Saturday's vote to pass the Health Care for America Act, HR 3962, will strengthen Medicare for seniors, relieve small businesses from unsustainable insurance costs, and provide affordable health insurance options for Americans, all while lowering our federal deficit over the next 10 years.
But in the mostly conservative western Pennsylvania district where freshman congresswoman Kathy Dahlkemper lives, it took a lot of courage to stand up to the status quo. Dahlkemper holds the seat formerly held by Republican Tom Ridge, who went on to become Pennsylvania Governor and the nation's first director of Homeland Security under George W. Bush.
Dahlkemper, whose own parents are suffering from cancer, knows the needs of the people in her district even better after hosting dozens of townhall meetings and speaking with individuals throughout the district in person and online. She took it upon herself to introduce several amendments which eventually found their way into the bill that passed. I'm not wild about the Stupak amendment myself, nor do I like the idea of the Catholic bishops having a role in shaping health care policy, but if that's what it takes to get health care reform on the books, I guess we might have to do our penance.
Below is an excerpt from a press releases on Dahlkemper's web site, issued Saturday night:
“Today, the House of Representatives took a historic vote to fix our broken health care system and give all Americans a higher quality of life. I am proud to have taken part in this legislation, and in particular, to have offered provisions that strengthen the bill. Our legislation meets all the criteria for effective, affordable reform. It will benefit hundreds of thousands of people in the 3rd District of Pennsylvania: seniors, small businesses, young adults, the uninsured, and the already insured. Significantly, our health insurance legislation reduces the federal deficit through effective cost-saving measures and healthy competition for insurance companies,” said Dahlkemper.
“This legislation also reaches an important goal I have long advocated for health care reform: it includes measures to help prevent chronic disease and promote healthy living. The Affordable Health Care for America Act includes robust prevention and wellness provisions to improve the actual health of Americans,” the Congresswoman said.
In addition to her pro-life amendment, Congresswoman Dahlkemper offered four proposals to provide coverage to young adults and create health and wellness programs, all of which were incorporated into the health care reform legislation. The Young Adult Healthcare Coverage Act (H.R. 2831) was included to allow young adults to remain on their parents’ health care plans up to their 27th birthday, offering them affordable coverage that does not come at taxpayers’ expense. This provision is one of several reforms that will take immediate effect once the bill is signed into law.
The Community Based Overweight & Obesity Prevention Program (H.R. 3894), based on HEALTHY Armstrong in Armstrong County, is a grant program administered by the Department of Health and Human Services that creates public-private partnerships at the community level focused on reducing obesity and improving local health. Another health and wellness measure Dahlkemper proposed is to include nutritional therapy as an authorized service under Medicaid, which gives low-income populations access to proven treatment for obesity.
To help reduce health care costs long-term, Dahlkemper proposed a study to determine the best methods to encourage individuals to adopt healthy behaviors and improve their overall health (H.R. 3895). Finally, Dahlkemper proposed the Small Business Health Information Technology Financing Act (H.R. 3014), which was included in recent small business legislation and creates a new loan guarantee program at the Small Business Administration for the purchase of health information technology by eligible health care professionals in solo and small group practices. These loans help small health care providers reduce their administrative burden, lowering costs overall.
The Affordable Health Care for America Act provides quality, affordable health care for Americans and controls health care cost growth. The Congressional Budget Office (CBO) estimates that it will provide coverage to 96 percent of Americans, that it does so under the $900 billion threshold outlined by President Obama, and that it reduces the deficit within the budget window and beyond.
Protecting Medicare for Seniors
“The Affordable Health Care for America Act benefits the 118,000 seniors in the 3rd District who are Medicare beneficiaries and closes the prescription drug donut hole for 12,900 seniors in our area,” said Dahlkemper. For seniors, the Affordable Health Care for America Act:
- Extends the solvency of the Medicare Trust Fund by five years.
- Closes the prescription drug donut hole for 12,900 seniors in PA-3 beginning next year. In 2010, seniors will see the donut hole reduced by $500 and will have access to 50 percent discounts on brand-name drugs in the donut hole until it is completely phased out by 2019.
- Enhances preventive coverage by eliminating copayments for preventive services in Medicare.
- Strengthens Medicare by eliminating waste, fraud and abuse in the program.
- Improves low-income subsidy programs to ensure Medicare is affordable for seniors with low and modest incomes.
- Eliminates overpayments to Medicare Advantage to drive down health care costs and improve Medicare Advantage through competition with traditional Medicare. The legislation in no way eliminates Medicare Advantage and retains choice for seniors who want supplemental coverage.
Making Insurance Affordable for Small Businesses
“Pennsylvania’s small businesses and self-employed entrepreneurs spent $6.8 billion in health care premiums in 2008. Our legislation will provide tax credits to help reduce health insurance costs for up to 13,200 small businesses in the 3rd District and gives 15,100 small businesses in the district the opportunity to provide affordable coverage through the health insurance exchange,” said Dahlkemper. Under the Affordable Health Care for America Act:
- Small businesses with 25 employees or less and average wages of less than $40,000 will qualify for tax credits of up to 50 percent of the costs of providing health insurance.
- Businesses with up to 100 employees will be able to join the health insurance exchange, benefitting from group rates and a greater choice of insurers.
- 86 percent of America’s businesses are exempt from the shared responsibility requirement to provide insurance. Payrolls of $500,000 or below are completely exempt; payrolls between $500,000 and $750,000 face only a graduated fee if they opt not to provide health insurance.
- 98.8 percent of small business owners will pay no surcharge because the limits are set so high—with the surcharge assessed only on the portion of any income over $1 million for a couple or $500,000 for an individual.
Providing Coverage for the Uninsured and Pre-Existing Conditions
“The 62,000 uninsured individuals in the 3rd District will have a path to affordable health insurance under the exchange and the public option. 172,000 households in our district could qualify for affordability credits under this bill to bring health insurance within their reach. And the 7,600 people in our area who have pre-existing conditions will never have to worry about being rejected by an insurance company because of their medical needs,” said Dahlkemper. Major reforms for the uninsured and underinsured include:
- Those who do not receive health care coverage through their employer will be able to purchase coverage at group rates through a health insurance exchange.
- Individuals and families with an income of up to four times the federal poverty level—an income of up to $88,000 for a family of four—will receive affordability credits to help cover the cost of coverage.
- 172,000 households in the 3rd District could qualify for affordability credits.
- There are 7,600 individuals in the district who have pre-existing medical conditions that could prevent them from buying insurance. Under the bill’s insurance reforms, they will now be able to purchase affordable coverage.
Lowering the Cost of Health Care for the Insured and Retaining Choice
“Nearly 400,000 people in the 3rd District have health insurance through their employers. This plan will help lower costs for the insured by increasing competition between health insurance companies. And people who like the health insurance they already have can keep their coverage and their doctors,” said Dahlkemper. Approximately 62 percent of the district’s population—394,000 residents—receive health care coverage from their employers. There are many reforms under the Affordable Health Care for America Act that strongly benefit the already insured:
- Individuals and families with employer-based coverage can keep the health insurance coverage they have now.
- As a result of the insurance reforms in the bill, there will be no co-pays or deductibles for preventive care; no more rate increases or coverage denials for pre-existing conditions, gender, or occupation; and guaranteed oral, vision, and hearing benefits for children.
- Caps for annual out-of-pocket costs at $5,000 for singles and $10,000 for families and eliminates lifetime limits on insurance coverage, ensuring that no citizen will have to face financial ruin because of high health care costs.
Reducing the Federal Deficit and Controlling the Cost of Care
“We cannot continue to incur unsustainable costs and pass on a bloated federal deficit to our children. The Affordable Health Care for America Act reduces the federal deficit by $109 billion over the next ten years, according to the CBO. And health care providers in the 3rd District, who spent $78 million on health care for the uninsured in 2008, will see this uncompensated care all but eliminated under our bill,” said Dahlkemper. To reduce the deficit and control costs, the Affordable Health Care for America Act:
- Creates incentives to reduce preventable hospital readmissions that reward transition planning and coordination for patients who move from a hospital bed back home or to another health facility.
- Increases funding for the Health Care Fraud and Abuse Control Fund to fight Medicare and Medicaid fraud.
- Eliminates wasteful overpayments to Medicare Advantage plans that increase private plan profits, not patient care.
- Improves payment accuracy for other providers, following recommendations by the non-partisan Medicare Payment Advisory Commission.
- Requires drug and device companies to disclose their payments to physicians to reduce excessive utilization.
- Helps reduce primary care costs by improving payments for family doctors and other primary care providers.
- Creates community-based programs that deliver prevention and wellness services.