Republican presidential campaign pyrotechnics can’t hide the record of a party that has turned its back on ordinary Americans. It’s worth remembering how, a year ago, the Republican-majority House of Representatives tried to repeal the 2010 Affordable Care Act.
What would have happened if they had succeeded?
2.5 million young adults would have no health insurance.
2.65 million seniors would have paid $1.5 billion more for prescription drugs.
24.2 million seniors would pay for preventative services they are getting for free.
And that’s just the beginning. A short report from the White House highlights how the Affordable Care Act is making insurance more available and affordable for millions of Americans.
It’s good reading at a time when the Affordable Care Act repeal is still a GOP battle cry, with all the presidential hopefuls and most Republicans in Congress vowing to overthrow the law—and trying to scare voters in the process.
Check out the Center for American Progress’ animated video (above) explaining the benefits of reform. The video was developed by MIT economist Jon Gruber, an adviser on both the Affordable Care Act and the Massachusetts health care reform program.
A lot of news stories make it out that a lot of people want to repeal the Affordable Care Act and get government out of health care. By contrast:
A new AP poll finds that Americans who think the law should have done more outnumber those who think the government should stay out of health care by 2-to-1.
Surprised?
The poll found that about four in 10 adults think the new law did not go far enough to change the health care system, regardless of whether they support the law, oppose it or remain neutral. On the other side, about one in five say they oppose the law because they think the federal government should not be involved in health care at all.
The AP poll was conducted by Stanford University with the Robert Wood Johnson Foundation. Overall, 30 percent favored the legislation, while 40 percent opposed it, and another 30 percent remained neutral.
Those numbers are no endorsement for Obama’s plan, but the survey also found a deep-seated desire for change that could pose a problem for Republicans. Only 25 percent in the poll said minimal tinkering would suffice for the health care system.
Why haven’t we heard this before? I’d suggest two reasons, though I’m sure there are more. One is that we only hear it if pollsters ask about it, and relatively few polls have gone into detail like that, allowing people the opportunity to say that they wish health care reform had gone further. The second is the fear factor. People have had a number of months now for the all-out, facts-by-the-wayside Republican assault to fade from their minds. While most people probably never bought into nonsense about “death panels,” having more chance to think about their real health care needs and the way the system is or is not working for them, without that constant barrage of misinformation, should be providing a clearer picture by now.
If you want to know how the health care reform law affects you, Healthcare.gov is one of the best places to go. And now they’ve made it possible to look up coverage options for your situation and your location. Check it out:
Americans are already starting to see the benefits of health care reform. The new law requires health insurance companies — starting in September — to end their most indefensible practice: rescinding coverage after a policyholder gets sick. In recent days insurers and their trade association have rushed to announce that they will end rescissions immediately.
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The insurers were wise to short-circuit the criticisms and end rescissions now. This follows a recent agreement by many companies to start letting dependents stay on their parents’ policies until age 26, which isn’t required until September. Under pressure from the White House, the industry has also agreed to cover children with pre-existing medical conditions as soon as new rules are issued.
Many of the other major provisions of reform don’t kick in until 2014, but it is already changing the behavior of insurers. That means more security for many Americans who might otherwise find insurance unaffordable or unavailable.
This year’s crop of college graduates may have trouble finding a job, given the state of the economy. But some of them will have a much easier time keeping health insurance while they look.
Insurance giant United HealthCare said it would implement, as of today, a requirement of the new health care law that allows young adults who are no longer full-time students to remain on their parent’s health plans until they reach the age of 26. WellPoint, too, announced it would do the same thing, effective June 1.
Since this provision of the new health care law doesn’t go into effect until September, this is significant:
United figures the change in policy could help at least 150,000 graduating seniors and their families from having to find temporary coverage between this spring and the time the new requirement becomes effective.
(This is an effective and meaningful move by United and Wellpoint. But insurance companies, by definition, still care more about profit than about your wellbeing.)
The new law will eliminate fees paid to private banks to act as intermediaries in providing loans to college students and use much of the nearly $68 billion in savings over 11 years to expand Pell grants and make it easier for students to repay outstanding loans after graduating. The law also invests $2 billion in community colleges over the next four years to provide education and career training programs to workers eligible for trade adjustment aid after dislocation in their industries.
The law will increase Pell grants along with inflation in the next few years, which should raise the maximum grant to $5,975 from $5,550 by 2017, according to the White House, and it will also provide 820,000 more grants by 2020.
Eliminating the middle man (the banks) means more help will be available, which will ease the financial burden of families who want to send their kids to college. It also means that repayment terms are a little kinder:
Students who borrow money starting in July 2014 will be allowed to cap repayments at 10 percent of income above a basic living allowance, instead of 15 percent. Moreover, if they keep up payments, their balances will be forgiven after 20 years instead of 25 years — or after 10 years if they are in public service, like teaching, nursing or serving in the military.
A disability rights activist sent me a link to Disability Scoop:
When health insurance reform was signed into law just last week, Democratic lawmakers said that coverage of children with pre-existing conditions would be one of the most immediate effects. But within days, insurers argued a detailed reading of the new legislation allowed them to continue cutting-off kids with conditions like Down syndrome and cerebral palsy in certain circumstances until 2014.
The good news is – that insurance companies quickly thought the better of that. From The NY Times (same day):
“Health plans recognize the significant hardship that a family faces when they are unable to obtain coverage for a child with a pre-existing condition,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group. Accordingly, she said, “we await and will fully comply with” the rules.
Ms. Ignagni made the commitment in a letter to Kathleen Sebelius, the secretary of health and human services, who had said she feared that some insurers might exploit a possible ambiguity in the new health care law to deny coverage to some sick children.
Apparently it didn’t take any time at all for the insurance companies to realize that refusing to cover kids with Down Syndrome wasn’t a good PR move.
The Class Act, a legacy of Senator Edward M. Kennedy (whose widow and son were on hand for the signing), sets up the first national government-run long-term care insurance program, which will be offered primarily through employers.
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The Class Act does not require screening of applicants for health problems, so people who might not qualify for private long-term care insurance can enroll. Participants will pay monthly premiums; after a five-year vesting period, they receive benefits if they need care, whether they are 28-year-olds hurt in snowboard accidents or 88-year-olds with Parkinson’s disease.
You pay premiums, and after you’ve been doing that for years, if you get sick or injured, you get some help with your daily care, with tasks that will help people stay out of nursing homes.
Naturally, the private insurance industry is against this. They’d rather keep collecting high premiums from people with no other choices—surprise! According to the executive director of the American Association for Long-Term Care Insurance (i.e. a spokesman for private insurance):
“Inevitably, Class will morph into an entitlement program that’s a mandatory tax on all individuals,” he said. He calls it “Medicare Part E.”
By using the words “entitlement” and “mandatory tax,” this private insurer spokesman is trying to paint the program as inevitably unpopular. But “Medicare Part E” gets closer to the truth. Because Medicare is popular, remember? And if there’s one thing private insurers don’t want, it’s popular programs doing what they do without the uncertainty and abusive price hikes.
“Medicare Part E,” may sound scary to the insurance companies, but to most of us, it sounds pretty good.
Until now, it has been perfectly legal in most states for companies selling individual health policies — for people who do not have group coverage through employers — to engage in “gender rating,” that is, charging women more than men for the same coverage, even for policies that do not include maternity care. The rationale was that women used the health care system more than men. But some companies charged women who did not smoke more than men who did, even though smokers have more risks. The differences in premiums, from 4 percent to 48 percent, according to a 2008 analysis by the law center, can add up to hundreds of dollars a year. The individual market is the one that many people turn to when they lose their jobs and their group coverage.
Insurers have also applied gender-rating to group coverage, but laws against sex discrimination in the workplace prevent employers from passing along the higher costs to their employees based on sex. Gender rating has taken a particular toll on smaller or midsize businesses with many women, like home-health care, child care and nonprofits. As a result, some businesses have been unable to offer health coverage or have been able to afford it only by using plans with very high deductibles.
In addition, individual policies often excluded maternity coverage, or charged much more for it. Now, gender rating is essentially outlawed, and policies must include maternity coverage, considered “an essential health benefit.”
It is breathtaking we lived under this system for so long, and that so many people were willing to fight change.
You didn’t have to be a cynic to think insurance companies would try to find loopholes in the health care fix. But I must confess, even I am a little surprised at their first stab at it. On the list of individual parts of the reform that would be hard for them, or for politicians pushing repeal, to take back, this one would rank pretty high.
Yup, the insurance companies went after kids. Specifically, they said that while the law said they couldn’t deny kids for having pre-existing conditions, they just didn’t have to sell insurance to the entire family of a sick child. No, really.
Insurance industry lawyer William Schiffbauer told the New York Times, “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.’’
This did not go over so well with policymakers such as Nancy Pelosi and Health and Human Services Secretary Kathleen Sebelius.
And the insurance companies backed down. This time.
In a letter to Health and Human Services Secretary Kathleen Sebelius, the industry’s top lobbyist said insurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year.
Quick resolution of the doubts was a win for Obama — and a sign that the industry has no stomach for another war of words with a president who deftly used double-digit rate hikes by the companies to revive his sweeping health care legislation from near collapse in Congress.
“Health plans recognize the significant hardship that a family faces when they are unable to obtain coverage for a child with a pre-existing condition,” Karen Ignagni, president of America’s Health Insurance Plans, said in a letter to Sebelius. Ignagni said that the industry will “fully comply” with the regulations, expected within weeks.
Anyone have any bets on which provision the insurance companies will go after next?
One more vote, one more signature, and that’s it. We can stop talking about health care reform bills and start talking about health care reform laws.
The Senate on Thursday passed the reconciliation bill to amend the health care reforms recently signed into law, bringing the health care debate one step closer to an end.
The package of changes passed by a vote of 56 to 43 and now goes to the House for a final vote. The House will take up the measure this evening.
The House has the final vote because there were some minor wording changes to the Senate bill. (Those were on provisions relating to student loans, not to health care.) That vote, going on now, should not be in any doubt given that it isn’t substantively different than what they passed Sunday night.
Some Republicans, of course, want to campaign on repealing the bill. President Obama’s response:
“My attitude is, go for it!,” Obama told a cheering crowd in Iowa City, Iowa. “If they want to have that fight, we can have it!”
The president also said he doesn’t believe voters “are going to put the insurance industry back in the driver’s seat. We’ve already been there — we’re not going back!”
There are good reasons to want to have that fight. After all, since the House passed reform and President Obama signed it, the law has gotten more popular as people assess what’s actually in it.
And with key provisions going into effect before November’s elections, who’s really going to be campaigning on “I’ll pass a law that lets insurance companies deny kids with pre-existing conditions”? How about “I’ll reopen the Medicare Part D donut hole”?
It’s still going to be a fight, but right now, working people have beat the insurance companies.
