Welfare Watch - March 22, 2010 - Major Health Care Reform Legislation Passes Congress

Health Care reform legislation has been discussed by the American public since President Clinton's failed attempt at reform in September 1993.  The problems remain the same.  Too many people are without health insurance.  More companies are chosing not to offer health insurance to their employees than do.  Too much of our gross national product is directed to health care.  We are the only industrialized country without universal health care coverage and have some of the worse health outcomes. Health care costs continue to escalate. 

Nothing has changed except the statistics have gotten worse and more than 17 years has passed since the last major push for reform.  Well, something did change last night, Congress passed health care legislation.  For some, this represented the greatest victory for the American public since the signing of the Declaration of Independence; for others, the world is about to end as we know it. 

The major provisions of this legislation includes the following:

Requires most U.S. citizens and legal residents to have health insurance.

• Creates state-based American Health Benefit Exchanges through which individuals can purchase coverage, with premium and cost-sharing credits available to individuals/families with incomes between 133 to 400% of the federal poverty level.
• Creates separate Exchanges through which small businesses can purchase coverage.
• Require employers to pay penalties for employees who receive tax credits for health insurance through an Exchange, with exceptions for small employers of 50 employees or less. Small businesses of 25 or fewer employees and average annual wages of less than $50,000 would be provided with a tax credit of between 35 and 50 percent.  A full credit would be available to employers with 10 or fewer employees and wage average of less than $25,000. 
• Impose new regulations on health plans in the Exchanges and in the individual and small group markets.
• Expand Medicaid to all individuals under age 65  to 133% of the federal poverty level. 
• Extends dependent coverage for children up to age 26 for all individual and group policies. 
• Prohibit individual and group health plans from placing lifetime limits on the dollar value of coverage and prohibit insurers from rescinding coverage except in cases of fraud.  Prohibit pre-existing condition exclusions for children. 
• Require states to maintain current income eligibility levels for children in Medicaid and the Children's Health Insurance Program (CHIP) until 2019 and extend funding for CHIP though 2015. 
• These health care benefits would only extend to U.S. citizens and legal immigrants. 
• Under Medicaid allows the creation of demonstration projects to pay bundled payments for episodes of care that include hospitalizations.  Extend the Medicaid Money Follows the Person Rebalancing Demonstration program through September 2016.  Provide state with new options for offering home and community-based services through a Medicaid state plan rather than through a waiver for individuals.  Establish the Community First Choice Option in Medicaid to provide community-based attendant supports and services to individuals with disabilities who require an institutional level of care. 

A good comparison of the bills passed can be found on the Kaiser Family Foundation website. 

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Welfare Watch, an email newsletter of the
Georgia Association of Homes
and Services for Children
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                            Normer Adams, Editor
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