Category Archives: The Affordable Care Act

Pallone: One Million Additional Young Adults Have Health Coverage Because of the Affordable Care Act

FOR IMMEDIATE RELEASE: September 21, 2011

Washington, D.C. – Congressman Frank Pallone, Jr. Wednesday announced that new data released from the Centers for Disease Control and Prevention shows that the Affordable Care Act has helped one million additional young adults to get health insurance.

“The Affordable Care Act is already improving the lives of America’s families, including one million young people who now enjoy health coverage,” Pallone said. “Young adults 18-25 are most likely to go without health insurance, putting them one emergency room visit away from thousands of dollars in medical bills that would burden them for years to come.”

Specifically, data from the National Health Interview Survey shows that in the first quarter of 2011, the percentage of adults between the ages of 19 and 25 with health insurance increased by 3.5 percentage points, representing approximately 1 million additional young adults with insurance coverage compared to a year ago.

The Affordable Care Act allows most young adults to remain on their parents’ health insurance plans until their 26th birthday.

The results from the CDC were also confirmed by a Gallup survey released today. As Gallup concluded, “The provision of the Affordable Care Act that allows children up to the age of 26 to remain on their parents’ plans appears to be having an immediate effect on the number of Americans who report they have health insurance. Since it went into effect in September 2010, the percentage of 18- to 25-year-olds who report being uninsured has significantly declined by four percentage points.”

The under 26 provision is included in the Patient’s Bill of Rights and in addition to covering young people provides other significant patient protections including prohibiting insurers from dropping people from coverage when they get sick, placing lifetime limits on coverage, and denying coverage to children with pre-existing conditions. All of these reforms are already helping Americans today and must be maintained.

Last week Pallone decried Republican efforts to repeal the Patient’s Bill of Rights.

“This is one of many examples of how health care reform is working for New Jerseyans. Without the Affordable Care Act, thousands of young people in New Jersey would go without health insurance. Their health is too valuable for me to allow them to lose the consumer protections they now enjoy.”

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Filed under Congressman Frank Pallone, Gallup poll, heath care reform, Patient Bill of Rights, press release, The Affordable Care Act, young adults

Rush Holt: New Evidence Could Shape The Health Care Debate

By Congressman Rush Holt (D-NJ 12)

I’ve always believed that the health care debate should be based on evidence, not ideology or demagoguery. Last week, the debate gained important new evidence thanks to an unprecedented study from Oregon.

In 2008, Oregon policymakers wanted to expand the state’s Medicaid program, but they lacked the funding needed to cover all 90,000 applicants. They decided that the fairest way to distribute their limited funds was through a lottery.

When researchers compared the 10,000 individuals who “won” the health care lottery to those who lost, they found dramatic differences in outcomes between these well-matched populations. Individuals covered by Medicaid were 35 percent more likely to see a doctor. They also felt better: they were more likely to rate their health as good or excellent and less likely to say that their health had deteriorated over the previous year.

Would you be surprised to learn that insurance coverage improved not only people’s physical health but also their financial well-being? People covered by Medicaid were 25 percent less likely to have an unpaid bill go to collection, and they were 40 percent less likely to borrow money or skip a bill payment because of medical expenses.

Although Oregon’s method of handling its budget limitations was novel, it dramatized an everyday phenomenon: a health care “lottery” in which some people gain health coverage while others are left to fend for themselves. Two similar Americans who work equally hard and are equally deserving of good health may experience very different outcomes, based only on chance factors: whether they live in a city with a strong job market, whether their employer provides health insurance, or whether their state supports its low-income workers through Medicaid.

Right now, 50 million Americans – including 8 million children – are losing the health care lottery. They are suffering all of the ills that the Oregon study revealed: poorer health, poorer access to doctors, and poorer financial security.

That situation is improving as the new Affordable Care law takes effect and helps 33 million Americans gain access to health insurance. Policymakers now have hard evidence to support what many of us argued when we enacted that law: insured Americans live healthier, happier, and more secure lives.

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Filed under Congressman Rush Holt, health care debate, Medicaid, Medicare, Newsletter, Oregon study, The Affordable Care Act

>Right-Wing Blogosphere Downplays Conservative Judge’s Opinion Upholding Health Care Reform Law

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If government can mandate auto insurance, homeowners insurance, flood insurance….Then it only makes sense that government can mandate health insurance. I believe that the Sixth Circuit Court and Judge Jeffery Sutton got it right.

From MediaMatters.org
July 01, 2011

After the U.S. Court of Appeals for the Sixth Circuit upheld the constitutionality of the individual mandate provision of the Affordable Care Act, many right-wing bloggers criticized the decision or downplayed its significance. But one of the judges who voted to uphold the statute was Jeffrey Sutton, an appointee of President George W. Bush who was such a proponent of states’ rights during his legal career that he once proclaimed that he became involved in states’ rights issues because “I really believe in this federalism stuff.”

By A 2-1 Vote, The Sixth Circuit Upholds The Constitutionality Of The Individual Mandate. In Thomas More Law Center v. Obama, the Sixth Circuit held by a vote of 2 to 1 that the provision of the Affordable Care Act mandating that individuals purchase health insurance does not violate the Constitution. The majority consisted of Sixth Circuit judges Boyce Martin and Jeffrey Sutton. District Judge James Graham, acting as a Sixth Circuit judge in this case, dissented. [Thomas More Law Center v. Obama, 6/29/11]


Read more HERE

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Filed under health care reform, Judge Jeffery Sutton, Media Matters, President George W. Bush, Right-wing bloggers, sixth circuit court, The Affordable Care Act, Thomas More Law Center v. Obama

>As A Matter Of Fact…A fair exchange: Consumer driven health insurance

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May 9th, 2011 | Published in NJPP Blog: As a Matter of Fact …

One of the most important provisions of the Patient Protection and Affordable Care Act (ACA) is the establishment in every state of a health insurance market place, called an “exchange.”

These exchanges will allow individuals and small businesses to easily find and compare options for high quality, comprehensive health insurance. If done properly, the exchanges will increase competition in the insurance market and, in turn, lower the cost of insurance for nearly 800,000 uninsured New Jerseyans who must find coverage under the terms of the Affordable Care Act. The exchanges will also make available information about services and subsidies available to low and moderate income families.

While the federal government has set certain standards for exchanges, the Affordable Care Act offers each state broad flexibility to design its own exchange. The federal government will provide funding to operate exchanges until January 2015, when all of the exchanges must become self-sustaining. If the state has not established an exchange by then, the federal government will establish one for the state.

That process of creating an exchange has already begun in New Jersey.

The state, through its Working Group on the Patient Protection & Affordable Care Act and under a federal grant, has contracted with the Rutgers University Center for State Health Policy to seek input on priorities the state should consider for the implementation of key provisions of the ACA. As part of its information gathering effort, CSHP is asking interested parties to participate in a web-based survey on the design of an exchange for New Jersey by May 11. The CHSP’s report is expected to be made public later this year.

The Legislature has also set to work. The state Senate held an informational hearing last month and three bills have been introduced to establish the basic structure of an exchange (S2553, S1288 and S2597). Much of the public discussion of the details of the final legislation will take place in the Legislature’s health and insurance committees.

One of the key issues up for discussion is the extent to which the exchanges represent the interests of consumers.

For example, the exchange can be a wide-open marketplace where all insurers may participate, regardless of how much they charge or whether they meet minimal standards to protect consumers. Because the Affordable Care Act requires everyone who is uninsured to purchase insurance, that unregulated approach might leave consumers vulnerable. Alternately, the exchange could operate as an “active purchaser.” In that role, the exchange would only allow insurers to participate if they could demonstrate that their rates are reasonable and they meet other standards aimed at protecting consumers. A similar issue involves the requirements for members of the board that will ultimately oversee the exchange. Most boards are expected to be small, so decision-making will be more manageable. That makes the composition of the board a key point. Some states are establishing very strong requirements to prohibit conflicts of interest for members of the board while others go further and ban insurers, brokers and other representatives of the health care industry. Because of the importance of the exchange to consumers, the NJ for Health Care Coalition developed a set of principles recently that should be used as a guide in finalizing any legislation on exchanges. The coalition represents a broad alliance of 68 health care, consumer and social justice organizations (including NJPP) with more than two million members. It believes the public should understand the choices being made and should actively support the principles as established by the coalition to ensure that the health care exchange in New Jersey represents consumers over special interests.

Following are the principles as adopted by the coalition:

Public Interest Mission – The New Jersey Exchange should be established in the public interest, for the benefit of the people and businesses who obtain health insurance coverage for themselves, their families and their employees. It should empower consumers by giving them the information and tools they need to make sound insurance choices. The Exchange should work to reduce the number of uninsured, improve health care quality, eliminate health disparities, control costs, and ensure access to affordable, quality, accountable care across the state.

Independent Public Exchange – The Exchange should be a distinct legal public entity that is independent of other units of state government. It should be able to perform inherently governmental functions like determining income eligibility, coordinating with other state agencies and programs, and adopt rules and policies governing health insurance plan participation. The Exchange must be transparent and subject to open meetings and public disclosure laws.

Qualified, Pro-Consumer Governing Board – Consumer representatives should comprise a majority of the board. All board members must have expertise in one or more of the following areas: consumer advocacy, individual health care coverage, small employer health care coverage, health benefits plan administration and health care finance. The governing board may not include members who are affiliated with the health care industry.

Negotiate on Behalf of Consumers – The exchange must be given the authority to act as an “active purchaser.” This means the Exchange should use its large pool of consumers to negotiate, as large groups do, for the best premiums and plans. The Exchange must use this leverage to demand quality, responsiveness to consumer concerns, reasonable rates, efficient plan designs, robust provider networks and comprehensive benefits.

Full Integration with Medicaid and NJ FamilyCare – To promote seamlessness in the application process and continuity in coverage, the Exchange plans must be fully coordinated and integrated with Medicaid and NJ FamilyCare. Plans that are available in Medicaid and NJ FamilyCare must also be available in the Exchange.

Consumer Friendly – The Exchange must be easily accessible to all consumers and small businesses, use plain, easy-to-understand language and meet established standards for language, literacy and cultural competency. The Exchange must adopt a “no wrong door” approach, meaning people can access insurance through the exchange no matter how they come to seek assistance. It must reduce paperwork for individuals and small businesses, and provide in-person, telephone and online assistance and access.

Effective Outreach and Assistance – The Exchange should contract with independent organizations that will help consumers and small groups “navigate” the various health insurance plans and services offered through the Exchange. Contractors providing these navigator programs should be free of insurer conflicts of interest and have a history of working with diverse communities. The exchange must also provide customer service that understands diverse populations, such as people with disabilities, mental health needs or low-income.

One Insurance Pool – Health insurance markets work best when risk is shared across large numbers of people. The Exchange should explore how best to transition toward a unified insurance pool that combines both the individual and small employer markets. Other opportunities to expand the pool of insured people should be explored.

Improve Health Care Quality & Promote Prevention – The Exchange should only offer plans that provide a comprehensive and high-quality package of health care services. Every plan should prioritize prevention and work to reduce health disparities. Dental and mental health benefits should be included. Health care delivery networks should include essential community providers. Patients should have access to providers who speak their native language.

Community Health – The Exchange itself should promote community health by fostering collaborations between the Exchange insurers and community organizations, such as local public health departments, mental health associations, maternal and child health consortia and disease-specific nonprofits. This will ensure the efficient delivery of health information, health promotion and disease prevention and screening services.

Ensuring Exchange Stability– The State must guard against the segregation of people by their health status. Premiums in the exchange could become very expensive if insurers and brokers have the power to steer less-healthy patients into the Exchange, keeping for themselves only healthier, more profitable enrollees. The same rules must apply to plans both inside and outside of the Exchange. The Exchange must set market protections to prevent insurers and brokers from cherry-picking healthy enrollees or steering them into or out the exchange.

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Filed under As a Matter of Fact, Consumer Driven Health Insurance(CDHI), health insurance, Insurance exchange, New Jersey Policy Perspective, NJ FamilyCare, Rutgers University, The Affordable Care Act

>Health reform’s benefits kick in

>By REP. CHRIS VAN HOLLEN posted at Politico.com

Six months ago, President Barack Obama signed the new health reform legislation that will bring down health care costs for American families and small businesses, expand health coverage to an additional 32 million Americans and end the widespread abuses in the health insurance industry. The Affordable Care Act is the most groundbreaking reform of health care coverage since Medicare. It reduces the deficit by $1.2 trillion in the next 20 years, according to the nonpartisan Congressional Budget Office.

Americans are already benefiting from several important provisions that have taken effect. More than 4 million small businesses are eligible for $40 billion in tax credits, helping them offer employee health insurance coverage. Children with pre-existing conditions who have long been denied coverage now have access to a health plan in every state, including Maryland. Seniors in the Medicare Part D program are now receiving an annual supplement of $250 as the first installment toward closing the notorious “doughnut hole.” No longer will seniors be forced to choose between food or heat and lifesaving medications. Early retirees are also benefiting, because the program helps employers continue their health coverage.

This week, some crucial health care consumer protections begin. This new Patients’ Bill of Rights helps Americans obtain better care, lower their costs and improve their health coverage security.

Health insurance companies will no longer be able to drop people’s coverage when they get sick and need health care the most. Young adults — the largest population of uninsured Americans before passage of this law — can now remain on their parents’ health insurance plan until their 26th birthday. Health plans can no longer impose lifetime limits on coverage, and annual limits are to be phased out over three years — a dramatic change for families, because more than 60 percent of people who declared bankruptcy in 2007 cited medical bills as a reason, and medical costs have only increased since.

Over time, the Affordable Care Act will prohibit insurance companies from denying anyone coverage based on pre-existing conditions, create insurance exchanges so that Americans have the same health plan choices as members of Congress and implement the biggest tax cut for health care in U.S. history to ensure that middle-class families can afford insurance. The new law puts Americans, not the health insurance companies, in charge of their own health care.

Unfortunately, Washington Republicans want to repeal the law and take away these important consumer protections and benefits. Under their plan, things would grow worse and the deficit would increase. The CBO found that the Republicans’ plan would increase the number of uninsured to 52 million — higher than today.

The Republican plan would also make coverage unaffordable for millions of Americans, eliminate tax credits that help people cover their premiums and remove assistance to small businesses that offer coverage for their employees.

I am proud that these reforms, enacted by Congress, are helping make a difference in Americans’ lives today, and I am committed to ensuring the legislation is implemented successfully.

To learn more about these provisions and other ways that health reform will help you, please visit http://www.healthcare.gov/.

Rep. Chris Van Hollen (D-Md.) serves as assistant to Speaker Nancy Pelosi (D-Calif.) and is chairman of the Democratic Congressional Campaign Committee.

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Filed under health care reform, Politico.com, President Obama, Rep. Chris Van Hollen, The Affordable Care Act