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Monday, August 03, 2009

One Small Step for Health Care Reform

The Energy and Commerce Committee approved H.R. 3200, "America's Affordable Health Choices Act," by a vote of 31 to 28. This legislation will build on what works in today's health care system, makes important insurance market reforms to protect consumers, encourages competition among insurance plans to improve choices for patients, and expands access to quality, affordable health care for all Americans.

"Today is a historic moment for the House of Representatives and a defining moment for our country," said Chairman Waxman. "It is a significant victory that all three committees in the House have worked together to pass comprehensive health reform legislation for all Americans. This bill will deliver the results the nation's health care system so desperately needs: lower costs, better quality, and broader coverage. I hope that when we return from recess, the House will act expeditiously to enact this bill into law."

The legislation contains critical insurance reforms to protect consumers. Insurance companies will no longer be able to discriminate on the basis of pre-existing conditions or drop coverage for those who become seriously ill. Insurers will no longer be able to discriminate on the basis of gender or selectively refuse to renew coverage. And they will be required to fully cover regular checkups and preventative care without cost-sharing and abide by limits on how much they can charge for out-of-pocket expenses.

The legislation also changes the structural costs in the health care system. It lays the groundwork for major reforms in the delivery system that will over time help improve the quality of care and put us on a path towards constraining the cost of our health care system. The bill is fully paid for and is deficit neutral.

The legislation is supported by hundreds of organizations representing doctors, surgeons, nurses, hospitals, providers, consumers, labor, researchers, state and local governments, public policy institutions, and others.

This legislation will be merged with provisions reported by the Committees on Ways and Means and Education and Labor for consideration by the full House of Representatives.

The key principles of legislation include, among other things:

Keeping what works today, and increasing choice and competition. First, the bill will protect and improve consumers' choices.

If an individual likes their current plan, they will be able to keep it.
For individuals who either aren't currently covered, or want to enroll in a new health care plan, the proposal will establish a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance option or a plan offered by private insurers.
This new marketplace will reduce costs, create competition that leads to better care for every American, and keep private insurers honest. Patients and doctors will have control over decisions about their health care, instead of insurance companies.
Giving Americans peace of mind about their health coverage. Second, the legislation will ensure that Americans have portable, secure health care plans - so that they won't lose care if their employer drops their plan or they lose their job.

Every American who receives coverage through the exchange will have a plan that includes standardized, comprehensive and quality health care benefits.
It will end increases in premiums or denials of care based on pre-existing conditions, race, or gender, and limited age rating (2:1).
The proposal will also eliminate co-pays for preventive care, cap out-of-pocket expenses, and guarantee catastrophic coverage that protects every American from bankruptcy.
Improving quality of care for every American. Third, the legislation will ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

The proposal guarantees that every child in America will have health care coverage that includes dental and vision benefits.
It will provide better preventative and wellness care. Every health care plan offered through the exchange will cover preventative care.
By growing the health care workforce, the proposal will ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
The proposal strengthens Medicare and Medicaid so that seniors, people with disabilities and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.
Ensuring shared responsibility. Fourth, the bill will ensure that individuals, employers, and the federal government all share responsibility for a quality and affordable health care system.

Employers who currently offer coverage will be able to continue offering coverage to workers. Employers who don't currently offer coverage could choose to cover their workers or pay a penalty.
All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.
The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.
Protecting consumers and reducing waste, fraud, and abuse. Fifth, the legislation will put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.

The proposal provides complete transparency in plans in the health exchange so that consumers have the clear, complete information needed to select the plan that best meets their needs.
Additionally, it establishes Consumer Advocacy Offices as part of the exchange in order to protect consumers, answer questions, and assist with any problems related to their plans.
The proposal will identify and eliminate waste, fraud, and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer friendly system.

Let's hope the plan is enacted in a victory over the denial that the present system is the ultimate in suboptimization, twice as expense and half as good as the key EU countries.

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