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Happy Anniversary, Failed-Repeal-Of-Obamacare!

One Year Later:
What if Congress Had Repealed the Affordable Care Act?

For too long, too many hard working Americans paid the price for policies that handed free rein to insurance companies with few protections for patients or providers. Nearly two years ago, President Obama signed health reform – the Affordable Care Act – into law. The law gives hard working families the security they deserve, makes insurance more affordable, ends the worst insurance company abuses and makes preventive care free for millions of Americans and everyone enrolled in Medicare.

One year ago yesterday, on January 19, 2011, the House of Representatives voted to repeal the law, and take us back to the days when insurance companies had the power to decide what care residents of the United States could receive – allowing them to once again deny coverage to children with pre-existing conditions, cancel coverage when people get sick, and place lifetime or low annual dollar limits on the amount of care people can get, even if they need it. What’s more, without the law, insurance companies could overcharge for insurance just to boost their profits.

Here are some of the statistics about what would have happened if Congressional Republicans had succeeded in repealing the Affordable Care Act:

  • 2.5 Million More Uninsured Young Adults. – 2.5 million young adults have been able to stay on their parent’s health insurance thanks to health reform.
  • 2.65 Million Seniors Pay $1.5 Billion More for Prescription Drugs. The Affordable Care Act provides a 50 percent discount on covered brand name prescription drugs for seniors and people with disabilities who hit the donut hole. This discount has saved 2.65 million seniors more than $1.5 billion through October 2011.
  • 24.2 Million Seniors Pay More for Preventive Care. The Affordable Care Act makes preventive care like mammograms and colonoscopies free for everyone with Medicare. Through November 2011, 24.2 million seniors have received free preventive services.
  • 45,000 Americans With Pre-Existing Conditions Remain Uninsured. As of November 2011, the Affordable Care Act’s Pre-Existing Condition Insurance Plan has provided insurance to 45,000 Americans who have been locked out of the insurance marketplace because of a pre-existing condition.
  • Insurance Companies Free to Cap Care for 102 Million Americans. Under the Affordable Care Act, insurance companies cannot drop your care when you get sick, or place a lifetime limit on your care. Today, the 102 million Americans whose health plan included lifetime dollar limits have seen their coverage expanded.
  • Insurance Companies Free to Drop Coverage for up to 15 Million Americans. The Affordable Care Act finally put an end to one of the most abusive practices of the insurance industry: retroactively canceling coverage for a sick patient based on an unintentional mistake in their paperwork. Before the health care law was signed, most of the 15 million people purchasing coverage in the individual market were vulnerable to this policy. Rescission often leaves people suddenly responsible for past expenses and with no coverage to pay for needed care.
  • 41 Million Pay More for Preventive Care. Approximately 41 million Americans are now enrolled in health insurance plans that must provide preventive services without cost sharing thanks to health reform. (more…)

Essential Benefits: Making Health Insurance Work For Us

From USA Today:

By Kathleen Sebelius

For families and small business owners struggling with health care costs and accessibility, help is on the way. The health care law that takes full effect in 2014 will provide a competitive marketplace to buy coverage. In fact, these state-based Affordable Insurance Exchanges are already taking shape. Through these one-stop shops, consumers will be able to see all their options in one place. More than $700 million in exchange grants have been awarded to 29 states.

That’s important because Americans today badly need better insurance options. In the past, finding and enrolling in coverage was often complicated and confusing. Rates could jump by double digits without much warning. Families and small business owners who bought their own coverage were often priced out or locked out of the system. And insurance companies could refuse to cover people with pre-existing health conditions.

The new insurance exchanges and other reforms in the Affordable Care Act mean that insurance companies will have to compete for your business, driving down prices. And, beginning in 2014, all Americans — whether they change jobs, retire early, or start a business — will have a way to access quality, affordable coverage in this new marketplace.

Last month, my department took an important step toward making that marketplace a reality by releasing a proposed approach to “essential health benefits,” the basic standard of coverage that all plans in this marketplace will have to offer. (more…)

Pre-Existing Condition Insurance Pool Sees Low Enrollment

From The Huffington Post:

By Jane Smith

10/20/11 03:48 PM ET

WASHINGTON — Fewer than 34,000 Americans have signed up for a health care reform program designed to insure the uninsurable until the new law’s broader provisions take effect in 2014.

Enrollment in the Pre-Existing Condition Insurance Plan (PCIP) has been far below all expectations, including one estimate that 375,000 people would sign up in 2010 alone. From July to August, only 3,563 signed up, according to the Department of Health and Human Services, which oversees the initiative. As many as 25 million Americans are uninsured and have pre-existing conditions.

In order to apply for PCIP, applicants must have a pre-existing medical condition such as heart disease, cancer, asthma, or diabetes, and they must have been uninsured for at least six months. Enrollees can expect basic health benefits such as prescription drugs, physician visits and hospital care.

The low enrollment figures can be partially explained by the fact that PCIP offers market-rate insurance premiums, which many people can’t afford. Yet the biggest obstacle to higher enrollment, according to health policy experts and a government audit, is the six-month waiting period the program imposes.

The Government Accountability Office (GAO) cited the six month requirement as a major drawback and called it a contributing factor to low enrollment. Though the PCIP caps out-of-pocket spending for U.S. citizens and offers many other benefits, individuals with pre-existing health conditions may be hesitant to live entirely without coverage for six months.

“Congress made a fatal mistake by imposing the six months of un-insurance requirement,” said Tim Jost, health care expert and law professor at Washington and Lee University. “I bet the numbers would be far higher if people could enroll without going bare for 6 months.”

Twenty-three states and the District of Columbia chose to have their PCIP program administered by the federal government while the rest are implementing the PCIP on the state-level. Only one person in Massachusetts has signed up for the program, and none have in Vermont, because those states, according to HHS, “have already implemented many of the broader market reforms included in the Affordable Care Act that take effect in 2014.”

The PCIP is modeled on existing state programs known as “high-risk pools,” which provide insurance for individuals whose pre-existing conditions prevent them from purchasing affordable insurance on the private market. Expanding state high risk pools was the centerpiece of the Republican alternative to President Obama’s Affordable Care Act, which was signed into law last year.

“This also shows that the Republican solution of high-risk pools for those with pre-existing conditions is highly problematic,” Jost said.

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