Lots of folks have been hitting the site this morning looking for the results of last evenings historic House vote on H.R. 3962 – the Affordable Health Care for America Act. Fox News must still be devoting all their resources to round-the-clock coverage of Tuesday’s New Jersey gubernatorial contest so I guess I should put something up as a public service.
Well the news is mixed. First off, 6th District, your Republican Congressman, Peter Roskam, as usual, sided with the interests of big corporations over those of his constituents who are being bankrupted and going without adequate healthcare. Peter Roskam voted against passage of H.R. 3962.
The measure passed by a vote of 220-215 with one lone Republican having the courage to stand up and do the right thing. That Republican, Rep. Joseph Cao of Louisiana, has since been viciously attacked by the Teabaggers (H/T to Wonkette) whom Rep. Roskam and his party have allied themselves in their efforts to kill any meaningful healthcare reform:
Thankfully, the Teabaggers are merely standing up for the freedom of all poor and middle class Americans to die an untimely death. Racism has in no way motivated their attacks on the President and his agenda for healthcare reform.
But I digress.
The bill that Peter Roskam voted against will, if enacted, by CBO estimates provide health coverage to 96% of Americans and do so under the $900 billion threshold outlined by President Obama and will reduce the deficit to a greater degree than the phony reform alternative presented by Roskam and the desperate Republicans at the last minute.
Specific providions of the bill include:
- The creation of a new national program to provide affordable coverage for those who can’t get health insurance today because of pre-existing conditions
- Implementation of insurance reforms to enforce an 85% medical loss ratio – meaning that insurance companies must spend 85 cents out of every premium dollar on medical services
- Coverage of young adults on their parents’ policies through age 26
- Limits on pre-existing condition exclusions
- A self-sustaining public insurance option (that is financed not by tax dollars but by insurance premiums) that provides an alternative to and competes on a level playing field with private health insurance companies
- Elimination of the antitrust exemption for health insurers and medical malpractice insurers, increasing competition in the insurance marketplace and removing the shield that has allowed them to price fix, divide up territory, and effectively create monopolies in particular markets.
- Establishment of a new essential benefit package that over time will become the minimum quality standard for employer plans. The basic package will include preventive services with no cost-sharing, mental health services, oral health and vision for children, and caps on the amount of money a person or family spends on covered services in a year.
- Creation of a new, voluntary, public, long-term care insurance program to help purchase services and supports for people who have functional limitations. Individuals determined to need assistance because of functional limitations would qualify to receive a daily or weekly cash benefit to help purchase the services and supports needed to maintain personal and financial independence.
- Provision of affordability credits to low- and moderate income individuals and families, up to 400% of the federal poverty level, to aid in the purchase of health insurance of their choosing through a new health insurance exchange that includes the public option.
- Caps for annual out-of-pocket spending. Will cap annual out-of-pocket spending at a maximum of $5,000 per individual and $10,000 per family to prevent bankruptcies from medical expenses.
- Expansion of Medicaid. Individuals and families with incomes at or below 150% percent of the federal poverty level will be eligible for an expanded and improved Medicaid program. Recognizing the budget challenges in many states, this expansion will initially be fully federally financed then transition to include a 9% contribution from states starting in 2015. To improve provider participation in this vital safety net – particularly for low-income children, individuals with disabilities and people with mental illnesses – reimbursement rates for primary care services will be increased to Medicare rates with new federal funding.
- Improvements to Medicare. Senior citizens and people with disabilities will benefit from provisions that fill the donut hole over time in the Part D drug program, eliminate cost-sharing for preventive services, improve the low-income subsidy programs in Medicare, increase access to primary care providers, and make other program improvements. The bill will also address future fiscal challenges by improving payment accuracy, encouraging delivery system reforms and extending solvency of the Medicare Trust Fund.
To make this all work the bill includes mandates: except in cases of hardship individuals must obtain insurance through their employer or independently. Assistance is providedfor those with low incomes. Care is made more affordable for everyone by increasing the size of the risk pool and by removing the antitrust exemption and providing public plan competition. Employers must either provide insurance to their employees or contribute to the cost of their coverage through the public plan/exchange. Small businesses are exempted from this requirement.
Sadly, an amendment was offered and passed to the original legislation by pro-life Democrats which restricts the ability of women to obtain a plan that covers abortion services, even if they are purchasing the plan through the exchange with their own money. The Democratic leadership was forced to compromise and allow a vote on the amendment or the whole reform bill would have failed. It was a necessary compromise, I think, but a painful one. The provision is an affront to all women and makes a mockery of the Republican claims that their votes against healthcare reform are votes for freedom. This addition allows unwarranted interference by the state in the lives of women seeking a legal medical procedure. Peter Roskam voted for the anti-choice amendment, even though he had no intention of voting for the final bill.
Difficult work lies ahead in reconciling this bill with Senate legislation and in passing a final conference report. But this was a big step.
