Lo and behold: the Senate has finally unveiled its health care reform legislation, and will officially announce the plan at a press conference this afternoon. Numbers and opinions are swirling around every media outlet in the country today and it can be mind-boggling to figure out what this means for you — the consumer. Here is my attempt to break down the Senate bill and highlight the provisions that may actually help to reform our system and those that are withered down to simply words on paper at this point.
The Patient Protection and Affordable Care Act released by the Senate late last night is estimated to cost $849 billion over ten years, but with carefully placed taxes like those on high-income earners and on insurance policies that have high costs (also known as “Cadillac plans”), as well as generating savings from Medicare and Medicaid, the bill proposes to pay for these costs and will end up reducing the government’s deficit by $127 billion over the first decade. Most provisions in the bill will take effect by 2014 — what happens before then? Find out here.
The Good:
31 million of the uninsured will now gain health insurance.
New health insurance exchanges will be created to choose from a range of insurance plans.
There will be a public plan offered in the exchanges.
Insurers can no longer deny coverage based on pre-existing conditions, health status or gender.
Those making up to 133% of the Federal Poverty Level (FPL) can get coverage through Medicaid(expected to insure 15 million more people).
Young adults will be able stay on their parents’ insurance plans until age 26.
People making between 133% and 400% of the FPL will be able to receive assistance from the government to purchase insurance.
The assistance is important because buying health insurance will now be a requirement for most everyone (except for those with very low-income).
Employers with under 50 employees can buy insurance in the exchange as well (including self-employed people) and receive tax benefits for doing so.
There will be caps on out-of-pocket expenses, like co-pays for doctor visits and deductibles.
Preventive care will now be covered by insurance plans.
Investments to bring more people into the health care workforce will be made through loan repayment programs and scholarships.
The Bad, The Ugly
24 million people will still remain uninsured, one-third of them are unauthorized immigrants.
Unauthorized immigrants will be banned from purchasing insurance through the exchanges, even if they can pay the full costs themselves (in the House bill they would be allowed to buy in the exchange but without federal assistance).
The health insurance exchanges will be on a state-by-state basis which is weaker than the national exchange offered in the House bill (think bigger pool of competition).
The public plan is not much more than words on paper at this point. It will have higher premiums than the private plans (due to the fact that it will be negotiating its own rates to providers instead of using set rates tied to Medicare) and states can refuse to offer the public plan to its residents if they want to.
Only 3-4 million people are expected to use the public plan, which defeats the purpose of it being effective with a large pool of consumers.
Young adults up to age 30, as well as anyone who may not be able to afford insurance (if their premiums exceed 8% of income), will be eligible for a Catastrophic plan, which means millions of people could get sucked into a plan with almost no comprehensive coverage and really high costs.
While 25 million people are expected to purchase coverage through the new exchanges, our health insurance system is still largely based on employer-provided insurance plans. Yet under this bill, employers will not be required to offer coverage to their employees.
But if an employer with 50 or more workers does not offer coverage they will be fined $750 for every worker that requires federal assistance to purchase insurance in the exchange. This is called the “free rider” provision and leaves the window wide open for companies to discriminate against hiring low-income workers and will encourage them to hire illegal immigrants.
There will be $50 million put towards abstinence-only sex education (way to throw money at ineffective solutions).
The Big Compromise
Abortion: The issue of whether a legal medical procedure should be covered by insurance or not shouldn’t even be a question, but this is America –the land of pro-choice vs. anti-choice– so it is. That said, the Senate bill has slightly less restrictive provisions for coverage of abortion than the House bill does with its Stupak-Pitts amendment.
Under the Senate bill, insurance plans can choose whether to cover abortions or not, but in each state there has to be at least one plan that covers it and one that doesn’t.
Unlike in the House bill, people receiving federal assistance to buy insurance can buy a plan that covers abortion, but the insurer can only use the money contributed by the consumer to pay for abortion services, putting the federal funds toward other services only. (This whole separation of funds for a certain medical procedure just irks me. To paraphrase Kierra Johnson of Choice USA, “I can’t separate my uterus from the rest of my body, right?”. It’s like going to the doctor and saying ‘you can go ahead and bill me separately for the part of the check up where you assessed the health of my uterus’.)
Finally, the public plan could provide abortion coverage but would have to segregate federal dollars, just like the private plans.
That’s it in a long nutshell; the Senate bill that will now be debated and amended over the month of December, and then merged with the House bill to produce what will hopefully be a still recognizabe piece of legislation aimed at reforming our health insurance system. Click here for a helpful side-by-side comparison of the Senate and House bills.
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
Today’s Updates – 11/18/09:
Here’s to progress: Senate Majority Leader Reid will unveil the long-awaited Senate health insurance reform bill tomorrow. We expect to see the cost estimate on the bill today from the Congressional Budget Office — rumor has it that the cost is lower than the House bill (Not surprising since the Senate bill has weaker provisions for reform).
On Friday, the Senate is expected to have a procedural vote that will determine whether debate on the bill can begin (yes, the Senate is a tricky place ). The vote to begin debate should pass — only three moderate Democrats have not committed to allowing the debate: Senators Landrieu of Louisiana, Lincoln of Arkansas and Nelson of Nebraska. However Reid and other Democrats are working hard to get their committment. Once debate begins, it is expected to last through the month of December (allowing time for amendments) with a goal of passing a health care bill out of the Senate by the Congressional holiday recess. Want to speed the process along? Do you live/are registered to vote in Arkansas, Nebraska or Louisiana? If not you can still join in on the action with our friends at SEIU and contact these key Senators and urge them to allow the debate on health care!
Senator Ben Nelson, Democrat of Nebraska, says he is not sure he is ready to help a Democratic health care proposal clear even the most preliminary hurdle: gaining the 60 votes his party’s leaders need to open debate on the measure later this week.
The bill’s release would clear the way for a vote on Friday or Saturday by the full chamber on whether to proceed to debate on the measure — the first key procedural hurdle for the Senate plan.
The Nevada Democrat would not confirm that he had received commitments from all 60 members of his caucus to overcome GOP procedural objections and bring the bill to the Senate floor, saying only, “I feel cautiously optimistic that we can do that. I think we’re together as a caucus.”
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
Today’s Updates – 11/9/09:
Saturday night around 11:30 pm, earlier in the weekend than expected, the House of Representatives passed their very first piece of legislation to reform the health insurance system in America by a 220-215 vote. Just one Republican, Rep. Joseph Cao of New Orleans, LA, voted for the legislation — which was a bit unexpected from the GOP. (And note that this means 39 Democrats did not vote for the legislation, which does not make the looming fight in the Senate look very easy!) The bill was passed pretty much in the same state that it entered the debate, with just one major amendment rearing its ugly head and unfortunately being accepted into the legislation. That amendment being the Stupak amendment, proposed by Representative Bart Stupak (D-MI), which effectively bans insurance plans offered in the new Health Insurance Exchange from covering abortion services. Also under the amendment, women who purchase comprehensive private insurance packages — that include abortion services — would have to pay for the entire cost of the package (even if they qualify for subsidies from the government to purchase that insurance). This is a big defeat for progressives and it personally breaks my heart to see that we have such a long way to go in this country when it comes to reproductive rights.
The new House health care bill, H.R. 3962, will insure 96% of the population, end denial of coverage based on pre-existing conditions, end higher rates based on gender, insure young adults under parent coverage until age 27, and open up a national Health Insurance Exchange where individuals can choose from insurance plans offered by private insurers and a plan offered by the government — the public option.
The backbone of our health insurance system will still mainly consist of employer-provided plans, as it has for years, but now those not receiving insurance from their employers will have more options. Also, large employers will be required to continue providing coverage to their employees, and small businesses will receive subsidies to help provide insurance to their employees. Those not receiving coverage from their employer will be able to purchase insurance in the Exchange, and most individuals, other than extremely low-income earners, will now be required to have insurance and some will receive federal subsidies in order to help purchase that insurance.
How much will this reform cost and how will we pay for it? The House bill comes in around $894 billion over ten years and will be paid for by taxing very high-income earners and finding savings in the Medicare and Medicaid programs.
It was a very exciting Saturday night here in D.C. and in millions of homes across the country, as many celebrated the completion of the first step in getting health care legislation that much closer to the President’s desk. Even in the Capitol, as the votes reached the 218 needed to pass the legislation, the chamber broke into applause. Now it’s time to strive for hearing that same applause from the Senate floor as they gear up to pass their own version of health care reform, then the next step will be to combine the two bills and have a final vote to bring health care reform legislation into law.
The U.S. House of Representatives answered “the call of history” put to it by President Obama Saturday and voted 220-215 in favor of the most sweeping expansion of health-care coverage since the enactment of Medicare and Medicaid Act of 1965.
If you thought that just because abortion is a constitutional right and part of basic reproductive health care it would be available in the reformed health insurance market known as the Exchange, think again. The Stupak Amendment, passed Saturday night by the House of Representatives after a compromise deal fell apart, potentially goes farther than any other federal law to restrict women’s access to abortion.
The White House, growing concerned that the Congressional timetable for passing a health care overhaul could slip into next year, is stepping up pressure on the Senate for quick action, with President Obama appearing Sunday in the Rose Garden to call on senators to “take up the baton and bring this effort to the finish line.”
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
Today’s Updates – 11/6/09:
The House of Representatives is scheduled to begin debate on their health care bill, The Affordable Health Care for America Act – H.R. 3962, this weekend. The final House legislation was released a couple weeks ago and is now ready to be voted on by our Representatives. However, as has been the case throughout this entire health care reform process, there may be some delays that would push the vote back to Monday or Tuesday — “some delays” meaning: more discussions about abortion and immigration to stall the way-bigger-than-those-two-issues health care bill.
This bill, which — among many other things — will contain costs, end discrimination based on pre-existing conditions or gender, extend coverage for young adults under their parents’ plan, and provide a public insurance plan that will compete with private plans, has not included language about keeping illegal immigrants from buying insurance in the new insurance marketplace, and this one omission is bothering many Representatives. However the bill does state that illegal immigrants will not be eligible to receive federal subsidies to purchase insurance. So even though the bill requires illegal immigrants to buy insurance or be fined with a penalty tax, it is not going to help them purchase it. Awesome — makes perfect sense.
Another reform deal-breaker for many Reps is abortion, and although the House bill clearly states that federal funds given out under reform will not be used to cover abortion, this language isn’t good enough for some and they are fighting to include amendments that strengthen the prohibition for abortion funds. Why abortion cannot be covered like any other medical procedure we have a right to is beyond me, but my opinion, and that of millions of others, is apparently neither here nor there in this debate.
Another topic of discussion that is sure to be included in tomorrow’s debate is the GOP’s alternative health care bill. Or, what I like to call, a plan only insurance companies could love, or the bill that will leave 52 million people uninsured and actually charge more for people with pre-existing conditions. Way to go guys. Luckily, the Republican bill has no chance of passing, but they had to produce something since all they were doing all these months was saying “no” to the other bills on the table.
So this is it. After the GOP bill gets laughed off of the stage and immigrants and abortion likely barred from being covered, the House will vote to pass their first piece of health care reform legislation. But while they decide their vote they have to hear from you. Especially after hearing from anti-reform crowds led by our favorite Rep. Bachmann yesterday.
A man at the Bachmann protest yesterday holds this sign –which doesn’t even make any sense.
It’s your turn to make your voice heard: Contact your Rep NOW and urge them to pass the House Health Care bill, H.R. 3962!
One year ago, my generation -adults ages 18-34 – saturated the voting polls across the country, casting their votes in record numbers with hope that things could change.
One year later, Congress is making progress on several of the issues that weighed on our minds as we stood in line to vote; one of them being health care, which is close to having a piece of legislation aimed at resolving our broken system.
On November 4th, Campus Progress and a coalition of 20 youth organizations that form the Y.I. Want Change Coalition, hosted a national day of action called Y.I. (Still) Want Change. This day marked the anniversary of last year’s historic election and made a strong, collective demand for comprehensive health care reform in events across the country.
Young people gathered in more than 20 states to participate in 44 events (representing our 44th President), including states such as Connecticut, Massachusetts and Montana – states represented by Senators that have a big stake in the health care debate. These events ranged from film screenings, to photo petition drives, to phonebanks and rallies.
Y.I. Still Want Change also engaged thousands of young health care reform supporters on Facebook, where they signed a photo petition demanding reform from Congress.
You can still participate in the Y.I. Want Change petition now by signing the photo petition on Facebook and changing your status to read:
Health care reform is one of the most pressing issues facing our country, yet there has been little discussion about the health care needs of young adults. Young people make up one third of the uninsured, but our voices are not being heard in the health care debate. November 4th’s national day of action had a mission to change that.
As Erica Williams, our Deputy Director here at Campus Progress, has said, “Young people have fought for months to make our voices heard in this debate. At this critical moment, on campuses and in communities across the country, we are showing our leaders that we are engaged and ready to hold them accountable for delivering real, comprehensive, health care reform.”
In addition to calling attention to young Americans’ health care needs, the Y.I. Want Change coalition supports a set of policy priorities to ensure that health care reform addresses those needs. The coalition formally announced these policy priorities at a press conference with Speaker of the House Nancy Pelosi a few weeks ago.
Some of these policies include removing the “Young Invincibles” plan – the catastrophic insurance plan written into the Senate Finance Committee’s bill- from legislation, extending coverage under your parents’ insurance plan until age 26, and securing funding to educate young adults on the benefits of their new health care system after reform.
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
Today’s Updates – 10/29/09:
Today marked a big day in the health care reform journey that we have all been on this year, and it was an even bigger day for those that have been fighting this fight for decades. The House of Representatives released their health care bill today — and made quite the production of it, with Speaker Pelosi and about half of the Democratic Caucus entering the stage of the press conference to U2 blaring over the loud speakers. Standing there on the stage behind these proud Members of Congress filing in to Bono made me think about what a special day for celebration it was, while simultaneously thinking about how oddly comical politics can be sometimes. As Representatives danced their way to their seats, and Pelosi took the podium, the tone of this significant announcement settled down and focused on the real reasons why we were all there: to ensure health care coverage for those that need it, make insurance affordable for everyone and stop the horrible practices of the insurance companies.
Along with many Representatives that spoke on the various provisions included in the bill, such as the long-debated public option and strong affordability measures, constituents from each of their districts shared their personal hardships with our current health system. One such story almost knocked me off of the stage. A mother of three triplets that were conceived by In Vitro Fertilization was denied health insurance based on a claim that she had a pre-existing condition of “infertility”, and her husband was denied coverage based on “spousal infertility” as a pre-existing condition. These are the kinds of ridiculous practices that will now be illegal.
The House bill will not only end denials based on pre-existing conditions, gender, age or income, but it will insure 96% of the population, expand Medicaid to more low-income Americans, offer a health insurance exchange in which plans can be purchased, including a public plan provided by the government (the public option), and it will reduce the deficit by $30 billion over the first ten years. This bill came out to be pretty strong — We’ll just have to see whether the public option stays in the bill on its journey from the House floor to Conference (when the House and Senate bills are merged), and if it does remain in the final legislation, how many people will really have access to it. As it stands now, the Congressional Budget Office has said that only about 6 million people would gain insurance through the public option included in this new House legislation.
However, one of the biggest victories in the bill for our generation — the Millenial generation of young adults ages 18-34– was the provision to extend coverage under our parents’ insurance plan up to our 27th birthday. This provision comes at no cost to taxpayers and is just a common sense solution to ensuring coverage for young adults.
All in all it was a happy day for health care and a reminder that we still have a journey ahead of us as we await the CBO score for the Senate bill and look forward to both chambers hashing it out on the floor to debate their legislation and get us one step closer to a strong bill for health care reform.
However, the House is always an entirely different cup of tea than the Senate..so a bumpy road may still lie ahead!
Fact #1: 47 million people are uninsured while another 87 million are underinsured
Fact #2: 18,000 people die every year because of a lack of proper health care.
Fact #3: 73% of physicians support a public option.
(Want more facts? Click here)
When looking at the facts, the answer to how to fix our broken health care system seems obvious. As the health care debate continues, the art of politics, or should I say, the bureaucracy within our democratic Congress, has made this answer more complicated than it should be.
Yesterday morning, Campus Progress attended a hearing, “Costs of Broken Health Care System, Benefits of Public Option,” hosted by Representative Jackson-Lee and Representative Conyers, who convened patients, physicians, and experts to push for a robust public option.
This hearing was by no means a political debate about health care; it was instead, an opportunity for individuals to give testimony to why the public option plays a fundamental role in the health and happiness of all Americans. While many of us are trying to understand the politics of the health care reform legislation, the answer becomes clear once you listen to the tragedies that many of our fellow Americans have had to endure due to poor or no coverage.
During the hearing, we watched a 3-minute clip of a film, “Reinventing Paradise,” where the producer, Natalie Noel, was also present and gave testimony. Natalie is a cancer patient whose insurance coverage was recently terminated and her 3-minute clip captures stories of Gulf Coast residents who have suffered health-care hardships post-Katrina. Representative Jackson-Lee responded to Noel’s film and testimony by stating, “although all of us want to believe we live in a democracy…we know some are left out; the sick, the frail, the mentally ill…those who can’t tell their stories.”
There were more than twenty witnesses who gave testimony, including a woman named Joan Kosloff. Joan came to the hearing on behalf of her son, Eric, who died last year to pneumonia due to his lack of health insurance. As Joan gave her testimony, pictures were passed around of Eric (who was 44) and his 3 year old daughter—it was very difficult to hold back tears. After her testimony, Dr. Carson of Johns Hopkins responded, “we must build a powerful coalition of consciousness” to remind members of Congress of what the consequences may be without a public option.
While every member of Congress is faced with 3.5 lobbyists working for insurance companies, testimonies like these should win out over lobbyist propaganda because these stories unveil the truth that this fight is no longer for a public “option,” it is for a public necessity.
Join our friends at Choice USA for a National Call-In Day TODAY to support comprehensive sex education!
It is wide-spread knowledge that abstinence-only sex education has not proven to be effective in preventing sexually-transmitted diseases or unwanted pregnancies. There has even been a highly conclusive congressional study showing that it has grievously failed our society as a substitute for sex education. However, leaders of our nation still insist on using our money to fund wishful thinking instead of facts, thereby cheating young adults of comprehensive sex education and putting their health and future at risk.
In a little-known subplot of the health care reform discussion, ineffective abstinence education just might get a big boost, thanks to Senator Orrin Hatch (R-UT). Sen. Hatch proposed an amendment to the Senate Finance Committee health care proposal to give $50 million in funding to abstinence-only programs. The amendment just squeaked by (with 12 out of 23 votes) to rear its disingenuous head in the committee’s final bill.
Concerned citizens living in areas where abstinence-only programs are currently taught could turn to more successful strategies of sex education, once government funding expires in the coming years. But now, if Hatch’s amendment makes it to the reform bill that reaches President’s Obama’s desk, we can all look forward to incomprehensive sex education that could result in another decade of increasing rates of HIV/AIDS and Sexually Transmitted Infections (STIs).
Responsible legislators must block this bogus amendment from getting through Congress. Senator Max Baucus (D-MT), who supports comprehensive, effective sex education, is in the small group that is compiling the Senate’s final health care reform bill, and it is imperative that he eliminate Hatch’s agenda from their plan. We owe it to our nation’s youth, and to all those who have suffered from disease and unwanted pregnancy because they were never given realistic tools to prevent it.
Join Choice USA NOW for a National Call-In Day to support comprehensive sex education!
*This blog was written by Carly Groff, Advocacy Intern
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
Today’s Updates – 10/26/09
Senate Majority Leader Harry Reid is making news today by announcing his merged Senate bill is ready and includes a public option. It is on its way to the Congressional Budget Office to be scored for cost, revenue and savings. That’s when we’ll know more about whether this bill will be the one to go to the floor to be voted on by the entire Senate. Once the bill is scored and more information on the legislation is released, we’ll also know more about the public option that is included. It is a public option that will allow states to “opt out” of offering it to their residents. Depending on who will make this decision for the state and when they would have to opt out by, this may be a decent compromise (except for those in the states that will be opting out of course). However, it seems the President is advocating for a “trigger” option, which is basically only implementing a public option if necessary down the road. Why he would advocate for that instead of this opt-out option, which contradicts his initial message surrounding health care reform, is a bit suspect since the “trigger” option has more support from the insurance industry.
In the House, the word is that their merged bill may be released this week after all.
Fueling the push for a new government insurance plan, Senate Majority Leader Harry Reid (D-Nev.) said today that his chamber’s healthcare bill would include a compromise that would create a nationwide public option but give states the right to opt out.
The White House is looking for a political victory on health care, and if a public option looks unlikely or impossible to pass, Obama is unlikely to waste political capital on it. But his support may be the deciding factor. The White House blog insists that the administration backs Sen. Majority Leader Harry Reid’s public option push, but not everyone sees action behind the words.
House Democratic leaders are hoping to unveil health reform legislation this week so they can vote on the package by November 6. House Majority Leader Steny Hoyer (D-Maryland) has warned Members of Congress to be available Saturday November 7 and possibly the Monday and Tuesday before Veterans Day so that the House can vote on healthcare. Moving that quickly would certainly put the House out in front of the Senate on healthcare.
When we heard news that our coalition partners at Health Care for America Now and the AFL-CIO had plans to host a protest against America’s Health Insurance Plans (AHIP), which represents the health insurance industry and recently released a false report attacking health care reform, we grabbed our “Youth for the Public Option” signs and joined them.
After a galvanizing speech by AFL-CIO President Richard Trumka, over 400 people marched to the Capitol Hilton where lobbyists from America’s Health Insurance Plans (AHIP) were meeting to discuss their despicable views on health care reform. The protesters picketed all along the block where the Hilton was located, chanting up and down the sidewalks on both sides of the street.
Seven families with heartbreaking stories of abuse by insurance companies flew into DC from all over the country in hopes of meeting with top insurance officials, including AHIP CEO Karen Ignani. But the big shots wouldn’t come out to hear their mistreated consumers’ stories.
Still, morale was strong, with people shouting chants like, “AHIP, get off it! People over profit!”
The rally demonstrated citizens’ dedication to achieving effective health care reform. Amidst clamorous applause, Trumka entreated protesters to “call those senators, and let them know that it’s not OK to have the insurance companies happy unless the American public are healthy… We’re going to have to redouble our efforts, we’re going to have to make more calls, we’re going to have to write more letters, and [we] will not stop until the health care bill that families desperately need, and desperately deserve, is signed by President Obama.” We support that 100%.
Funding our Future is a campaign to pass a progressive federal budget for 2010 and ensure that our nation.s key economic choices invest in our education, spark reform of our health care system, and address climate change through cap and trade and clean energy investments. Click here for more info.
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
A man at the Bachmann protest yesterday holds this sign –which doesn’t even make any sense.
One year ago, my generation -adults ages 18-34 – saturated the voting polls across the country, casting their votes in record numbers with hope that things could change.
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!
should I say, the bureaucracy within our democratic Congress, has made this answer 
The push for health care reform is moving fast and furiously, so I thought it’d be helpful to have semi-daily “Health on the Hill” updates that should help you keep track of the reform debate and get to the meat of the issue. Enjoy!