Health Care Reform Update from Rep. Honda

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An update on health care reform from U.S. Representative Michael Honda

As a Member of Congress, Chair of the Congressional Asian Pacific American Caucus, and Appropriator on the Subcommittee handling Health and Human Services, I and my colleagues in Congress have spent the last decade focused on healthcare reform. Our efforts are finally paying off. This spring, President Barack Obama’s signed the Patient Protection and Affordable Care Act, marking a huge step forward for a healthcare system desperately in need of reform.

So what now? Before we begin forecasting the future of healthcare reform, let’s take a quick look at the context in which this reform took place. Under our previous unreformed healthcare system, the United States paid more than any other country for healthcare, yet we ranked 17th globally in the personal health of our citizens. With each year that passed, our uninsured patients cost the U.S. over $56 billion in uncompensated care and $248 billion in lost productivity.

Now that healthcare reform has passed, all this is about to change.

First and foremost, the Patient Protection and Affordable Care Act enacts measures to ensure that all Americans are covered by health insurance. The most important of these is the establishment of a Health Insurance Exchange. Once created, Americans who do not otherwise have access to insurance (for example, those not covered by their employer or their spouse’s plan), as well as small businesses, will be able to join together in a new purchasing group.

Group membership will bring a boost in negotiating power and purchasing rates currently enjoyed by large companies and organizations. After reviewing the Exchange-negotiated plans through a central database, you will be able to choose the plan that is right for you, based on price, copayments, services provided, and other factors. The good news is that insurance plans offered through the Exchange will be required to take all newcomers, regardless of health status, and will not be able to refuse coverage except in cases of fraud. Plans will be strictly regulated, requiring insurance companies to limit annual costs and eliminate patient copayments for preventive care.

This last point is of particular importance. Eliminating co-payments makes it easier for low- and middle-income people to see their doctor on a regular basis. It enables doctors to intervene early in conditions like obesity, heart disease, and cancer. It also increases local communities’ ability to address public health concerns by working with primary care providers to track conditions as they arise and to get treatment before the condition spreads.

Secondly, the bill begins the reform process immediately. Already, within the first year, insurers will be barred from imposing exclusions on children with pre-existing conditions. Additionally, insurers are not able to rescind policies to avoid paying for coverage when a person becomes ill. Lifetime limits on benefits and restrictive annual limits are prohibited and young adults are able stay on their parents' insurance.

Thirdly, this bill encourages people to take responsibility for their health by ensuring that all Americans be covered by a health insurance plan by 2014. This coverage can be provided through an employer, a family member, a government program, or purchased through the Exchange. Regardless of the source, all Americans must have at least a basic level of coverage. This ensures that fewer people are visiting emergency rooms for non-emergency conditions, more people are purchasing insurance before they get sick, and more people are pursuing a preventive approach to health.

Keep in mind that there are many people who, even without a mandate, would gladly purchase insurance if they could afford to do so. The individual mandate, therefore, must include measures to ensure that Americans of all income levels can purchase affordable care. This bill aims to do that, by offering subsidies to citizens and legal residents who are not eligible for Medicaid or employer-sponsored care. Families with income levels below 400% of the Federal Poverty Level ($43,320 for an individual and $88,200 for a family of four) will be eligible for healthcare subsidies from the federal government, which they can use to purchase any plan available through the Exchange.

In sum, these key reforms, plus others included in the Patient Protection and Affordable Care Act, will have a dramatic effect on public health. This reform ensures that all Americans can afford to purchase insurance, helps Americans take responsibility for their personal health, and increases access to primary care providers and services.

As we begin to implement the changes in this bill, we empower our doctors, our public health workers, and our citizens to take greater control of our countries’ health, and make our country a model for health around the world. It’ll take a national effort to improve the nation’s poor personal health ranking. We’ll need everyone on board to make this happen, including you.