Cantwell Says Health Care Provisions Beginning Today Bring Real Help to Real People

Press Release

Major benefits for Washingtonians: 'Increasing access to health care, making it more affordable and controlling costs is not a pledge, it is now the law'

Key provisions in the health care reform law taking effect today will bring much-needed help to individuals and small businesses beset by rising health insurance costs, U.S. Senator Maria Cantwell (D-WA) said at a news conference with Health and Human Services Secretary Kathleen Sebelius. The provisions that take effect today, on the six-month anniversary of the signing into law of the Affordable Care Act, will hold insurance companies accountable, lower health care costs, guarantee more health care choices, and enhance the quality of health care. Beginning today, insurers will be barred from placing lifetime limits on coverage and from cancelling coverage retroactively. Insurance plans will be required to cover preventative care at no additional cost to consumers. And young adults will be able to stay on their parents' insurance until age 26, among other important benefits.

"We're here today because increasing access to health care and making it more affordable, and controlling costs, is not a pledge, it is now the law," Senator Cantwell said. "There are many parents across the nation who are celebrating today because they don't have to worry if their children up to 26 years old will have coverage because they can remain under their insurance. This law is also going to rebalance away from institutional nursing home care to home and community-based care, which has shown to provide up to 70 percent savings and better outcomes than institutional nursing home care. With the implementation of this law, we really are starting the process of controlling health care costs and increasing access to care."

Joining Cantwell and Sebelius at the news conference in the U.S. Capitol were Senate HELP Committee Chairman Tom Harkin (D-IA) and Senate HELP Committee Senior Member Christopher Dodd (D-CT). Oregon small business owner Jim Houser, speaking at the news conference, talked of the benefits to his small business of health care cost savings. And Paul Brayshaw of Falls Church, Virginia, who suffers from hemophilia, said the end to lifetime limits on health care claims would protect him from financial disaster. Watch a video of Senator Cantwell's remarks at today's press conference.

"Today is the day that the worst abuses of insurance companies come to an end in America," Secretary Sebelius said at today's press conference. "And it's long overdue for millions of Americans who now will have some peace of mind. I want to acknowledge that the leadership here in the Senate was an instrumental part of why millions of Americans starting today will see some of the worst practices come to an end and will have the benefits of health insurance that they've never had before."

Today, the following provisions go into effect:

* Eliminating Pre-Existing Condition Exclusions for Children: Bars health insurance companies from placing pre-existing condition exclusions on coverage of children through age 18 for any new plans.
* Extending Coverage to Young Adults: Plans that provide dependent coverage to children must now make that coverage available until the child turns age 26. This provision could allow up to 20,500 Washington youths to retain coverage through their parents' health insurance.
* Abolishing Lifetime Limits: Prohibits insurance companies from imposing lifetime limits on benefits so that the 3.8 million Washington residents with private insurance coverage will never have to worry about their coverage running out.
* Covering Preventive Health Services: All new plans must provide FREE coverage for over 100 preventive services, including mammograms for women over age 40, screenings for colorectal cancer for those over age 50, depression, smoking cessation programs, and autism for children age 18 months to 24 months. 879,000 Medicare beneficiaries in Washington will also now receive free preventative services and other benefits.
* Improving the Appeals Process: Requires that new group or individual health plans offer an effective process for appealing coverage decisions, such as refusals to cover procedures partially or at all. Consumers first file an internal appeal with their insurers, but if they are not satisfied they can appeal to an impartial reviewer.
* Prohibiting Rescissions: Prohibits the abusive practice whereby health insurance companies rescind existing health insurance policies when a person gets sick as a way of avoiding covering the costs of enrollees' health care needs. Under this provision, 3.8 million Washingtonians are now protected from rescissions.
* Enhancing Ability to Choose Your Own Doctor: Expands consumer choice by ending the insurance company practice of limiting a consumer's ability to choose a doctor in her own insurer network.
* Ending Restrictions on Emergency Room Care: For new plans, consumers can no longer be charged more for emergency services obtained out-of-network.

Cantwell also hailed the wins for seniors, discussing Medicare Advantage and long-term care wins: "The Centers of Medicare and Medicaid got bargaining power in this legislation. Therefore, costs will be lower next year for those seniors enrolled in Medicare Advantage plans, which insure about one-fourth of all beneficiaries. So premiums for seniors will not be going up for the same -- or better -- benefits. They will be lower. This is further evidence that this new law is making the health care system more efficient and passing those savings onto consumers."

Cantwell, a member of the Senate Finance Committee that played a major role in crafting the law, authored several key provisions including a new Medicare reimbursement formula that rewards quality care. She also fought to include $1.1 billion in the new law to help seniors in need of long-term care who prefer to remain in their homes.

In 2011, Cantwell's Balancing Incentives Payment Program (BIPP) will take effect. The BIPP provides financial assistance of up to $3 million to states to switch from institutional nursing home care to home and community-based services, which are overwhelmingly preferred by seniors and the disabled. Additionally, in 2014, the new law will provide the same income protections to spouses of those who opt for home and community-based services as those given to the spouses of those who opt for institutional nursing home care, so that people won't be forced in to the poorhouse in order to qualify for long-term care through Medicare.

Parts of the Affordable Care Act will continue taking effect into 2014. For more information about the health care implementation, please see this timeline on HealthCare.gov/. http://www.healthcare.gov/law/timeline/index.html

For more information on the provisions taking effect today, see the Democratic Policy Committee's "Six Months of Health Reform and a Patient's Bill of Rights" fact sheet. http://dpc.senate.gov/dpcdoc.cfm?doc_name=fs-111-2-147

High quality video and audio of Senator Cantwell's remarks at today's press conference available upon request.

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