Vote to Repeal Health Care Reform Scheduled

The letter says, in part,

“Since March, we have made great strides toward a health care system that is stronger and more affordable and that will work better for all Americans.

“If the Affordable Care Act were repealed as some have proposed, the individuals we have heard from plus the millions of families, seniors, other individuals, and small businesses already helped would lose this support and these protections.

“We urge you to consider all that this law has already done to improve the health and financial security of so many Americans – and what it will mean to hundreds of millions or more in the next several years – as you evaluate any proposal that would set the Nation back on a path to higher costs and skyrocketing premiums, less competition, and fewer consumer protections against industry abuses.”

Rep. Eric Cantor (R-VA) has indicated that the Republican-led House will hold a vote next week (Wed., Jan. 12)  to repeal President Barack Obama’s health care overhaul. Not on the table is ‘anything’ at all which might continue some of the provisions people are already enjoying and are not going to be very happy about losing.  It’s not all that likely that, even if the House were to pass ‘repeal’ of the Health Care Reform (HCR) bill, that the Senate would do the same.  And … even if both houses were to pass a repeal of HCR, one would hope that President Obama would summarily veto the bill.  It’s highly suspect whether Congress could muster enough votes to override such a veto.

It will be interesting to watch the actions taken by our two Republican Representatives (Heller and Heck).  How will they vote on this issue?  With the GOP along partisan lines?  Or, will they vote according to what is best for their constituents?

If you’ve been paying any kind of attention to the TV advertisements over the past few weeks, you should have noticed that Medicare just had their open enrollment period.  Many Seniors just made benefit elections and selections relying on provisions of the HCR bill that have gone or that will go into effect shortly.  The Prescription Donut hole got fixed last year, but effective 1/1/2011, out-of-pocket expenses are no longer required for cancer screenings (e.g., mammograms, colonoscopies, prostate exams).  If HCR is repealed, many Seniors will once again be charged higher prices for prescription drugs, and find themselves buried even deeper in that all to familiar donut hole.  Once again, they’ll start taking only partial doses of medication they can’t afford if they still want to put food on their tables or pay utility bills to keep from freezing this winter.

It’s time to bombard members of the House of Representatives, especially GOP members of the House with massive numbers of inquiries.  Those letters should just say “please don’t vote to repeal” the health care bill.  Instead, they need to be much more specific as suggested by a recent article published in the Desert Beacon.

Here’s a list of provisions of the bill that have already been implemented, and that would vanish if the GOP were to be successful in repealing HCR:

Implemented, effective March 23, 2010 (primary focus of expenditures on building infrastructure to support health care, with exception being a fix for Seniors hitting the donut hole):

• Medicare Rebate.  A $250 rebate was provided for Medicare recipients who reached the Part D coverage gap.
• Medicare Extension for Health Hazards.  Medicare eligibility was expanded to individuals who were exposed to environmental health hazards in an area subject to an emergency declaration and who developed chronic health conditions as of June 17, 2009.
• Premium Increase Justification.  Health plan administrators are now required to justify premium increases when subject to established review process.
• Tax Credit. Tax credit of up to 35% of premiums are now available to small employers (those with no more than 25 employees and less than $50,000 average annual wages) providing health insurance to employees.
• Expanding the Healthcare Workforce.  Improvements have been made to low-interest student loan programs, scholarships, and loan repayment programs for health students and professionals to bolster the healthcare workforce capacity and meet patient needs.
• Public Health Professionals.  $60M was appropriated in fiscal year 2010 for scholarships to mid-career public health professionals, with annual appropriations through 2015.
• Disadvantaged Health Professionals.  $60M annually was appropriated  for fiscal year 2010 through 2014 for educational assistance in health professions to individuals from disadvantaged backgrounds.
• National Health Care Workforce Commission.  A national Commission was created to better align federal resources with health care needs.
• Nurse Managed-Health Clinics.  Annual grants were initiated for nurse-managed health clinics, appropriating $50 million for fiscal year 2010 and increasing thereafter.
• National Health Service Corps.  Annual funding was increased for the National Health Service Corps and Ready Reserve Corps to enable effective response during national emergencies and public health disasters.
• Provider Screenings.  Health care provider screenings procedures were enhanced to address waste and fraud in healthcare system.
• Generic Versions of Biologics.  FDA was authorized to approve generic versions of biologics after 12 years of exclusivity.
• New Therapy Investment.  $1B in credits were created to encourage investments in new therapies to prevent, diagnose, and treat acute and chronic disease.
• Mental and Behavioral Health Education and Training Grants.  $35M  annually was appropriated for fiscal year 2010 through 2013 for mental and behavioral health education and training grants.
• Fellowship Training Grants.  $39.5M annually was appropriated for fiscal year 2010 through 2013 towards fellowship training grants in public health.
• Early Detection Grants.  $23 million was appropriated for the fiscal year 2010 through 2014, and $20 million for each five-year period thereafter for grants toward early detection of medical conditions related to environmental hazards.
• Patient-Centered Outcomes Research Institute.  The Federal Coordinating Council for Comparative Effectiveness Research was terminated. The independent non-profit Patient-Centered Outcomes Research Institute is now being used to identify national priorities in comparing the effectiveness of treatments and strategies.
• Teaching Health Centers.  $25M was appropriated for fiscal year 2010 and $50 million annually for two years toward Teaching Health Centers to operate primary care residency programs.
• Centers of Excellence. $50M annually was appropriated for fiscal year 2010 through 2015 to expand Centers of Excellence with a particular focus on expanding regional locations, helping to promote specialized treatment.
• Medical Homes.  Required the Department of Health and Human Services (HHS) to create programs to facilitate development of medical homes and other collaborative management.
• Cure Acceleration Network.  Appropriated $500 million in fiscal year 2010 towards Cure Acceleration Networks (CAN), which are to promote technologies that support the development of high need cures, helping move new medical cures through the development pipeline faster.
• Prevention Efforts. $15B Prevention and Public Health Fund established to sustain the national investment in public health and prevention programs.
• Preventive Improvements.  A Preventive Services Task Force and Community Preventive Services Task Force was created to develop, update, and disseminate evidence-based recommendations.
• Wellness Services. A 5-year grant program was created to support delivery of evidence-based and community-based prevention and wellness services.

Implemented, effective April 1, 2010:

• Medicaid Expansion. Provides a state option that covers childless adults through a Medicaid state plan amendment (SPA).
• FMAP.  Extended Medicaid federal match (FMAP) to cover MIAs up to 133% FPL.

Implemented, effective June 23, 2010:

• Funding for Pre-Existing Conditions.  $5 billion in funding became available for uninsured individuals with pre-existing conditions to obtain insurance coverage in high-risk pools through 2014.
• Temporary Re-insurance Program. A temporary re-insurance program was created for employers that provide benefits to retirees age 55 to 64 to help offset the costs of expensive health claims.

Implemented, effective July1, 2010:

• Web Access to Information. Healthcare.gov was created as a website where individuals can identify affordable health insurance options offered in their state.
• Payment Protection for Rural Providers.  Medicare payment protection was extended to small rural hospitals with outpatient services, lab services, and those facilities playing a critical role in their communities.
• Tanning Service Tax.  A 10% tax on the amount of indoor tanning services went into effect.

Implemented, effective September 23, 2010:

• Dependent Coverage Insurance Reform.  Dependent children up until age 26 eligible to remain on parents plans for all individual and group polices.
• Ending Insurance Rescission and Limitations.  Prohibited individual and group health plans from rescinding coverage and from imposing a lifetime limit on the dollar value of coverage. (This excludes cases of fraud and certain annual limits as determined by the Secretary.)
• Appeals Process Implemented.  Requires new group and individual health plans to develop and implement an internal and external appeals process for coverage determination and claims.
• Preventive Care.  Provides preventive care services, as rated by the U.S. Preventive Services Task Force, at no cost sharing for infants, children, adolescents, and women.
• Elimination of Pre-existing Conditions for Children.  Bars employer and new individual health plans from imposing pre-existing condition exclusion on childrens’ coverage (applies to adults as of January 1, 2014).
• Medical Loss Ratio Reporting.  Health plan administrators are now required to report medical loss ratios (MLRs) in individual and small group markets.

Effective January 1, 2011:

• Medicare-Preventive Exams.  Eliminates all cost sharing for preventive services, as recommended by the U.S. Preventive Task Force, covered by Medicare and waives the deductible for colorectal cancer screening test.
• Wellness for Medicare.  Provides personalized prevention plans and access to comprehensive health risk assessments to Medicare patients while also providing incentives for Medicare and Medicaid patients to complete behavior modification programs.
• Pharmaceutical Discount.  Pharmaceutical manufacturers must provide a 50% discount on brand name drugs filled in the Medicare part D coverage gap while phasing in federal subsidies for generic filled prescriptions.
• Tobacco Programs.  Requires health plans to cover tobacco cessation programs for pregnant women.
• Medicare Bonus.  Provides a 10% Medicare bonus for health professionals, specifically primary care physicians and general surgeons, practicing in shortage areas (effective through 2015).
• Medicare Payments.  Sets Medicare Advantage Plan payments to different percentages of Medicare fee-for-service rates.
• Innovation in Medicare.  Establishes an Innovation Center within the Centers for Medicare and Medicaid Services.
• Medical Home for Chronic Conditions.  Establish a new Medicaid state plan option to allow enrollees, with at least two chronic conditions to specify a provider as a health home, providing a 90% FMAP for two years for related services.
• Wellness Programs.  Provide $200 million in grants for up to five years to small employers to create wellness programs.
• National Health.  Develops a National Prevention, Health Promotions and Public Health Council that will be required to develop a national strategy to improve the nation’s health.
• Workforce.  Addresses health care workforce shortage through a variety of loans, grants, and scholarships towards training programs.
• CLASS Program.  Creates a national insurance program to purchase community living assistance services and supports.
• Care Coordination.  Creates the Community-based Collaborative Care Network Program to support coordination and integration of health care services for low-income uninsured and under-insured populations.
• Improving Access.  Provides $1 billion funding for community health centers and $1.5 billion for the National Health Services Corps over five year, creating new programs to support school-based health centers and nursed-managed health clinics.
• Plans Report Amount Spent on Care.  Health Insurance and grandfather plans must report annual share of premiums dollars spent on medical care, and those totaling less than 80-85% of benefits must provide consumer rebate.
• Pharmaceutical Fee.  Imposes an annual fee on the pharmaceutical manufacturer industry, excluding companies with sales of brand drugs totaling $5 million or less.
• Tax on Pharmaceutical Manufacturers.  Imposes $2.5 billion fee on pharmaceutical manufacturers according to market share.
• Health Savings Account.  Increases the tax on health savings account (HSA) withdrawals for non-qualified health expenditures from 10% to 20%.
• Caloric Reporting for Restaurants and Vending Machines.  Requires chain restaurants and vending machines to display calorie information for each menu item.
• Community Health Centers.  Increases funding for community health centers, $1 billion in 2011 increasing to $3.6 billion in 2015, with additional $1.5 billion annually for infrastructure renovation.
• Primary Care Training.  Allows unused residency training slots to be redistributed to increase primary care training in under-served areas.
• State Tort Projects.  Appropriates $50 million for state tort reform demonstration projects.
• Reporting Value of Health Benefits on Tax Forms.  Requires employers to report the value of health benefits on each employee’s FY 2011 W-2 tax form.
• Simple Cafeteria Plan.  Establishes a Simple Cafeteria Plan to provide small business with a tax-free mechanism to provide benefits to their employees.
• Geriatric Career Incentives.  Initiates $10 million in annual funding towards geriatric career incentive rewards (extends through 2013).

I urge you to write or call your Republican Senators.  I also urge you to frame your communication in terms of what they’re TAKING AWAY and not replacing.  If any of these provisions are important to you, then it’s up to you to take action to let the Republican majority know that they need to back away from repealing health care reform and tend to what’s really important … FIXING THE ECONOMY and creating an economic environment conducive to creating jobs in the United States, and that includes revisiting tariffs on imported goods of corporations who’ve shipped the jobs overseas and now enjoy tariff free imports from those foreign subsidiaries.

Related posts concerning HCR implementation timelines:

• ITUP summary of the HCR Implementation Timeline
• Healthcare.gov — Implementation Timeline
• American Cancer Action Network — HCR Timeline for Implementation