With A United Front How Can You Lose
I Salute You President OBAMA
AND YOUR TEAM FOR A JOB WELL DONE.
WINS PASSAGE IN HOUSE
Adult children would not be able to stay on a parental plan if they had access to employer coverage of their own. But they could get married and still be covered. (Grandkids, however, would not qualify.) Regulations will clarify to what degree young adults have to be financially dependent on their parents.
Other reforms starting this year would prevent insurers from canceling the policies of people who get sick, from denying coverage to children with medical problems, and from putting lifetime dollar limits on a policy.
These changes will spread risks more broadly, but they're also likely to nudge insurance premiums somewhat higher.
Obama's plan also includes an important new program for the most vulnerable: uninsured people who can't get coverage because of major medical problems. It's intended to provide an umbrella of protection until the broad expansion of coverage takes effect in 2014.
The government will pump money into high-risk insurance pools in the states, making coverage available for people in frail health who have been uninsured for at least six months. The premiums could still be a stretch, but for people who need continuing medical attention, it could make a dramatic difference.
"For people who have not been able to get anything, who have expensive chronic illnesses or other conditions, it could be a lifesaver," said Friedholm. There is a catch, however. The $5 billion Obama has allocated for the program is unlikely to last until 2014. In fact, government experts have projected it could run out next year.
Among seniors, the plan will create both winners and losers. On the plus side, it gradually closes the dreaded "doughnut hole" prescription coverage gap, improves preventive care and puts a new emphasis on trying to keep seniors struggling with chronic diseases in better overall health.
But it also cuts funding for popular private insurance plans offered through the Medicare Advantage program. About one-quarter of seniors have signed up for the plans, which generally offer lower out-of-pocket costs. That's been possible because the government pays the plans about 13 percent more than it costs to cover seniors in traditional Medicare. As the payments are scaled back, it could trigger an exodus from Medicare Advantage.
"It's not all black and white; sometimes it's gray," said James Firman, president of the National Council on the Aging. "Overall we think this plan is very good, and will provide some significant benefits for seniors. There will be some pain among some people in Medicare Advantage plans."
The prescription coverage gap will be totally closed in 2020. At that point, seniors will be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in, dropping their copayments to 5 percent.
• COMING LATER:
The real transformation of America's health insurance system won't take place until 2014.
Four breathtaking changes will happen simultaneously:
• Insurers will be required to take all applicants. They won't be able to turn down people in poor health, or charge them more.
• States will set up new insurance supermarkets for small businesses and people buying their own coverage, pooling together to get the kind of purchasing clout government workers have now.
• Most Americans will be required to carry health insurance, either through an employer, a government program or by buying their own. Those who refuse will face fines from the IRS.
• Tax credits to help pay for premiums will start flowing to middle-class working families, and Medicaid will be expanded to cover more low income people. Households making up to four times the poverty level — about $88,000 for a family of four_ will be eligible for assistance. But the most generous aid — including help with copayments and deductibles — will be for those on the lower-to-middle rungs of the income scale.
When all is said and done, the majority of working-age Americans and their families will still have employer-sponsored coverage, as they do now. But the number of uninsured will drop by more than half. Illegal immigrants would account for more than one-third of the remaining 23 million people without coverage.
Republicans Vow Repeal Effort Against Health Bill
As jubilant Democrats prepared for President Obama to sign their landmark health care legislation with a big ceremony at the White House, Republicans on Monday opened a campaign to repeal the legislation and to use it as a weapon in this year’s hotly contested midterm elections.
We will not allow this to stand,” Representative Michele Bachman, Republican of Minnesota, promised Monday afternoon as the House reconvened.Democrats said they would focus on explaining the measure to their constituents and on highlighting some immediate benefits, and called on Republicans to ease off the attacks now that the legislation had passed.
“It is time to chill out, Republicans,” Representative Bob Filner, Democrat of California, said. “Let this bill work. Let our constituents finally get health care.”
But there were no signs of a ceasefire. Senate Democrats said they would take up a budget reconciliation measure containing the final revisions to the health care overhaul shortly after Mr. Obama signs the main bill at the White House ceremony on Tuesday.
Far from sounding a conciliatory note, Senate Republicans said they would employ every procedural maneuver available to try to derail the reconciliation bill, or at least punch holes in it by knocking out key provisions.
The Senate Republican leader, Mitch McConnell of Kentucky, quickly adopted a new rhetorical strategy on Monday, asserting that the revisions Democrats want to push through would make the health care law worse, not better.
“Democrat leaders now want us to take the bill that passed the Senate in December and that the House voted on last night and make the tax hikes even higher, the Medicare cuts even deeper,” Mr. McConnell said in a floor speech. “They want us to endorse a raft of new sweetheart deals that were struck behind closed doors last week so this thing could limp over the finish line last night.”
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