White House: Quality, Affordable Health Care for All Americans

Editor's note: This is what the White House has to say about the health care reform bill. All parts of the overview come from the White House. Foodconsumer.org simply puts them in one page to make it easy for readers to use. Read it for yourself to see how the new law will affect you.

Quality, Affordable Health Care for All Americans

This Act puts individuals, families and small business owners in control of their health care. It reduces premium costs for millions of working families and small businesses by providing hundreds of billions of dollars in tax relief – the largest middle class tax cut for health care in history.  It also reduces what families will have to pay for health care by capping out-of-pocket expenses and requiring preventive care to be fully covered without any out-of-pocket expense. For Americans with insurance coverage who like what they have, they can keep it. Nothing in this act or anywhere in the bill forces anyone to change the insurance they have, period.

Americans without insurance coverage will be able to choose the insurance coverage that works best for them in a new open, competitive insurance market – the same insurance market that every member of Congress will be required to use for their insurance. The insurance Exchange will pool buying power and give Americans new affordable choices of private insurance plans that have to compete for their business based on cost and quality. Small business owners will not only be able to choose insurance coverage through this exchange, but will receive a new tax credit to help offset the cost of covering their employees.  

It keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses.  And it bans insurance companies from denying insurance coverage because of a person’s pre-existing medical conditions while giving consumers new power to appeal insurance company decisions that deny doctor ordered treatments covered by insurance.

This year, American families and small business owners will begin to experience the benefits of this common-sense reform:

New Affordable Choices:

Uninsured Americans with pre-existing conditions will finally have the choice of quality, affordable insurance through a new insurance pool;

Small business owners will be eligible for billions in tax credits to help offer insurance coverage to employees;

New plans will have to offer preventive care and immunizations at no cost;

New plans and certain existing plans that offer dependent coverage will have to cover an enrollee’s dependent children until age 26;

A re-insurance program for employers that offer health insurance to their early retirees will save as much as $1,200 for every family enrolled.

More Power for Consumers:

A new website to help consumers  compare different insurance coverage options along with state-by-state health care consumer assistance and ombudsman for any of their health insurance questions;

A new independent appeals process for new plans so consumers and patients can appeal insurance company decisions.

Insurance Company Accountability:

Prohibits new plans and existing group health plans from denying coverage for children because of a pre-existing medical condition;

Review of requested insurance premium increases; health insurers with a pattern of excessive rate increases can be blocked from selling through new insurance exchanges;

Remove arbitrary lifetime limits on coverage in all plans, and remove restrictive annual limits on benefits in all new plans and existing group health plans so people know that all of the care they need will be paid for;

Prevent insurance companies from dropping insurance coverage when a person gets sick and needs it most.

These common-sense reforms will be implemented step by step so that families and small business owners have the information they need to make the choices that work best for them.

If You Like the Insurance You Have, Keep It:

Nothing in the proposal forces anyone to change the insurance they have.  Period.

More Choices, Greater Competition -- Health Insurance Exchange

The proposal creates a new insurance marketplace that lets individuals and families without coverage and small business owners pool their resources and increase their buying power to make insurance more affordable.  Private insurance companies will compete for business based on cost and quality and they’ll have to follow common-sense rules of the road that rein in the worst insurance industry abuses.  

For the first time ever, Americans who lose their jobs, change jobs, move out of state, get divorced or get sick will have the peace of mind and security of knowing they will always have quality affordable health care they can rely on.  For Americans who get coverage through their job but can’t afford it, the exchange will give them new choices.  For small business owners, the exchange will level the playing field with big businesses and lower their costs.

Same Coverage Choices as Members of Congress

Every member of Congress will be required to purchase their insurance from the new health insurance exchange.

Making Coverage and Care More Affordable for Families

The Act will provide the largest tax cut for health care in American history.  Millions of families will receive hundreds of billions of dollars in tax credits to help them pay for insurance in the new exchanges.  This tax relief for working families will make insurance more affordable for those who can’t get it through work or whose employer insurance is too expensive.   

The Act also provides financial assistance to reduce out-of-pocket costs for moderate and low-income eligible Americans.

Tax Relief and Incentives for Small Business Owners

The proposal will also provide tens of billions in tax credits for small business owners to make insurance coverage more affordable. Small businesses will also have a new option of purchasing insurance through the exchanges. By pooling their resources in the new insurance marketplace, small business owners will lower their costs and have the same choices that big corporations and unions enjoy.

Keeping Insurance Companies Honest

Some health insurance reforms will begin immediately, but others will phase in as more Americans obtain coverage.  As more Americans buy insurance, insurance companies will have to abide by new consumer protections that will keep them honest and rein in some of the worst abuses of the insurance industry.  

Once the exchanges are up and running, insurance companies will be banned from:

Denying coverage or setting premiums based of your health status, medical history, genetic information or evidence of domestic violence;

Setting different premiums based on gender or salary;

Dropping coverage when someone gets sick;

Refusing to renew someone’s coverage because of an illness.

Limiting Out-Of Pocket Expenses:

To prevent insurance companies from discriminating against older Americans, the Act requires insurance companies to limit the amount they can charge based on age.  

To make sure that insurance is there when you need it, they must cover minimum benefits that every American can count on.  

And the Act helps prevent an illness from ruining a family financially by limiting out-of-pocket expenses that individuals and families have to pay for treatments they need.  

Shared Responsibility

The Act asks everyone to take responsibility for improving America’s health care.  In order to lower costs for all Americans and extend coverage to people with pre-existing conditions, all Americans who can afford to purchase insurance will be asked to. 

Those who are  uninsured add over one thousand dollars to the average premium of families with insurance.  This added cost covers emergency room care for Americans without insurance.  To help bring costs under control for all Americans and cover all Americans with pre-existing conditions, all Americans who can afford insurance will have the responsibility to purchase it.

"Hardship" Waiver

Individuals and families are eligible for a waiver from the requirement to purchase health insurance if coverage is unaffordable – if premiums exceed 8 percent of income.

In addition, exceptions are made for religious objectors, taxpayers with incomes below the tax-filing threshold ($9,350 for a single or $18,700 for a married couple in 2009), and Indian tribe members.

Americans under the age of 30 and other Americans who are exempt from the requirement to purchase insurance are eligible for a low-cost catastrophic plan that covers serious illness and injury.

Employer Responsibility 

Larger companies that offer coverage must automatically enroll any new eligible employees. Any company with 50 or more employees that does not offer coverage and whose employees access taxpayer supported health programs will be required to help offset the costs to the American taxpayer.

No small business owner will be required to enroll an employee or to offset health costs to taxpayers.  As mentioned earlier, small business owners will receive incentives to cover employees through tax credits and enjoy greater buying power and insurance choices in the exchanges.