Time to Cross the Finish Line on Health Care Reform

Our goal is to get the strongest bill to the President’s desk, one that provides good, affordable coverage to all and holds insurance companies accountable. Generally, the legislation passed by the House does a good job of this, whereas the bill about to be passed by the Senate falls short in key areas. We will urge President Obama to work with leaders in both houses of Congress to agree on legislation that will realize the promise that all of us have good health insurance we can count on.

Health care must be affordable

Without better affordability provisions, people will continue to have to choose between groceries and health care, and thousands of families will continue to go bankrupt because of health care costs. We support the Senate moving forward so we can fix affordability and other key concerns in conference. Requiring people to buy insurance that they cannot afford is not a legitimate, feasible or desirable solution to our health care crisis. 
The House bill did a much better job for lower income families. The House expands Medicaid up to 150% of the poverty line, saving federal dollars that can be used to increase subsides for other lower income families. Deeper subsidies would benefit people such as the average family of three earning $28,400 (about 155% of the poverty line). Without subsidies like those in the House bill, this family would pay $2100 more in premiums and out-of-pocket costs than under the House bill. That is just over 1 month's income for this family.

The House bill also says that mid and large size employers who do not provide coverage need to make a reasonable contribution to help pay for uninsured people to buy insurance. This raises money from employers that can be spent to bring the cost of insurance down for people who need to buy their own coverage. The final bill should include such a provision.

Important reforms

Even as we continue to fight for affordability, for a public option, for greater efforts on racial disparities, for lifting restrictions on women's access to health services and immigrant inclusion, we believe it is important for all Americans to take stock of the truly important changes that the current reform will achieve:
 
Largest Expansion of Coverage Since Medicare's Creation: Thirty-one million previously uninsured Americans will get insurance.
 
A Huge Expansion in Coverage for Low/Middle Income Americans: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill's provisions will cover many working class Americans who currently go without basic health care coverage.
 
Insurance Companies Will Not Be Able to Drop or Deny You Coverage Because You are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can't rescind coverage or impose significant lifetime or annual limits on care. Importantly, the bill also ends insurer discrimination against women who currently pay as much as 48% more for coverage than men and ensures women access to preventive services with no cost sharing.
 
Lower Premiums For Families: The reform could lower premiums for families by 8.4%. For people receiving subsides, premiums would decrease even more dramatically. According to the Congressional Budget Office, the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law.
 
Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.
 
Insurers No Longer Able to Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer be able to sell sham policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.
 
Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill's state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.
 
Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that impacts  3.4 seniors access to affordable prescription drugs. 

Deepak Bhargava is the Executive Director of the Center for Community Change.