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Rep. Foster Announces Health Insurance Reform Provisions That Will Immediately Go Into Effect

Press Release

Location: Washington, DC

Today, Congressman Bill Foster (IL-14) announced provisions of the Patient Protection and Affordable Care act that will go into effect today after attending the White House Signing Ceremony to witness President Barack Obama sign the legislation into law.

"Today, now that the Patient Protection and Affordable Care Act is law, key provisions of this health insurance reform will go into effect, and families and small businesses in the 14th District will begin to benefit," said Foster. "For example, seniors will start to see the Medicare Part D "donut hole' close, small businesses can receive tax credits to make employee coverage more affordable and young adults will be able to stay on their family insurance plans until the age of 26."

The Senate is scheduled to begin consideration of the legislation containing the improvements to the Patient Protection and Affordable Care Act today. This legislation passed the House on Sunday evening.

"I was proud to support a package of changes in the House that would improve the Senate health insurance reform bill, and I urge the Senate to quickly pass these improvements," said Foster.

The following benefits will be available in the first year after enactment (this year) of the Patient Protection and Affordable Care Act. (Note: This list reflects what is in the Senate bill, which is now law, not the reconciliation language, which is currently pending in the Senate.)

* The Medicare Part D "donut hole" will begin to close by raising the ceiling on the initial coverage period by $500 in 2010. It will also guarantee 50 percent price discounts on brand-name drugs and biologics purchased by low and middle-income beneficiaries in the coverage gap.

* Small businesses that choose to offer coverage will be eligible for tax credits of up to 50 percent of premiums to make employee coverage more affordable.

* Young adults will be allowed to stay on family policies until age 26.

* $5 billion is provided in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions. Coverage under this program will continue until new Exchanges are operational.

* Early retirees will have immediate access to re-insurance for employer health plans providing coverage for them -- this re-insurance will help protect coverage while reducing premiums for employers and retirees.

* Insurance companies can no longer impose lifetime limits on benefits, and will restrict the use of annual limits.

* Insurance companies cannot rescind insurance when claims are filed, except in cases of fraud or intentional misrepresentation of material fact.

* Group health plans are prohibited from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees.

* Standards for insurance overhead will be established to ensure that premiums are spent on health benefits. It will also require public disclosure of overhead and benefit spending and require premium rebates for insurers that exceed established standards for overhead expenses.

* A new Web site will be created to provide information on and facilitate informed consumer choice of insurance options.

* Assistance will be provided to States who establish offices of health insurance consumer assistance or health insurance ombudsman programs to assist individuals with the filing of complaints and appeals, enrollment in a health plan, and, eventually, to assist consumers with resolving problems with tax credit eligibility.

* All health plans will implement an effective appeals process for appeals of coverage determinations and claims, and will adopt uniform descriptions of plan benefits and appeals procedures and will use uniform forms and claims processing processes to reduce costs.

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