrats have been fighting to enact for nearly a decade.  These patient protections take effect for policy or plan years beginning on or after September 23, 2010, and apply to various types of health insurance plans, as noted.

·         No lifetime limits on coverage. Insurers will be prohibited from imposing lifetime limits on benefits.  This provision applies to all new and existing plans in all markets.

·         No coverage rescissions when Americans get sick. Insurers will be prohibited from rescinding health coverage when a beneficiary gets sick as a way of avoiding paying that person’s health care bills.  This provision applies to all new and existing plans in all markets.

·         Required coverage of preventive care with no cost-sharing. Insurers will be required to provide coverage of preventive health care services without cost-sharing.  This provision applies to all new plans in all markets.

·         Regulated annual limits on coverage. Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This provision applies to all new plans and existing employer plans, until 2014, when the Exchanges are operational and use of any type of annual limit will be banned for all new plans and existing employer plans.

·         Fair opportunity to appeal coverage and claims decisions. Health insurers will be required to develop an appeals process that, at a minimum, provides beneficiaries with a notice of internal and external appeals processes and allows beneficiaries to review their file and present evidence in their appeal.  This provision applies to all new plans in all markets.

·         Right to choose your doctor. Patients’ rights are protected by allowing health insurance plan members to choose any participating primary care provider, or in the case of children, any participating pediatrician, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.  This provision applies to all new plans in all markets.

Republican Repeal Plan Revokes Patients’ Rights

The Republican scheme to repeal health reform would deny all Americans the consumer protections and patients’ rights that will soon take effect as a result of the new health reform law.  The Affordable Care Act puts control over health care decisions in the hands of the American people, not insurance companies.  It seems Republicans advocating for repeal of the new law are on the side of insurance companies, not patients.

Republican Repeal Raises Costs for Early Retirees

Health Reform Lowers Costs for Early Retirees

The Affordable Care Act created a $5 billion re-insurance program for employer health plans that offer coverage to retirees who are not yet eligible for Medicare, to help protect access to coverage while reducing costs for employers and retirees.  This temporary program will provide financial assistance until 2014, when health insurance Exchanges will make it easier for early retirees to access affordable health insurance options.  Early retirees are at particular risk of becoming uninsured, or of being forced to pay exorbitant premium costs until they become eligible for Medicare, and the percentage of large firms offering retiree coverage has dropped precipitously, from 66 percent in 1988 to just 31 percent in 2008. [The White House, 5/4/10]  The program began on June 1, 2010, in advance of the June 22, 2010, effective date required by law. [Federal Register, 5/5/10; The White House, 5/4/10]  Information on the number of early retirees in your state who may benefit from this program is available from the DPC. [DPC, 6/22/10]

Republican Repeal Plan Leaves Early Retirees Without Critical Protections

The Republican scheme to repeal health reform fails to protect early retirees, who will continue to be at a very high risk of becoming uninsured or of paying excessive premiums if they are lucky enough to maintain their health insurance coverage.  Employers are struggling to continue providing health benefits to retirees, and Republicans are working to repeal the assistance that the health reform law provides them to do the right thing.