Health Care Reform Bill: What’s In It For Us?

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As members of Congress begin August recess, temporarily setting aside intense negotiations for a passable health care reform bill, the Congressional Black Caucus has vowed to continue pushing for specific provisions that its members feel are vital for African-Americans.

The original House and Senate bills would significantly reduce the staggering number of uninsured Americans, of which are disparately Black. But it won’t be as effective if other provisions are not also included, CBC members argue.
The CBC and the Congressional Tri-Caucus, which also comprises the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus, introduced a bill recently that outlines their priorities for health care reform for people of color.

They call for expanded data collection, improved health care workforce diversity efforts, comparative effectiveness research provisions for the disaggregation of data, community-centric prevention efforts that focus on reducing racial and ethnic health disparities, language and translation services throughout the health care system and a significant investment in community health centers and in community health workers.

With hopes that certain reform provisions from their Health Equity and Accountability Act of 2009 will make it into the final health care bill, CBC leaders – including Chairwoman Barbara Lee (D-Calif.) – wrote a letter to both President Obama and House Speaker Nancy Pelosi.

”We are very concerned about the current negotiations and feel that it is necessary to restate our strong position on several issues and provisions going forward,” the letter stated.

They are vehemently urging Congress to keep efforts that would correct health disparities and make improvements to Medicare and health services for children. They argued that additional cuts to the proposed bill that passed the three House committees will weaken the initiative itself.

”The Tri Com bill is budget neutral and we are concerned that efforts to cut more costs would mean cutting the vital services, like prevention and comparative effectiveness or disproportionate share,” the CBC wrote in the letter, which was also signed by co-chairs of the CBC Health and Wellness Taskforce Rep. Danny Davis (D-Ill.) and Rep. Donna Christensen. (D-V.I.).
While nothing is finalized yet, Rep. Christensen, a medical doctor, said the new bill, as proposed, will include an expansion of Medicaid to young people that meet poverty guidelines.

”Those who meet 133 percent of poverty guidelines, which has been increased from before, will qualify for Medicaid,” the congresswomen said in an interview. ”It has been expanded beyond just the elderly and the disabled.”

Christensen wanted Medicaid to become a part of the public plan because, she said, services are not covered in the same degree. For example, Medicaid covers some expensive procedures for children differently than the proposed public plan, and long-term care is not covered the same.

Christensen, the first female physician in the history of the U.S. Congress, pointed out that those whose incomes are not above 400 percent of poverty, which amounts to about $88,000 for a family, will qualify for subsidies if they purchase their coverage from an insurance exchange. This exchange is being considered to go along with the hotly contested public option.

Congresswoman Donna Edwards (D-MD) has also been fighting for the public option to be included in the final health care bill.

”[The] most significant part of the health care bill is the public option,” Edwards contends. ”It’s a vital option for people who don’t have insurance.”

Edwards represents Maryland’s 4th District, home to the state’s affluent Montgomery and Prince George’s counties. Both Washington, D.C. suburban counties boast significant Black populations and are among the richest in the country. Yet, one-fifth of its residents are uninsured.

”The doctor would bill the public plan option like Medicare,” Edwards said, explaining how the public option would work.

The biggest health care concerns of her largely Black constituency are those related to accessing insurance, the amounts of co-payments, being denied for pre-existing conditions and sky-rocketing costs of premiums and deductibles.

”The U.S. health care system is one of the most expensive systems in the world. We spend $2.2 trillion per year on health care services and products, and yet approximately 46 million Americans are uninsured, 80 percent of whom are from working families,” Rep. Edwards wrote in an editorial, published in The Washington Informer.

”Almost half of all personal bankruptcies are attributed to medical debt. And, for the 80 percent of Americans who have health insurance, premiums, deductibles, and co-payments are skyrocketing; and we all pay for the flaws that leave millions uninsured and seeking care in expensive hospital emergency rooms. In fact, premiums rose 114 percent from 1999 to 2007, greatly outpacing incomes,” Edwards wrote.

She stated that a ”robust public health insurance option modeled after Medicare must be available to compete alongside private insurers”.

The public plan that the Maryland congresswoman hoped for won’t be as robust as she likes because a deal to water it down was made with a group of conservative ”Blue Dog” Democrats threatening to block passage of the bill over the cost.

Speaker Pelosi announced that the deal would lower the estimated cost of reforming health care by a $100 billion dollars and bring the total cost to under a trillion dollars over ten years. Specifics of the compromise called for less subsidies for the uninsured and more lenient requirements for mandates for large employers to provide coverage for their workers.

Also, in an effort to balance the board for competing private insurers, the rates for the ”public option” must be negotiated with doctors like the private industry has to do. If the compromised bill reaches the floor as negotiated, then it will likely infuriate progressives and will not be directly tied to Medicaid for which Christensen is lobbying.

”We do think that it makes sense to have a public option alongside the private option,” President Obama said at an AARP sponsored town hall event on health care. ”So you could still choose a private insurer, but we’d also have a public plan that you could choose from that would be non-for-profit, wouldn’t have, hopefully, some of the same high administrative costs, and would be potentially more responsive to your needs at a lower cost. I think that helps keep the insurance companies honest because now they have somebody to compete with.”

The president engaged older Americans about their concerns about health care reform last week. In an hour long forum, President Obama answered questions and cleared up misconceptions about components being legislated upon such as the bill’s affect on Medicare to a rumored clause that pertains to living wills.

”So the idea behind reform is: Number one, we reform the insurance companies so they can’t take advantage of you,” the president explained.

”Number two, that we provide you a place to go to purchase insurance that is secure, that isn’t full of fine print that is actually going to deliver on what you pay for. Number three, we want to make sure that you’re getting a good bargain for your health care by reducing some of the unnecessary tests and costs that have raised rates.”

Following the town hall the Obama administration shifted their health care sales pitch strategy to stress security and stability. In an email campaign, the president focused on eight specific consumer protections in order to ”create a new foundation for health care security”.

Some of these new provisions include non-discrimination for pre-existing conditions, exorbitant out-of-pocket expenses, deductibles or co-pays; no cost-sharing for preventive care, no dropping of coverage if a person becomes seriously ill and extending coverage for young adults.

”Over the next month there is going to be an avalanche of misinformation and scare tactics from those seeking to perpetuate the status quo,” Obama wrote in the email. ”But we know the cost of doing nothing is too high. Health care costs will double over the next decade, millions more will become uninsured, and state and local governments will go bankrupt.”

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