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Senate Passes Historic Legislation to Reform Health Insurance to Save Lives, Save Money, and Save Jobs

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Location: Washington, DC

Senate Passes Historic Legislation to Reform Health Insurance to Save Lives, Save Money, and Save Jobs

U.S. Senator Debbie Stabenow announced Senate passage of the Patient Protection and Affordable Care Act of 2009, by a vote of 60 to 39. Next, the bill will move to a joint Senate and House conference committee. Then the Senate and House will vote on the complete legislation before it is sent to the President to be signed into law.

"This is a historic day for our nation. We have passed legislation that will provide health insurance reforms that save lives, save money, and save jobs," said Stabenow. "The Patient Protection and Affordable Care Act provides over $430 billion in tax cuts for small businesses and individuals to help pay for health insurance. These tax cuts will reduce health care costs for small businesses and free up billions of dollars for large employers that can be reinvested in our economy to save 3.5 million jobs."

As a member of the Senate Finance Committee, Stabenow championed provisions in the legislation to stop insurance company abuses, lower costs for businesses and families, and strengthen Medicare for seniors. Without these reforms, businesses would have seen their health care costs more than double over the next 10 years and an estimated 1.3 million Michigan residents would be without health insurance. The Patient Protection and Affordable Care Act makes sure that people at every stage of life from pre-natal care, to young adulthood, through the working years, and into retirement have quality, affordable health insurance coverage. According to the nonpartisan Congressional Budget Office, the legislation is fully paid for and reduces the deficit.

"I got my start in public service fighting to save a nursing home in my community. I have been working on health care issues ever since," said Stabenow. "14,000 people woke up this morning with health insurance but will go to bed without it. This happens every day in America. This legislation will help them and thousands of others ensure that if they lose their jobs, their family won't lose their health care."

The Patient Protection and Affordable Care Act is supported by well-respected groups in the medical and business community including the American Medical Association, AARP, the American Heart Association, the American Hospital Association, the American Nurses Association, the Business Roundtable, the Small Business Majority, and Families USA.

The Patient Protection and Affordable Care Act:

Creates a Health Care "Bill of Rights"

As the new reforms are implemented, every American purchasing a policy will benefit from a health care "bill of rights," ending business as usual for insurance companies. Senator Stabenow has fought for this Bill of Rights since being elected to the U.S. Senate. She was also a leading voice in ending gender discrimination by insurance companies and making sure companies offer women the care they need.

The new reforms and protections include provisions that address:

* Pre-existing Conditions - Prohibits insurance companies from denying coverage or increasing premiums for those with pre-existing conditions and from dropping coverage for those who get sick.

* Unfair Practices and Limits on Coverage - Stops insurance companies from charging different premium rates based on gender, health status, family history or occupation. Eliminates excessive out-of-pocket costs. Stops insurance companies from imposing limits on how much coverage you can use per year or during your lifetime. Also requires companies to provide clear, easily-comparable information on benefits and costs.

* Coverage for Young Adults - Allows young adults to stay on their parents' health insurance plan until the age of 26.

* Basic Health Services - Requires health insurance plans to cover basic services like maternity care, emergency services, hospitalization, physician services, diagnostic imaging and screenings (x-rays, mammograms), prescription drugs , and mental health services .

* Excessive Rates and Insurance Company Profits - Penalizes insurance companies that increase premiums. Any company that raises their rates excessively will be prevented from participating in the new exchanges, which will cover uninsured individuals and small businesses, creating a powerful incentive to keep premiums affordable. Requires health insurance companies to spend more of their premium revenues on medical services and quality improvement, and less on administrative costs and profits-or else pay refunds to policyholders. Reduces costs by eliminating tax deductions for health insurance companies that give their executives huge salaries.

Makes Comprehensive Health Insurance Affordable for Families and Small Businesses

* Strengthens Current Employer-Based System - Helps Americans who currently get their health insurance through their employer to keep it. The bill lowers the cost of employer-based health insurance by eliminating the estimated $1,100 "hidden tax" that families pay because their medical providers are caring for the uninsured. Providers will focus on real health care, not "sick care" by rewarding higher quality care rather than the quantity of procedures. It also cuts down on waste, fraud, and abuse throughout the entire health care system.

* Creates Small Business Health Care Tax Cuts - Creates $40 billion in tax cuts for small businesses that offer health insurance to their employees. Senator Stabenow authored a provision to ensure small businesses have immediate access to these tax cuts. While small businesses make up 75 percent of all Michigan businesses, only 44 percent of them offered coverage in 2008. Over 109,000 small businesses in Michigan and 3.6 million nationwide could be eligible for these cuts. The tax cut will be available to employers with fewer than 25 employees and average annual wages less than $50,000 to purchase health insurance for their employees. To be eligible for the cut, employers must contribute up to 50 percent of the total premium cost.

* Creates Health Care Tax Cuts - Helps more low and middle-class families and individuals afford health insurance by providing tax cuts to purchase insurance and caps on out-of-pocket expenses. Senator Stabenow led the effort to ensure that no eligible family will have to pay more than 9.8 percent of their income on health insurance premiums. Over 790,000 Michigan residents could receive these tax cuts. Individuals making up to $43,320, or $88,200 for a family of four, will be eligible for the tax cuts. Eligible individuals will also receive assistance for out-of-pocket expenses.

* Establishes State Health Insurance Exchanges for the Uninsured - Insurance "exchanges" will provide an easy, efficient place for consumers and small businesses without insurance to make real price comparisons and purchase health insurance plans. These exchanges will make insurance more affordable for Michigan residents by pooling individuals and small businesses, much like large companies do with their employees. Americans will be able to choose from current private insurance company plans, non-profit plans, or consumer-operated and oriented plans called CO-OPs. Individuals will be able to keep these plans no matter where they work or whether they lose or change their job offering real security and stability. These exchanges will give Americans access to the same kind of insurance choices Members of Congress have, and all Members of Congress will now be required to buy their health insurance through the same exchanges that people in their own states will use. Senator Stabenow championed a provision to make sure dental-only insurance plans can be offered in the new health insurance exchange , so that if a family likes their dental coverage, they can keep it.

* Strengthens Mental Health Coverage - Senator Stabenow authored a provision to ensure that the new exchange plans comply with federal "parity" laws to provide coverage for mental health services that is equivalent for physical health services. She also sponsored a provision to create a national network of up to 30 Centers of Excellence for the treatment of depression disorders modeled after the excellent work at the University of Michigan. Through the collaboration of university and community-based research and services, these centers will increase access to the best possible treatment for depression and bipolar disorders.

* Supports Early Retiree Health Coverage - Senator Stabenow co-authored a provision to provide $5 billion in financial assistance to employer health plans that cover early retirees and their families. In Michigan, an estimated 192,000 people have early retiree coverage through their former employers.

* Creates State Basic Insurance Plans - Senator Stabenow co-authored a provision that allows states to create affordable Basic Health Plans for lower-income working families and individuals. States will be able to negotiate for high-quality, lower-cost coverage options to meet the needs of individuals and families in their states. Eligible individuals will have the option of using this plan instead of relying on tax cuts to pay for premiums purchased through the exchange. States will then receive 95% of the value of those tax cuts to offset the costs of the program.

* Makes Medicaid a True Safety Net - Increases coverage and improves access to the Medicaid program that provides vital health care to millions of vulnerable Americans. It will continue the successful Children's Health Insurance Program, which covers nearly 7 million children. Senator Stabenow sponsored a provision that makes sure children covered by Children's Health Insurance Program continue to receive quality coverage as the number of enrollees increases.

Strengthens and Protects Medicare for Our Seniors

* Strengthens Medicare for the Future - Senator Stabenow successfully passed an amendment prohibiting any reduction or elimination of benefits guaranteed to participants in Medicare Advantage plans such as hospital stays, access to doctors, home health, nursing homes, and prescription drug coverage. This will help 1.6 million seniors in Michigan who rely on Medicare for their health care needs.

* Lowers Prescription Drug Costs - Reduces the cost of brand-name prescription drugs for seniors and disabled Americans in Medicare Part D by closing the "doughnut hole" over time. The "doughnut hole" is a gap in Medicare prescription drug coverage that impacts over 270,000 Michigan seniors. Senator Stabenow authored a provision to give seniors enrolled in Medicare Part D more opportunities to sample affordable generic medicines free of charge.

* Makes Premiums More Affordable - Lowers seniors' Medicare premiums by $30 billion over the next 10 years by focusing on prevention, increasing efficiency, and making the program more cost-effective. It also eliminates wasteful spending, including substantial overpayments to private insurance companies for Medicare Advantage plans. All seniors--regardless of whether they are in a Medicare Advantage plan or traditional Medicare--pay a hidden tax to subsidize that program. This bill will put the savings back into their pockets.

* Provides Free Preventive Care - Eliminates all out-of-pocket costs for recommended preventive care and screenings such as colonoscopies and mammograms. Michigan's 1.6 million seniors will receive free preventive services. It will also provide seniors with free annual visits under Medicare. These visits will give seniors a personalized prevention plan to address health risks and chronic health problems.

* Coordinates Better Care for Seniors - Encourages doctors and other health care providers to work together to better serve a patient's needs and to reduce repeated, sometimes unnecessary tests. Health care providers will receive incentives to coordinate care across a range of settings- from the hospital to the home- to ensure the best outcomes for seniors and people with disabilities. Senator Stabenow co-authored a provision to protect our nation's seniors from abuse by assisting nursing homes and long-term care facilities with employee background checks.

* Protects Rural Health Care - Extends Medicare provisions that protect access to inpatient, outpatient, ambulance, and lab services in rural areas.

Investing in Our Workforce and Improving Access to Services

Investing in Our Nation's Healthcare Workforce - The Patient Protection and Affordable Care Act will address shortages in primary care and other providers by making necessary investments in our nation's health care workforce. It will invest in and improve upon grants, scholarship, and loan repayment programs in fields such as primary care, dentistry, pediatrics, nursing, and mental health. It will increase funding for the National Health Service Corps, a program which provides scholarships and loan repayments to encourage primary care providers to practice in underserved areas. Senator Stabenow authored a provision to support the training of nurses through a new, federally-funded partnership between Medicare and nursing schools, hospitals and community health centers .

Improving Access to Health Care Services - The Patient Protection and Affordable Care Act provides additional funding for federally qualified health centers- more commonly called community health centers- currently serving over 500,000 patients at 160 sites across Michigan. Senator Stabenow has been a champion for community health centers throughout her career, having worked to double the funding for these critical health centers since 2001 . The Patient Protection and Affordable Care Act includes a $10 billion fund to help pay for operations, workforce, and construction for new sites and to renovate and expand existing centers. It also includes a provision, co-authored by Senator Stabenow, to make sure the new exchange plans pay these centers fairly when their members take advantage of the services provided by community health centers. Additionally, Stabenow included a provision to provide competitive grants for more school-based health centers so more children can receive the care they need.


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