On Sunday night (3/21/10), House Democrats approved the Senate health reform bill (HR 3590), which now proceeds to President Obama to be signed into law on Tuesday. The so-called “corrections” bill (HR 4872), which contains a series of changes favored by the House, was also passed and will be voted on by the Senate within the next week, requiring a majority vote (51 votes) to pass.
Sunday’s vote is major victory for ensuring a comprehensive and historic health reform package that provides more security and stability for those who have coverage, and new, affordable options for those that don’t. While 23 million are still predicted to be uninsured in 2019 under this legislation (1/3 of whom would be undocumented immigrants), it would expand coverage to 32 million uninsured in that same time frame and help control health care costs. It would also lower the federal deficit by $143 billion over the first 10 years and by more than $1 trillion over the second 10-year period. As President Obama noted in his televised address after the vote, “this isn’t radical reform, but it is major reform.”
Many health care consumers, both the insured and the uninsured, will benefit greatly under the proposed bill. In addition, most consumers will be required to have coverage, yet significant reforms and relief will be available to help people meet that requirement.
Below are some highlights summarized by Health Access on how the bill will affect those currently with insurance and those without.
IF YOU ARE INSURED, nothing requires you to change your coverage; but it will make your coverage more secure and stable:
- It makes it more likely your employer continues to offer coverage, and set minimum standards for such coverage.
- It improves Medicare; It expands and streamlines Medicaid.
- It fixes the “individual market,” giving individuals the bulk purchasing power of large purchasers, preventing “junk” insurance, and stopping denials for health status.
- It provides the foundation to bring down the overall costs of health care.
IF YOU ARE UNINSURED OR UNDERINSURED, you will need to get coverage, but there will be new help and new options to ensure coverage is:
- AVAILABLE: No denials or different rates for pre-existing conditions.
- AFFORDABLE: Subsidies/affordability credits for low- & mid-income families, so you don’t have to pay more than a percentage of their income (based on a sliding scale up to 9.5%).
- ADEQUATE: Minimum benefit standards and a cap on out-of-pocket costs, so no one goes into significant debt or bankruptcy.
- ADMINISTRATIVELY SIMPLE: The Exchange provides choice and convenience, making it easy to sign up for and compare plans.
- ALSO: Other efforts attempt to bring down the cost of coverage.
Summary of Major Provisions that Would Take Effect Within the 1st Year
Some provisions in the legislation would take effect almost immediately and continue through 2018. Others wouldn’t take effect until 2014. Within its first year, the legislation would:
- Prohibit insurance companies from rescinding the coverage policies of consumers who become ill;
- Ban health insurers from denying coverage to children with pre-existing conditions;
- Eliminate lifetime coverage limits and restrict annual coverage limits;
- Allow young adults to remain under their parents’ health plans until age 26;
- Provide uninsured adults with pre-existing conditions the opportunity to obtain coverage through a new program that would expire in 2014, when the new state-based insurance exchanges begin operating;
- Provide sliding scale subsidies based on income (where consumers pay based not on how sick they are, but on what they can afford);
- Provide eligible seniors a $250 rebate to bridge the “doughnut hole” coverage gap in the Medicare prescription drug benefit;
- Give some small businesses a tax credit to help them provide coverage to employees; and
- Provide momentum to do more in health care policy and reform in the coming days, weeks, months and years.
See the bill texts for more information.