Health Care Q&A
While it may seem easy to jump to conclusions about health care reform legislation, it is important to remember that there is not yet a final product; it is still a work still in progress. Having said that, I know constituents across Delaware have questions about the bill, which the following Q&A is meant to address.
How does the Senate bill provide quality, affordable health care for all Americans?How does the legislation improve the quality and efficiency of health care?
Does the Senate health care bill increase the national debt?
How does the bill hold insurance companies' feet to the fire and ensure competition to bring down costs?
I've heard a lot about "exchanges." What is an exchange and how will it work?
What does the bill do for small businesses?
Will seniors and Medicare be affected?
Will the bill force me to join a government-run health care plan? What if I want to keep my current plan?
What changes will I see in my health care immediately after the bill passes?
Is it true that "death panels" that would control seniors' access to health care and promote the use of euthanasia?
Is the health care reform bill a "government takeover"?
Will the health care reform bill pay for health care for illegal immigrants?
Does this bill change current law prohibiting the use of federal funds for abortion?
Are members of Congress "exempted" from participating in reforms included in the bill?
What's in the bill that I haven't already heard about in the media?
What's in it for Delawareans?
What are the next steps?
How does the Senate bill provide quality, affordable health care for all Americans?
The bill expands coverage to 94 percent of all Americans and begins to move us away from a costly and ineffective fee-for-service system. The health care reform bill also focuses on encouraging wellness and healthy behaviors.
How does the legislation improve the quality and efficiency of health care?
The bill will make substantial investments to improve the quality and delivery of health care so that patients receive the best and most up-to-date medical services possible. It works to ensure that providers, researchers and patients are always working towards improving health care quality. In addition, the bill creates the Medicare and Medicaid Innovation Center, which will develop and test new strategies for saving money and getting the best outcomes for patients, like encouraging doctors to work together or to use electronic health records.
Does the Senate health care bill increase the national debt?
No. The nonpartisan Congressional Budget Office has estimated that the legislation will reduce the federal deficit by $132 billion in the first decade it is implemented and up to $1.3 trillion in the second decade.
The legislation demands greater accountability from insurance companies and forces them to end their most discriminatory and damaging practices. The bill will ensure that no one can be refused insurance for having pre-existing conditions. In addition, insurance companies will not be allowed to charge exorbitant prices to people who are older or in poor health.
Finally, insurers will be required to spend the money they collect through premiums primarily on patient care and services, instead of using it for unnecessary administrative costs, wasteful expenses and high profits. This way, patients can be assured that their dollars are going directly towards medical care.
I've heard a lot about "exchanges." What is an exchange and how will it work?
The legislation sets up a number of exchanges, which are online marketplaces where Americans without insurance will be able to purchase coverage, possibly with the help of a tax subsidy based on their income level. In short, it is a place for consumers to shop for health insurance, with the assurance that they will get a quality product with a guaranteed level of benefits. Because the exchanges will be a large purchasing pool with lower administrative costs, a wide range of health care coverage should be available at a reasonable price.
What does the bill do for small businesses?
Currently, small business owners and employees suffer from the crippling cost of health insurance.
To help offset the cost of providing insurance, this legislation provides tax credits to small businesses with 25 or fewer employees. It also protects small businesses with 50 or fewer employees from having to pay a penalty for not offering coverage.
And to help bring down health care costs from another angle, a provision I authored allows for $200 million in grants so small businesses can establish programs to help their employees take care of their own health and wellness before they even get sick, for example by losing weight or lowering bad cholesterol.
Will seniors and Medicare be affected?
Under the status quo, the Medicare system is estimated to go broke in less than a decade. Therefore, inaction was unacceptable and we need reform to ensure the program's remains available to seniors in years to come. The Patient Protection and Affordable Care Act will make Medicare a stronger, more sustainable program.
In addition, other provisions in the bill will help seniors live better lives - and save money. For example, under the current system, seniors are eligible for just one physical when they join the program. However, under the new legislation, seniors may receive a free physical every year. Preventive care like this is shown to bring down health care costs and keep patients healthier.
The bill will also address the so-called "donut hole," which is the gap in Medicare Part D prescription drug coverage that can leave seniors paying as much as $3,500 out of pocket for costly medications until catastrophic coverage kicks in. The Senate bill begins to close this gap in coverage by requiring pharmaceutical companies to provide a fifty-percent discount on brand name drugs within the donut hole, and I believe that the final version of the bill will close the donut hole completely.
No. The bill does not force anyone to join a specific health care plan, and moreover, the Senate bill does not even include a government run health care plan. Consumers will have a variety of private insurance options available to them on the exchanges, and they are free to choose whichever suits them best, including their current plan.
What changes will I see in my health care immediately after the bill passes?
While some of the bill's reforms will take several years to implement, there are a few changes that will take place right away.
- Seniors will receive assistance in paying for prescription drugs.
- Insurance companies can no longer set limits on the amount of health care services they pay for in a given year or over a lifetime, and they cannot drop patients when they get sick.
- All group health plans and plans in the individual market must provide free coverage for prevention and wellness services.
- Children will be allowed to stay on their parents' insurance until the child turns 26.
- Tax credits will be offered to small businesses to help them provide health insurance to their employees.
- Insurance companies will be prohibited from denying coverage to children because of pre-existing conditions.
- Low-interest student loan programs, scholarships and loan repayments will help more students and professionals afford the necessary education and advanced training to bolster our health care workforce.
For more even information about immediate benefits, please click here.
No. The Senate bill does not require or even suggest that treatments be refused to seniors or any person at the end of their life. Decisions about a person's health care will continue to be left in the hands of that person and their doctor.
Is the health care reform bill a "government takeover"?
No. Private insurance coverage will not be reduced or eliminated. In fact, the Senate bill preserves and strengthens our existing employer-based health care system.
Will the health care reform bill pay for health care for illegal immigrants?
No. Under this health reform bill, illegal immigrants will not receive any federal subsidies for purchasing health insurance. In addition, the bill explicitly prohibits illegal immigrants from even using the state exchanges to purchase insurance.
Does this bill change current law prohibiting the use of federal funds for abortion?
No. This bill continues the current policy of not allowing federal funds to be used for abortions. Abortions will be restricted except where the mother's health is in danger or if the woman has been the victim of rape or incest.
Are members of Congress "exempted" from participating in reforms included in the bill?
No. Members of Congress currently receive health insurance benefits through the Federal Employees Health Benefit Program, along with about 8 million other federal employees and their families. Under the bill passed by the Senate, members of Congress and Congressional staff will have to purchase their health insurance coverage through the newly created exchanges with the same rules and regulations that apply to other individuals participating in the exchange.
What's in the bill that I haven't already heard about in the media?
In the heat of the Senate floor debate last month, lawmakers, media, interest groups and the public focused all their attention on controversial issues like public option, abortion, special Medicaid deals and the falsely coined "death panels."
What got lost in that firestorm were positive, albeit lesser known, provisions that will help Americans lower their health care costs by incorporating healthy habits into their lifestyles. Which is important because we know that when people take better care of themselves, their health care costs go down.
For example, the final Senate bill includes my bipartisan amendment that encourages employers to reward employees for participating in wellness programs.
I also led a bipartisan effort to require chain restaurants to list calories on their menus and menu boards, and provide additional nutritional information upon request.
This legislation will help more than 130,000 Delawareans get affordable health care coverage, and provide unprecedented security and stability for Delawareans who have insurance. For example, no one will lose coverage because they are sick or have a preexisting condition. It will lower costs for families, businesses and the government, and protect from unfair insurance practices that deny them care when they get sick.
As you may know, the House of Representatives approved a measure of its own in November, and the two different bills would need to be reconciled before being enacted into law. My colleagues and I are reaching out to groups and individuals in Delaware, and across the country, to determine the best path forward on health care reform that will benefit all Americans.
For more information, feel free to contact any of my office locations or E-MAIL ME.