Over the past couple of weeks, there have been an increasing number of posts and diaries saying that the current health care plans are worthless and will not help anyone. There have also been increasing calls for the current bill to fail and then we can push for single payer. Below is a list of items included in the current house healthcare bill not including the public option. While we need a strong public option in the final healthcare bill, I want to highlight some other important pieces currently in the House healthcare bill.
All private insurance plans the participate in the health exchange must meet this essential benefit plan:
Maximum $5,000 Single Out-of-Pocket charge - This is not a 1st dollar policy. You will get coverage before you pay the $5,000. This just means that the total out of pocket amount you spend on co-pays and co-insurance can't exceed $5,000.
Maximum $10,000 Family Out-Of-Pocket charge
No annual maximum benefit cap
No lifetime maximum benefit cap
Insurers are prohibited from the act of recession (denying a claim payment based on a pre-existing condition) except in cases of fraud.
Require insurers to issue and renew policies. No pre-existing conditions exclusion for coverage.
Insurers can no longer rate on existing medical conditions. The only rating variation is based on age, premium rating area, and family enrollment.
The maximum rate difference between the lowest age group rate and the highest is 2:1.
Expansion of Medicaid people who make 133% and less of the federal poverty line.
Eliminate any co-pays or co-insurance on preventive services for Medicare to encourage more patients to get preventive care.
Increase provider payment for preventive services for Medicare and Medicaid members to 100% of actual charges or fee schedule rates to encourage more providers to provide preventive care.
Eliminate the donut hole in Medicare D drug coverage over a 15-year period.
Require drug manufacturers to provide a 50% discount on any non-generic drug that are purchased while Medicare member is in the donut hole.
Reform Graduate Medical Education to increase training of primary care providers by redistributing residency positions and promote training in outpatient settings and support the development of primary care training programs.
Support training of health professionals, including advanced education nurses, who will practice in underserved areas.
Provide grants to each state health department to address core public health infrastructure needs.
Conduct a study of the feasibility of adjusting the federal poverty level to reflect variations in the cost of living across different areas.
The items above are all reasons to fight for health care reform. If you want to see more about this bill or compare this bill to other bills, use this link.
Another great tool to see how many people will be helped by the House bill is here. It lets you look district by district to see the # of people and businesses helped by this plan.