DPC Special Report 1
DPC Staff Contact: Jacqueline Garry Lampert (202) 224-3232 March 22, 2010 DPC Press Contact: Barry Piatt (202) 224-0577
Available Online: dpc.senate.gov
We won't get these benefits because our Attorney General is suing to block it.
Together, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act will ensure that all Coloradans have access to quality, affordable health insurance. The Congressional Budget Office has determined that these two bills are fully paid for, will bend the health care cost curve, and will reduce the deficit by $143 billion over the next ten years with further deficit reduction in the following decade. The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act will reduce the cost of health care for the middle class, ensure health security to seniors, and provide tax credits to small businesses and individuals to further reduce the cost of health coverage.
Key Benefits for Colorado
•Provide tax credits for up to 68,800 Colorado small businesses to help make coverage more affordable. [HealthReform.gov, accessed 3/20/10]
•Prohibit insurance companies from excluding coverage of pre-existing conditions for the 1.2 million children in Colorado, starting this year. [U.S. Census Bureau, 1/7/10]
•Close the "donut hole‟ and improve other Medicare benefits for 574,000 Colorado seniors. [HealthReform.gov, accessed 3/20/10]
•Reduce Medicare premiums for the 394,000 Colorado seniors who are not enrolled in Medicare Advantage and will no longer subsidize these private insurance plans. [Senate Finance Committee]
•Ensure affordable coverage options for 826,000 Coloradans who are uninsured and 345,000 Coloradans who purchase health insurance through the individual market. [HealthReform.gov, accessed 3/20/10]
•Ensure immediate access to affordable insurance options for as many as 104,110 uninsured Coloradans who have a pre-existing condition. [staff estimate using Agency for Healthcare Research and Quality (AHRQ), 4/09 and HealthReform.gov, accessed 3/20/10]
•Provide tax credits for up to 439,000 Coloradans to help make health insurance more affordable, bringing $7.1 billion in premium and cost-sharing tax credits into Colorado during the first five years of the health insurance Exchange. [HealthReform.gov, accessed 3/20/10; Senate Finance Committee]
•Reduce family health insurance premiums by $1,510 - $2,160 for the same benefits, as compared to what they would be without health reform by 2016. [Senate Finance Committee estimate based on CBO, 11/30/09]
DPC Special Report 2
•Provide access to Medicaid for 286,388 newly-eligible Coloradans, and provide $5.7 billion in federal funding for the cost of their coverage. [Urban Institute, 1/25/10; Senate Finance Committee]
•Create 4,100 - 6,500 jobs by reducing health care costs for employers. [U.S. Public Interest Research Group, 1/20/10]
•Allow 476,210 young adults to stay on their parents‟ insurance plans. [U.S. Census Bureau, 1/7/10]
•Provide more federal funding for 160 Community Health Centers in Colorado. [National Association of Community Health Centers, 2009]
Affordable Coverage Options for Colorado Small Businesses
Small businesses make up 76.7 percent of all Colorado businesses, yet just 38.1 percent of these small businesses are able to offer health insurance to their employees. [AHRQ, accessed 3/20/10; AHRQ, accessed 3/20/10] Starting this year, up to 68,800 Colorado small businesses will be eligible for tax credits for a percentage of their contribution to their employees‟ health insurance. [HealthReform.gov, accessed 3/20/10] Small businesses of the size that qualify for these tax credits employ 246,458 Coloradans. [AHRQ, accessed 3/20/10]
Protecting Children
Recognizing the special vulnerability of children, health reform prohibits insurance companies from excluding coverage of pre-existing conditions for the 1.2 million children in Colorado. This takes effect six months after enactment and applies to all new plans. [U.S. Census Bureau, 1/7/10]
Strengthening Medicare for Colorado Seniors
Health reform improves Medicare benefits for the 574,000 Medicare beneficiaries in Colorado. [HealthReform.gov, accessed 3/20/10] Each year, 102,000 Colorado seniors hit the Medicare Part D "donut hole.‟ [HealthReform.gov, accessed 3/20/10] Starting this year, seniors who hit this gap in their prescription drug coverage will receive a $250 check, and the "donut hole‟ will be completely closed by 2020. The 574,000 Medicare beneficiaries in Colorado will see other improvements to the program, including a free, annual wellness visit and no cost-sharing for prevention services. Finally, by gradually moving to a more fair payment system for private insurance companies who participate in Medicare Advantage, health reform will lower Medicare costs for the 394,000 Colorado seniors not enrolled in Medicare Advantage, by as much as $45 in premium costs each year. [Senate Finance Committee]
Affordable Coverage Options for Coloradans
The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act contain several provisions to expand affordable coverage options for millions of Americans. First, health reform will provide immediate access to quality, affordable health insurance for as many as 104,110 uninsured Coloradans who are unable to obtain health insurance because of a pre-existing condition. [staff estimate using AHRQ, 4/09 and HealthReform.gov, accessed 3/20/10] This new $5 billion program will take effect 90 days after enactment of health reform.
DPC Special Report 3
Second, health reform will ensure that the 826,000 uninsured Coloradans and 345,000 Coloradans who purchase health insurance through the individual market have access to affordable health insurance options through state-based health insurance Exchanges. [HealthReform.gov, accessed 3/20/10] By reforming the insurance market and forcing insurance companies to compete for business through the Exchange, health reform will reduce family health insurance premiums by $1,510 - $2,160 for the same benefits. [Senate Finance Committee estimate based on CBO, 11/30/09] In addition, 439,000 Coloradans will receive premium tax credits to help make health insurance even more affordable. [HealthReform.gov, accessed 3/20/10] During the first five years that the health insurance Exchange is operational, Coloradans will receive $7.1 billion in premium and cost-sharing tax credits to further reduce the cost of health insurance. [Senate Finance Committee]
Finally, health reform will open access to Medicaid for 286,388 newly eligible Coloradans, by expanding eligibility to non-elderly parents, childless adults, children and pregnant women with income up to 133 percent of the federal poverty level. [Urban Institute, 1/25/10] The federal government will fully fund the cost of covering these newly eligible individuals for three years and will pay 90 percent of these costs after 2020, compared to the current contribution in Colorado of 50 percent of costs. In total, Colorado could receive $5.7 billion in federal funding during just the first five years of this coverage expansion. [Senate Finance Committee]
Affordable Coverage Options for Colorado Young Adults
According to the National Conference of State Legislatures, “Young adults often lose their health insurance if covered under a parent‟s or guardian‟s policy at age 19 or upon graduation from high school or college.” [NCSL, accessed 3/20/10] Starting this year, 476,210 young adults in Colorado will be able to remain covered by their parent‟s insurance policy until age 26. [U.S. Census Bureau, 1/7/10] In addition, once the health insurance Exchanges are operational in 2014, 790,234 Coloradans under age 30 will have access to less costly catastrophic-only health insurance plans. [U.S. Census Bureau, 1/7/10] These plans will also be available to others who are exempt from the individual responsibility policy.
Job Creation
A recent analysis found that slowing the growth rate of health care costs will make it more profitable for businesses to expand employment, leading to estimated job gains nationwide of 250,000 – 400,000 per year for the next decade as a result of health reform. [Center for American Progress, 1/10] For Colorado, this could mean 4,100 - 6,500 new jobs each year. [U.S. Public Interest Research Group, 1/20/10]
Support for Colorado Community Health Centers
Community health centers provide critical health care to Coloradans, regardless of their ability to pay. Health reform makes an immediate and substantial investment in the 160 federally-funded health centers in Colorado. [National Association of Community Health Centers, 2009]
Showing posts with label new benefits. Show all posts
Showing posts with label new benefits. Show all posts
Thursday, March 25, 2010
Monday, March 22, 2010
The Immediate Benefits
KEY PROVISIONS THAT TAKE EFFECT IMMEDIATELY UNDER SENATE BILL AS AMENDED BY RECONCILIATION BILL
Below are some of the key provisions that will take effect immediately, under the legislative package the House will consider later this week (the Senate health bill as amended by the reconciliation bill). The reconciliation bill is based largely on the improvements put forward by the President’s proposal – moving towards the House bill in certain critical areas.
1. SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
3. FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
4. HELP FOR EARLY RETIREES—Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55‐64. Effective 90 days after enactment
5. ENDS RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.
6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
7. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.
8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS—Requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)
10. NEW, INDEPENDENT APPEALS PROCESS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.
11. ENSURING VALUE FOR PREMIUM PAYMENTS—Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment.
13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.
14. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.
15. INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.
16. PROHIBITING DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.
17. HEALTH INSURANCE CONSUMER INFORMATION—Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.
18. CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM—Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.
OFFICE OF SPEAKER NANCY PELOSI MARCH 18, 2010
Below are some of the key provisions that will take effect immediately, under the legislative package the House will consider later this week (the Senate health bill as amended by the reconciliation bill). The reconciliation bill is based largely on the improvements put forward by the President’s proposal – moving towards the House bill in certain critical areas.
1. SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
3. FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
4. HELP FOR EARLY RETIREES—Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55‐64. Effective 90 days after enactment
5. ENDS RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.
6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
7. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.
8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS—Requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)
10. NEW, INDEPENDENT APPEALS PROCESS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.
11. ENSURING VALUE FOR PREMIUM PAYMENTS—Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment.
13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.
14. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.
15. INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.
16. PROHIBITING DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.
17. HEALTH INSURANCE CONSUMER INFORMATION—Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.
18. CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM—Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.
OFFICE OF SPEAKER NANCY PELOSI MARCH 18, 2010
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