Senate Democrats

The Bottom Line on the Senate Health Care Bill

With Republicans trying to distort the facts surrounding the Senate health care bill and much of the media focused on the legislative sausage-making progress, we thought you might be interested in a straightforward take on what’s really in the final legislation. Bottom line — you want to know how the Senate health care bill will affect you and your family. 

Ends discrimination based on pre-existing condition. Insurance companies will have to take all comers.  They can’t deny you coverage or jack up your premiums based on your health status.

Ends gender discrimination. Insurance companies will no longer be able to charge higher premiums based on gender.

Caps out-of-pocket expenses. Insurance companies will have to abide by limits on what they can charge you for out-of-pocket expenses like deductibles and co-pays.

Prevents dropping of coverage for seriously ill.  Insurance companies will be prohibited from dropping, watering down, or refusing to renew your coverage when you get sick and need it most.

Prohibits caps on total coverage. Insurance companies will no longer be able to limit the total amount of coverage you can receive.

Allows children to stay on their parents insurance until age 26.

Limits premium differences based on age. Currently insurance companies can charge older Americans up to 5 or 6 times as much as younger Americans.  The bill will limit that ratio to 3-1.

Provides seniors with relief from prescription drug prices.  Seniors in the so-called “donut hole” will immediately receive a 50 percent discount on prescription drugs, and the size of the donut hole will be reduced by $500 in 2010.

Tax credits for individuals, families, and small businesses.  The bill provides tax credits for small businesses, as well as middle- and low-income Americans, to help them afford health insurance.

Makes preventive care completely free. Insurance companies will be forced to fully cover – with no co-pays – preventive care like colonoscopies or mammograms.

Significantly reduces the federal deficit. The Congressional Budget Office reports that the bill will reduce our deficit by $132 billion over the first decade, and by as much as $1.3 trillion by the end of the second decade.

Creates new health insurance Exchanges. The bill creates new health insurance Exchanges where individuals, families, and small businesses can compare plans and choose the one that works best for them.  These Exchanges will lower premiums by increasing competition and reducing administrative costs.  They will also provide consumers with unprecedented information.

Extends the life of the Medicare Trust Fund. The bill roots out waste, fraud, and abuse in Medicare and adds 9 years to the life of the Medicare trust fund.

Controls skyrocketing health care costs. The bill contains a wide range of cost-control measures, such as rewarding quality of care, and encouraging health care providers to work together.

Protects patients’ choice of doctors. Individuals will be allowed to choose any participating  primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.

Ensures Americans get value for their premium payments. Insurers won’t be allowed to gouge consumers or funnel dollars that should be spent on health care to line their executives’ pockets.  They will be required to spend 80 percent of small group and individual premiums and 85 percent of large group premiums dollars on health benefits or provide customers a rebate. 

Expands community health centers. An immediate and substantial investment in community health centers will expand access to health care in communities where it is needed most.

Lowers premiums for retirees and employers. The bill creates access to re-insurance for employer health plans providing coverage for early retirees.  This re-insurance will help protect coverage while reducing premiums for employers and retirees.