The late Senator Edward Kennedy was a champion of health care financing reform – he called it "the cause of my life." He introduced the Affordable Health Choices Act and sheparded it through his committee, the Health, Education, Labor and Pensions Committee (HELP). Below is his summary of his bill. Representative John Dingell (D-MI) proposed similar legislation in the House – America's Affordable Health Choices Act – where it has cleared several committees. Both bills are summarized below.
The full text of Senator Kennedy's proposed Affordable Health Choices Act is available here. Beware - it is 615 pages long. Senator Kennedy's website contains the following summary of this bill:
The Affordable Health Choices Act
In July 2009, Senator Kennedy’s Health, Education, Labor and Pensions (HELP) Committee passed The Affordable Health Choices Act, landmark legislation that will reduce health costs, protect individuals’ choice in doctors and plans, and assure quality and affordable health care for all Americans.
The legislation builds on the existing employer-based system and strengthens it. If people like the health insurance they have, they get to keep it. The bill provides better choices for those with no coverage now, and those for whom coverage is unaffordable. It also gives small businesses better options for high value health coverage.
Under the insurance reforms in the bill, no American can be refused health coverage because of a preexisting medical condition, or have that coverage denied when they need it most. No American will ever again be subject to annual or lifetime limits on their coverage, or see it terminated arbitrarily to avoid paying claims.
The bill reduces health care costs through stronger prevention, better quality of care, and use of information technology. It also roots out fraud and abuse, reduces unnecessary procedures, and creates a system that enables everyone to obtain insurance, thereby gaining access to doctors, medication and procedures essential for prevention and disease management. By sharing in this responsibility, our nearly 50 million uninsured fellow citizens will avoid eleventh-hour treatment in emergency rooms that drive up costs for everyone else.
Shared responsibility requires that everyone – government, insurance companies, medical providers, individuals and employers – has a part in solving America’s health care crisis. The bill requires businesses which do not provide coverage for their workers to contribute to the cost of providing publicly sponsored coverage for those workers. It includes an exception for small businesses.
It also includes a strong public option that responds to the wishes of the American people to have a clear alternative to for-profit insurance companies. Like private insurance plans, the Community Health Insurance Option will be available through the American Health Benefit Gateway, a new mechanism to enable individuals and small employers in every state to find and purchase quality and affordable health insurance.
Representative Dingell's bill, H. 3200, has passed the House Energy and Commerce Committee, the House Ways and Means Committee, and the House Education and Labor Committee. It is still under consideration by the House Oversight and Governmental Reform Committee and the House Budget Committee. The Congressional Research Service summarized the bill as follows:
America's Affordable Health Choices Act of 2009 – Sets forth provisions governing health insurance plans and issuers, including: (1) exempting grandfathered health insurance coverage from requirements of this Act; (2) prohibiting preexisting condition exclusions; (3) providing for guaranteed coverage to all individuals and employers and automatic renewal of coverage; (4) prohibiting premium variances, except for reasons of age, area, or family enrollment; and (5) prohibiting rescission of health insurance coverage without clear and convincing evidence of fraud.
Requires qualified health benefits plans to provide essential benefits. Prohibits an essential benefits package from imposing any annual or lifetime coverage limits. Lists required covered services, including hospitalization, prescription drugs, mental health services, preventive services, maternity care, and children's dental, vision, and hearing services and equipment. Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family.
Establishes the Health Choices Administration as an independent agency to be headed by a Health Choices Commissioner. Establishes the Health Insurance Exchange within the Health Choices Administration in order to provide individuals and employers access to health insurance coverage choices, including a public health insurance option. Requires the Commissioner to: (1) contract with entities to offer health benefit plans through the Exchange to eligible individuals; and (2) establish a risk-pooling mechanism for Exchange-participating health plans.
Provides for an affordability premium credit and an affordability cost-sharing credit for low-income individuals and families participating in the Exchange.
Requires employers to offer health benefits coverage to employees and make specified contributions towards such coverage or make contributions to the Exchange for employees obtaining coverage through the Exchange. Exempts businesses with payrolls below $250,000 from such requirement.
Amends the Internal Revenue Code to impose a tax on: (1) an individual without coverage under a health benefits plan; and (2) an employer that fails to satisfy health coverage participation requirements for an employee. Imposes a surtax on individual modified adjusted gross income exceeding $350,000.
Amends title XVIII (Medicare) of the Social Security Act to revise provisions relating to payment, coverage, and access, including to: (1) reduce payments to hospitals to account for excess readmissions; (2) limit cost-sharing for Medicare Advantage beneficiaries; (3) reduce the coverage gap under Medicare Part D (Voluntary Prescription Drug Benefit Program); (4) provide for increased payment for primary health care services; and (5) prohibit cost-sharing for covered preventive services.
Requires the Secretary of Health and Human Services (HHS) to provide for the development of quality measures for the delivery of health care services in the United States.
Establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research and Quality, financed by a tax on accident and health insurance policies, to conduct and support health care services effectiveness research.
Sets forth provisions to reduce health care fraud.
Amends title XIX (Medicaid) of the Social Security Act to: (1) expand Medicaid eligibility for low-income individuals and families; (2) require coverage of additional preventive services; and (3) increase payments for primary care services.
Sets forth provisions relating to the health workforce, including: (1) addressing health care workforce needs through loan repayment and training; (2) establishing the Public Health Workforce Corps; (3) addressing health care workforce diversity; and (4) establishing the Advisory Committee on Health Workforce Evaluation and Assessment.
Sets forth provisions to: (1) provide for prevention and wellness activities; (2) establish the Center for Quality Improvement; (3) establish the position of the Assistant Secretary for Health Information; (4) revise the 340B drug discount program (a program limiting the cost of covered outpatient drugs to certain federal grantees); (5) establish a school-based health care program; and (6) establish a national medical device registry.
Next week I will summarize the contents of these two bills and compare them to the Wyden-Bennett bill and the House Republican plan.
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As a UAW Retiree, if I loose any part of my health care or Medicare I will vote for all Republicans in the future. Do you understand!!!