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Mr. CARDIN. Madam President, I have taken the floor before to talk about the health care reform bill, to comment on the Supreme Court decision, which I believe history will show was clearly the right decision. It was the right decision on the law giving the Congress the power to legislate in an area where there is a national need, as the legislature did in the 1930s with Social Security and in the 1960s with Medicare.
The health reform proposals that were adopted by Congress are within the purview of the legislative branch of government. The Supreme Court upheld that right in that decision. I also said it was the right decision because it allows us to move forward on a path toward universal coverage, where all Americans are guaranteed access to affordable health care. America will now join all of the other industrial nations of the world to say health care is a right, not a privilege.
The legislation that was passed, the health reform bill, has already helped American families. Let me talk about an area--I could talk about many--about what it has done in protecting our consumers against the practices, the arbitrary practices of health insurance companies. We already are seeing that it is in effect where families are being able to take advantage of the fact there are no longer any lifetime caps on health insurance policies. By 2014, we will eliminate annual caps on benefits on health insurance plans. We already have seen for our children the elimination of preexisting conditions, so our children can get policies without having restrictions on what is covered and what is not covered. By 2014 we will see that the preexisting conditions for everyone will no longer be an obstacle to full insurance coverage. That is particularly important for women, where we know at times they have been held to a preexisting condition because of a pregnancy or being the victim of domestic violence.
We have seen discrimination in premiums against women. That no longer will be the case. I could talk about many Marylanders who are happy today because they can stay on their parents' insurance policies--the fact that they are over the age of 21. They can now stay on that policy until age 26.
I want to talk about one other aspect of this law that may not be quite as familiar to our constituents. This provision will take effect on August 1, but we already are seeing the benefits. What I am talking about is the 80-20 rule, where health insurance companies must give value for the premium dollar to the beneficiary. At least 80 percent of the dollars we pay for premiums must go for benefits.
Let me share with you a letter I received from one of my constituents. She wrote:
I recently had a pleasant surprise. ..... two checks from my health care [insurer] that were rebates on premiums paid. I am someone who has to buy individual health coverage and have been doing so for the last 8 years. The premiums are high and the deductible is high--so I am essentially paying a high price for catastrophic coverage while still paying for individual doctor visits, prescriptions, etc. It is frustrating, but the choices are limited and expensive for individual coverage, and you don't really know how good your coverage is because you don't use it unless you have a major medical event. My premiums go up every year despite the fact that I don't file claims. This month I received a check in the amount of $139 from my current [insurer] and over $300 from a previous [insurer]. Both checks were rebates as a result of the new health care act.
I did not realize it, but the act requires insurance companies to use 80% of the premiums they collect on health care costs. ..... and neither of them hit that percentage and were thus required to provide a refund. Wonderful! The bill is so complicated that I do not understand a great deal of it--but am very pleased with this aspect which seems to go a long way in helping keep health care costs reasonable and prevent consumers from being gouged ..... So thanks to the Senator and all who helped with this health care act.
I bring this to my colleagues' attention, because there are going to be millions of American who are going to be getting rebate checks, and some are going to start scratching their heads, wondering where it is coming from. They are going to be saying: Gee, I guess I made a mistake in the premiums I paid. They are returning them. They are getting those checks because of the passage of the health reform bill, and the provision in the health reform bill that requires insurance companies to give value for the premium dollars we pay.
That protection is now the law of the land. Thanks to the acts of Congress and President Obama, and the Supreme Court upholding the law, those rebates are going to be received. The number of people in the country is 12.8 million Americans who are going to get rebate checks worth about $1.1 billion. Average rebate: $151. That is real money for people who are struggling with their health care needs.
I am proud that in the State of Maryland, there is going to be $27 million made available to 141,000 Marylanders, with an average rebate of $340 for those who get rebates in my State. Let me break this down a little bit further. In the individual market, like the person I received the letter from, the rebates for the people in Maryland will actually average a higher amount. They will average $496. I think that speaks to the fact that insurance companies have hedged their bets in the individual market. They tell us that, you know, we have got to charge a lot more because we do not know what we are getting, when in reality they are making a lot more money in the individual market.
So for the people of Maryland, 38,000 of them are going to get, on average, close to $500 in rebates thanks to the passage of the Affordable Care Act, thanks to the passage of health reform, and thanks to the Supreme Court upholding our right to do it.
The same thing is true in the small group markets where we find that there will be 3.3 million Americans getting rebate checks who are in the small group markets. These are the markets, of course, in which again the options were not as great, more difficult, because of insurance carriers not being as anxious to insure people in small group markets as they are in the larger markets.
The average rebate per family will be $174. In Maryland that number again is higher, $310 for the 13,000 people in Maryland. It also applies to those in the large group markets. These are the large plans. They also are going to see rebates because the insurance carriers charged excessive
fees. And they are going to get premium dollar rebates. Some 5.3 million Americans in these large plans will see rebates that average $135. In my State of Maryland, it will be 89,000 people, with rebates averaging $268 a family. These are 1-year numbers. These continue every year. So let me tell the people of Maryland and the people of this country what you can expect. You might get a check that will be delivered to you in the mail. It will be a rebate check. That is as a result of the passage of the health reform bill. You might also see a deposit into the account that automatically pays for your health premiums, because the insurance carrier can make a direct deposit into the accounts which are paying for these premiums.
It is possible you might find a reduction in future premiums. They can use it to reduce your future premiums, but they have to let you know that, so you realize you are getting the rebate, but it is being applied against future premiums. Or if the employer is paying the premiums, the rebates will go to the employer, but the employer must use it to benefit your plan. They cannot use it for themselves. It is used to help again the beneficiary. You will get notice of that.
My purpose again is to make it clear that you would not have gotten these rebates but for the protections that are in the Affordable Care Act. I know my colleague from Vermont and I have been on the floor many times pointing out that all Americans, not just those who do not have insurance today, not just those who might have been discriminated against because of preexisting conditions, not only that 24-year-old who is now on her parent's policy, but all Americans have benefited from the Affordable Care Act, the protections that are in it.
Now millions who thought they were being treated unfairly by their insurance companies are going to be able to get rebates because of excessive premiums. The rule works in combination with another provision of the law that requires rate review to ensure premium increases are reasonable. In other words, we have put into the law protections against unreasonable increases in your premiums. Insurance companies are now required to justify any premium increases of 10 percent or higher. Most States now have the authority to determine whether these increases are excessive, while HHS reviews rates in States that do not operate under effective rate review programs.
That is how federalism should work. States have an opportunity to act. If they do not have adequate review, we have national backup and protection to make sure the rate reviews are being handled in the appropriate way. So as our constituents start to get the benefits--another benefit of the health reform bill, and there are many more that are starting to take effect, and we will hear about some more of those next week, on August 1--I wanted my constituents of Maryland and my friends around the Nation to know we have provided that you get value for the premium dollar you pay for your health insurance.
We back that up with enforcement, so if there are excessive premiums being charged, the insurance carriers must rebate those premiums to you. Millions of Americans will get the benefit, starting now. We are pleased that this type of protection is in the Affordable Care Act.
I yield the floor and I suggest the absence of a quorum.
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