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Health Reform: What Would it Do?
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What Would Health Reform Do For Us?  What Should We Ask For?
 
 
What We Want: Talking Points
 

HEALTH REFORM WOULD MAKE COVERAGE MORE SECURE:

The House bills are worth fighting for. Under H.R. 3200, we’ll get secure coverage, more affordable health care and medicines, better quality of care, improved preventive care and public health protections.

But we can do better!

·    Insist on a strong public plan like Medicare that is open to all of us, and start this in 2010, not 2013

·     Include Dennis Kucinich’s state single payer amendment so California can keep moving forward

           See State Single Payer Amendments

COUNTERING HEALTH REFORM MISINFORMATION

Center for Medicare Advocacy

As the debate over health care reform continues, special interest groups have begun spreading rumors and misinformation designed to make the public doubt, or even fear, reform. Below are real facts about our current system and proposed reforms.

Why Health Reform Works for You

Our Current System
Proposed Health Reform

You currently have health insurance through

  • Your employer
  • Medicare
  • Medicaid
  • VA
  • The military
  • Other

You will be able to keep the health insurance that you have.

You may be, or may become, uninsured:

  • Your employer can change or end your health insurance coverage at any time;
  • You lose your job and are not eligible for or can't afford COBRA health care continuation insurance;
  • You do not have insurance through your work place;
  • You cannot afford private insurance or no private insurance company will sell you a policy.

You will be able to purchase health insurance through a Health Insurance Exchange:

You will have a number of health plans from which to choose;

If you have limited income, you will receive assistance with the cost of the premium.

You have a pre-existing condition:
  • Health insurance companies can refuse to sell you health insurance;
  • If health insurance companies sell you insurance, they may not cover services they decide are related to the pre-existing condition.

You have a pre-existing condition:
  • Health insurance plans will not be able to deny you insurance;
  • Health insurance plans will not be able to deny coverage of claims based on pre-existing conditions.

Health insurance companies can charge you a higher premium based on:

  • Gender;
  • Health status.

Health insurance plans will NOT be able to charge you higher premiums based on:

  • Gender
  • Health Status

Health insurance plans can charge exorbitant out-of-pocket expenses:

  • High deductibles;
  • High co-pays;
  • Limits on how much they will pay in a year and over a lifetime.

There will be limits on out-of-pocket costs:

  • No cost-sharing for preventive care;
  • Annual out-of-pocket caps;
  • No annual or lifetime limits on how much coverage your insurance will provide.

Insurance premiums and health care costs are rising rapidly.

Mechanisms will be in place to help contain costs;
  • A public health insurance option that competes with private plans will keep costs low as it encourages innovation and efficiency in health care.
  • Other health system reforms, including a focus on prevention and coordination of health care, will help reduce costs.

Medicare IS Public Health Insurance

44 years ago Medicare was enacted into law. All of today's dire warnings about a public health option - socialism and government barring the doctor's door - were made in opposition to Medicare. Despite such opposition from "conservative," leaders, Medicare passed because of some courageous, principled law-makers.

Before Medicare, 50% of everyone 65 or older had NO health insurance. Now, as a result of Medicare, almost all older people are insured. Medicare, which is national, government-run health insurance, succeeded in insuring older people where private insurance failed. Further, until the Bush Administration privatized Medicare with huge subsidies to private "Medicare Advantage" and Part D plans, Medicare was also remarkably cost-effective. It's private Medicare, not the traditional, public program, that's bleeding taxpayers of billions of dollars.

Medicare has been a success, fiscally and morally. It took on the job of insuring health coverage and care to people that private insurance had abandoned. Since 2003, on the other hand, private Medicare plans have cost us all tens of billions of dollars that went to support the private insurance industry, not to providing health care. In addition, private Medicare plans have too often engaged in marketing abuses and restrictive coverage practices.

As numerous studies have shown, people with Medicare love it. They do not want government to fool around with the traditional program. Ironically, some people with Medicare are arguing against a public health care reform option - while also telling the government "to keep its hands-off their Medicare!" They, and their family members, (which accounts for pretty much all of us), forget that the traditional Medicare program is a public health insurance option.

Meet Medicare: Our 44 year-old public health insurance option that provides care to all its enrollees everywhere in the country, and that has provided health and economic security for millions of older people, people with disabilities, and their families. For two generations, the public Medicare program has shown what a true public insurance program can offer: health insurance for the otherwise uninsured, at a price that taxpayers can afford.

Now, for all generations, we need a public option in health reform!
                              www.medicareadvocacy.org

From David Axelrod:

Across the country we are seeing vigorous debate about health insurance reform. Unfortunately, some of the old tactics we know so well are back — even the viral emails that fly unchecked and under the radar, spreading all sorts of lies and distortions.

As President Obama said at the town hall in New Hampshire, “where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that's actually been proposed.”

So let’s start a chain email of our own. At the end of my email, you’ll find a lot of information about health insurance reform, distilled into 8 ways reform provides security and stability to those with or without coverage, 8 common myths about reform and 8 reasons we need health insurance reform now.

Right now, someone you know probably has a question about reform that could be answered by what’s below. So what are you waiting for? Forward this email.

Thanks,
David

David Axelrod
Senior Adviser to the President

8 ways reform provides security and stability to those with or without coverage

  1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
  2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
  3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
  4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
  5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
  6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
  7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
  8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

Learn more and get details: http://www.WhiteHouse.gov/health-insurance-consumer-protections/

8 common myths about health insurance reform

  1. Reform will stop "rationing" - not increase it: It’s a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
  2. We can’t afford reform: It's the status quo we can't afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
  3. Reform would encourage "euthanasia": It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
  4. Vets' health care is safe and sound: It’s a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
  5. Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
  6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.
  7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
  8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts.  Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose.  Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.

Learn more and get details:
http://www.WhiteHouse.gov/realitycheck
http://www.WhiteHouse.gov/realitycheck/faq

8 Reasons We Need Health Insurance Reform Now

  1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more: http://www.healthreform.gov/reports/denied_coverage/index.html
  2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job.  Americans pay more than ever for health insurance, but get less coverage. Learn more: http://www.healthreform.gov/reports/hiddencosts/index.html
  3. Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more: http://www.healthreform.gov/reports/women/index.html
  4. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more: http://www.healthreform.gov/reports/hardtimes
  5. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline
  6. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more: http://www.healthreform.gov/reports/inaction
  7. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more: http://www.healthreform.gov/reports/inaction/diminishing/index.html
  8. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more: http://www.WhiteHouse.gov/assets/documents/CEA_Health_Care_Report.pdf


EQUAL Health Network
Center for Policy Analysis
San Francisco Presidio
P.O. Box 29586, San Francisco, CA 94129  
ph. 415-922-6204  fax 415-885-4091