Bringing Reform to a Broken System:
H.R. 3200, America’s Affordable Health Choices Act
Thank you for taking the time to pursue more information regarding the ongoing health care reform effort. This is an issue of critical importance not only for the personal health of our country, but also for the health of our economy. In 2007, the United States spent approximately $2.2 trillion on health care and the Congressional Budget Office estimates that by 2025, one out of every four dollars in our national economy will be tied up in the health system. Reform to our broken system is long overdue.
H.R. 3200, America’s Affordable Health Choices Act of 2009, was recently approved by the House Energy and Commerce Committee with my support after a long markup process. The bill also underwent markups in the House Education and Labor Committee and the House Ways and Means Committee; and the House leadership is now tasked with combining the significant changes to the legislation that were made by each Committee. This process includes a dialogue between the leadership and members representing disparate interests, and along every step of the way I have been sure to emphasize the concerns of my constituents. For example, I have spent considerable time ensuring that the final version of H.R. 3200 will include provisions that combat an existing inequity in Medicare reimbursement rates that has been penalizing Washington state physicians for the efficiency they demonstrate. Rest assured, as the House leadership continues the process of reconciling the different versions of H.R. 3200, I will fight for real reform that will improve the way Washingtonians get health care, including the creation of a strong public option and various cost-containment measures that are addressed at more length below.
Finally, you may be aware that the Senate is currently debating health care reform legislation as well. At this time, the Senate Health, Education, Labor and Pensions (HELP) Committee and the Senate Finance Committee have passed two separate bills out of Committee, and the Senate leadership will now work to join the legislation into one comprehensive bill. While I have no direct influence over this process, I am monitoring the developments in the Senate closely. As soon as the House and Senate have each passed a health care reform bill, a conference committee made up of members from both bodies will merge the two bills and I will have a chance to vote on the final product. It is my hope that this process can be completed in a timely fashion, as the reforms we are discussing are a long time in the making.
I have included the following information on H.R. 3200 in hopes of addressing questions or concerns you may have regarding the legislation. If you require more information, please feel free to contact me. Because security measures in the House cause delays in receiving postal mail, I encourage you to contact me by telephone, by fax, or through the contact section of this website (http://www.house.gov/inslee/contact).
WHAT IS CURRENTLY IN THE HOUSE HEALTH CARE LEGISLATION (H.R. 3200)?
- A national Health Exchange where consumers can compare health plans.
- A public option, funded entirely by premiums
- Bans the use of preexisting conditions by insurance companies to deny or charge more for coverage
- Provides sliding-scale affordability credits for those making less than 400% of the federal poverty level.
- Caps annual out-of-pocket spending on health care.
- Expands Medicaid for those making less than 133% of federal poverty level.
- Eliminates the “donut hole” for Medicare Part D prescription drug coverage.
- Shared responsibility for providing and maintaining health insurance. Consumers must have coverage. Employers must provide insurance, contribute funds elsewhere, or pay a penalty.
- Focuses on prevention and wellness by eliminating cost-sharing for preventive services.
PAYING FOR HEALTH CARE REFORM
- $156 billion in savings by eliminating overpayments to private Medicare Advantage plans over 10 years.
- $102 billion in savings over 10 years by incorporating productivity adjustments into Medicare payment updates for hospitals. This adjustment will encourage greater efficiency in health care provision, while more accurately aligning Medicare payments with hospital costs.
- $110 billion in savings over 10 years by closing the Medicare Part D “donut hole”.
- $100 billion in additional savings over 10 years through key delivery system reforms such as incentives to reduce readmissions to hospitals and promoting accountable care organizations.
- Tax on the wealthiest 1.2% of Americans.
WHAT H.R. 3200 MEANS FOR WA-01
- 41,000 uninsured people would get access to health care
- 17,900 small businesses could get tax credits to help them provide health coverage
- 3,200 seniors would avoid the donut hole in Medicare
- 1,100 families will avoid bankruptcies due to medical costs
- Health care providers would receive payment for $28 million in uncompensated care each year.
Medicare Geographic Variation and Promotion of High Value Care: An agreement that will move the nation to a system that rewards high quality, cost-effective care, rather than the current system that has focused on the volume of care. It will represent a historic transformation of the Medicare payment system to ensure better care for patients and reduce health care costs over the long-term.
Additional information on H.R. 3200, including the bill text, can be found at: energycommerce.house.gov.
FREQUENTLY ASKED QUESTIONS
Q: The Public Option - A government-run public option would force employers to drop their coverage and force everyone onto a public plan.
A: Under the bill, no one can ever be forced onto the public plan. The only way someone would be in the public plan is the person’s own individual choice. All those using the Health Insurance Exchange will have a range of options – various private plans, and the public plan. If the employer is providing their employees health insurance through the Exchange, it is the employee – not the employer – choosing the plan.
Q: The Public Option=Government takeover - A government-run public option would put private insurers out of business
A: Under the bill, employers are required to provide insurance for their employees, or pay a penalty. Individuals can use the Exchange only if they do not have coverage from another source (e.g. an employer, Medicare, etc.). Additionally, the public option is not taxpayer funded in the long term – it must survive on premiums alone, like private companies. This is like the Postal Service, which is not taxpayer funded, and competes with FedEx and UPS.
Q: PG 50, section 152 states that free, taxpayer-paid health care will be given to the 30 million noncitizens in the USA, even illegal aliens.
A: This bill only covers individuals who are lawfully present in the United States. This provision (Div A, Title I, Sec 152) prohibits health care providers from discriminating against individuals who are eligible for high-quality care and services under this bill.
Q: “Death Panel” - "You have every right to fear....a government run plan to decide when to pull the plug on Grandma.” –Senator Chuck Grassley (R-IA)
A: Nothing in the bill mandates advance care planning consultations, which are discussions between patients and physicians on end-of-life care. The provision referred to (Div B, Title II, Sec 1233) requires Medicare to cover advanced care planning, or ACP, consultations for the first time, but it does not mandate doctors or individuals to undertake ACP consultations—this is a decision made between a doctor and their patient.
Q: Everyone will be affected by the reform except Members of Congress and their families.
A: Members of Congress’ health care plans will be subject to the same rules as all other employer-sponsored plans. Nothing in the legislation exempts the plans available as part of the Federal Employee Health Benefits (FEHB) program (the plans Members of Congress and staff enroll in) from the reforms. By the end of 2018, all employer-sponsored health insurance plans, including the plans that are part of Federal Employee Health Benefits program, will have to meet at least the same basic minimum standards of coverage as those insurance plans as offered through the exchange.
Q: Pg 30, Sec 123 states that there will be a government committee that decides what treatments you are allowed and what your overall benefits are.
A: You and your doctor will decide what treatments you receive. The Health Benefits Advisory Committee will make recommendations that will assure that all insurers provide meaningful benefit packages within the health insurance exchange. This committee has no role in making decisions about treatments for individuals.
Q: The House Democrats’ health insurance reform bill will harm small businesses – undermining their ability to create new jobs.
A: Far from undermining small businesses, the bill would significantly cut the costs of health care coverage for small businesses – thereby reducing the cost of doing business for many small business owners and allowing them to help their employees while saving and creating jobs. The Small Business Majority recently released a report that showed that without reform, small businesses will pay nearly $2.4 trillion in health care costs over the next 10 years. If health insurance reform is enacted, the report found that small businesses could save as much as $855 billion over 10 years, nearly 36 percent.
Q: We have the best healthcare in the world, why should we change it?
A: It is true that we have the best care in the world when it comes to serious conditions like cancer, severe trauma, or organ failure, especially because of our investment in medical research and the large number of specialists we have. However, our healthcare system lags far behind the entire industrialized world (and even some developing countries) when it comes to primary care and more common conditions like fevers, broken bones, etc., and preventative care. Health care reform is about improving the quality and access of our primary care, while maintaining our leadership in critical care and specialty care.
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