[My] Life in Wisconsin

Now I Lay Me Down to Sleep...

Hi everyone;
I am going to bed in a little while...
And just have a little favor to ask of you...
...Before you fall to sleep tonight would you please say a prayer to help our people in DC make the right decision tomorrow?
So  very many sick / uninsured people are counting on this bill for their very existence. 

If you read nothing else below, please read the Facts and Myths section

More info on HR 3962: (Click for the bill).

The House of Representatives is expected to vote on health care reform bill HR 3962 over the weekend.

CLICK HERE for author info. I totally agree with her statement at the end.

To refresh your memory, the bill being considered in the House:
  •     * Creates an Exchange where individuals and small businesses can purchase health care

  •     * Gives tax credits to those in the Exchange to help them afford coverage

  •     * Includes a national public health insurance option in the Exchange to keep the insurance industry honest and lower prices

  •     * Strengthens employer-based coverage and asks employers to provide good coverage for their employees

  •     * Regulates all insurance plans to outlaw denials for pre-existing conditions, charging more if you're a woman, and a host of other bad practices

  •     * Strengthens Medicare and fully closes the Medicare Part D donut hole over time

  •     * Provides access to coverage for those uninsured in the interim before the entire program is up and running

"It may not be the bill some of us expected when we voted for real reform, but in my opinion it is a great start."

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WHY WE URGENTLY NEED REFORM

    * Every day up to 14,000 Americans lose their health coverage.

    * Over the past nine years insurance premiums have doubled, growing three times faster than wages.

    * Health care reform is deficit reduction. In 10 years, $1 out of $5 will be spent on health care.

    * An average family of four with health insurance paid an additional $1,100 towards their premiums in 2008 to cover the costs of the uninsured.

    * The $42.9 billion in unpaid health expenditures from 2007 to 2008 increased health care costs of covered families.

    * 47 million Americans lack insurance because they are not covered by their employer or cannot afford health coverage on their own.

    * Without health care reform, premiums for employer-sponsored health care plans are expected to more than double in the next few years, increasing from $11,381 in 2008 to $24,291 in 2016.


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Myths vs. Facts       

While some political and industry-led groups continue to spread myths about components of Affordable Health Care for America Act, independent analysis—and the facts—are knocking them down.



Myth: “Health Care isn’t broken now” – For the vast majority of Americans who have health care coverage, there’s no need for reform.

Fact: The average American family pays $1,100 extra each year now to cover costly care for 47 million uninsured Americans.  American businesses are struggling to cover their workers, and falling behind global competitors.  Health care costs are driving up the federal deficit and busting state budgets.  Right now, insurance companies can deny care or coverage for those who have insurance or take coverage away if you get “too sick.”  Millions of Americans are making job and life decisions based on the fear they will lose health care coverage.



Myth: “Forcing Americans into the Public Plan/Employers to Drop Coverage” – The House bill contains a government-run and –subsidized public option that would force employers to drop their more expensive coverage and force everyone onto a public plan.

Fact: Under the House bill, no one can ever be forced onto the public option.  The only way someone would be in the public plan is as a result of their own individual choice.  Approximately 1 in 10 Americans is expected to enter the Health Insurance Exchange to purchase their own insurance at competitive rates – and there they will have a range of options including various private plans, and the public plan.  If an employer is providing their employees health insurance through the Exchange, it is the employee – not the employer – choosing the plan.  Furthermore, the non-partisan Congressional Budget Office projects that more employers are likely to provide coverage under the bill – and just over 3% of Americans will actually choose the Public Option.



Myth: “Government Takeover/Socialized Medicine” – The House bill will lead to a government takeover of your health care – and who can trust the government?

Fact: The non-partisan Congressional Budget Office predicts just over 3% of Americans will choose the public health insurance option the House bill would offer, providing competition to insurance companies, which in some areas have a virtual monopoly.  In the current health care system, insurance companies hold more power than doctors and patients.  They can decide whether or not to cover treatments, procedures and routine doctor visits, and price for profit, not patient care.  The House bill would empower physicians and patients, with better information on what treatments work and incentives to provide higher quality and more integrated and coordinated care.  The same “government takeover” argument was made against Medicare, and it has turned out to be a very popular government-run health system, just like health care for our veterans.



Myth: “Rationing Care” – The House bill will put government bureaucrats in charge of who gets care and what treatments are available to patients.

Fact: Our current system rations care – with no cost caps on costly treatments pricing patients out of the ability to choose them, with insurance company accountants deciding when they will refuse coverage, and with 47 million Americans lacking basic health care coverage at all.  There is no rationing of care under this bill.  How did this rumor get started?  Opponents of “comparative effectiveness research” are trying to claim government panels would decide what care you can get.  In reality, it would provide doctors with the best research and information on what treatments work – in effect, making them smarter and better able to treat you.  Additionally, a committee of doctors, patient advocates, and other experts who do not work for the government would help make recommendations about the minimum benefits insurance plans should provide, to protect patients.



Myth: “Hurts Small Businesses” – The House bill will harm small businesses – undermining their ability to create new jobs and imposing large tax hikes – taking a big chunk out of their hard-earned income.

Fact: Far from undermining small businesses, the bill would significantly cut the costs of health care coverage for small businesses – making insurance companies compete for customers, and allowing small business owners to enter into a large purchasing pool (the Exchange) to get the kind of low rates big businesses get.  As the New York Times has pointed out, “The small business community would be one of the biggest winners from health care reform.”

Small businesses are offered two kinds of tax credits to help pay for insurance: a permanent tax credit that phases out for bigger businesses and those with higher salaries; and small businesses with 25 or fewer employees and average wages of less than $40,000 get tax credits of up to 50% of their insurance costs.

The vast majority of small businesses – those with payrolls under $500,000 in the latest version of the House bill – would be completely exempt from the shared responsibility concept that would require them to purchase insurance for their workers.

Under the bill, 96% of small business owners would pay NO increased taxes – and half of the remaining 4% earn less than a third of their income from a small business – so are more likely wealthy investors with some small business income.



Myth: “Cutting Medicare” – The House bill would cut Medicare benefits, leaving seniors with fewer choices and lower quality care.

Fact: Nothing in this bill would reduce benefits to seniors. The cost savings measures in Medicare under America’s Affordable Health Choices Act are all targeted at protecting and improving services and ensuring choice, by achieving new efficiencies; expanding authority to fight waste, fraud and abuse; and eliminating the wasteful Medicare Advantage subsidies to private insurance companies that Republicans ignored for eight years.

In fact, the $563 billion in savings over 10 years is a gross number—with a net of $340 billion in new spending to IMPROVE Medicare benefits and health care for seniors, including the following:

    * Lowers drug costs by gradually closing the “donut hole” for prescription drug reimbursement;
    * Preserves choice of doctors by eliminating a 20% cut in doctor reimbursements;
    * Lowers costs by eliminating copayments for preventive services;
    * Improves low-income subsidy programs, including under the part D program, to help ensure Medicare is affordable for those with low and modest incomes;
    * Computerizes medical records so seniors won’t have to take the same test over and over or relay their entire medical history every time they see a new provider
    * Expands the medical workforce so seniors will have more doctors to choose from and an easier time getting an appointment;
    * Develops new practices to improve quality such as the new Center for Quality Improvement that will identify best practices are distributed widely; and
    * Lengthens the solvency of Medicare by five years.



Myth: “Undocumented Immigrants” – The House bill provides health benefits for undocumented workers and their families.

Fact: Taxpayers will not fund health care for undocumented workers.  America’s Affordable Health Choices Act, Section 246 states that “Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.”



Myth: “Exploding the Federal Deficit” – The House bill would increase the federal deficit – one more drag on future generations.

Fact:  Health reform will not increase the deficit.  On July 17, the Congressional Budget Office (CBO) confirmed that the House bill will be fully paid for just three years after the bill takes effect.  CBO estimated that the cost of the bill’s reforms was $1.042 trillion over 10 years, while the bill’s cost savings and revenues totaled $1.048 trillion.   Since then, amendments to the bill have trimmed the cost even more.

The reforms will be fully paid for through a combination of almost $500 billion in net Medicare and Medicaid reforms, included in the bill, and over $500 billion in revenue raised through a tax surcharge on the wealthiest 1.2% of Americans.  These reforms will provide affordable coverage to 97% of Americans two years after the bill takes effect – and reform our private insurance system to lower costs for all Americans and improve their coverage. I believe the naysayers will find their remarks to already be rebutted above
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TOP 10 CHANGES TO HEALTH INSURANCE REFORM BILL
 
1. REDUCES THE DEFICIT MORE
According to the CBO, the revised bill reduces the deficit by $30 billion over the first 10 years.  (The original bill reduced the deficit by $6 billion over the first 10 years).  The revised bill also continues to reduce
the deficit over the second 10 years.  
 
2. ENDS HEALTH INSURANCE COMPTION FROM ANTI-TRUST LAWS
In order to open up health insurance markets to real competition, the revised  blanket exemption from anti-trust laws, bringing anti-trust enforcement to the two most abusive practices of health insurers  price fixing and market allocation.
 
3. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27  BIRTHDAY THROUGH PARENTS INSURANCE
The revised bill requires health plans to allow young people through age 26 
 
4. CREATES A NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM
The revised bill creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.  The measure provides a cash benefit to help individuals with community-based services. 
 
5. EXEMPTS SMALL BUSINESSES WITH PAYROLLS BELOW $500,000 FROM EMPLOYER MANDATE
The revised bill exempts a greater number of small businesses from the employer mandate  exempting 86% of all. Specifically, the bill exempts firms with payrolls up to $500,000 (instead of $250,000) from the mandate and provides only a graduated penalty for not offering coverage for firms with payrolls between $500,000 and $750,000 (instead of firms with payrolls between $250,000 and $400,000.) 
 
6. LIMITS THE HEALTH CARE SURCHARGE TO MILLIONAIRES
Under the revised bill, only the wealthiest 0.3% of Americans would pay a surcharge on the portion of their income above $500,000 (instead of $280,000) for individuals and $1 million (instead of $350,000) for couples, in order to help make health insurance affordable for middle class families.   
 
7. ADDRESSING GEOGRAPHIC VARIATIONS IN MEDICARE PAYMENTS/MOVING TO MEDICARE PAYMENTS REWARDING QUALITY AND COST-EFFECTIVENESS
The revised bill provides that the Institute of Medicine (IOM), through two studies, will make recommendations on how to fix the current Medicare reimbursement system, including addressing current geographic variations.  Under the bill, the Centers for Medicare and Medicaid Services (CMS) will implement the IOM recommendations on changes to Medicare payment systems unless disapproved by Congress. 
 
8. BEGINS CLOSING THE MEDICARE PART D DONUT HOLE IMMEDIATELY
The revised bill moves forward the effective date of reducing the donut hole by $500 and instituting a 50% discount for brand-name drugs in the donut hole, from January 1, 2011 to January 1, 2010.  It also completes elimination of the donut hole by 2019 (instead of 2024).      
 
9. IMMEDIATE HELP FOR THE UNINSURED (INTERIM HIGH-RISK POOL)
To fill the gap before the Exchange is available, the revised bill immediately creates an insurance program with financial assistance for those who have been uninsured for several months or denied a policy because of pre-existing conditions. 
 
10. HHS NEGOTIATION OF DRUG PRICES
Under the revised bill, the Secretary of HHS is required to negotiate drug prices on behalf of Medicare beneficiaries.   
 
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TOP 14 PROVISIONS THAT TAKE EFFECT IMMEDIATELY

1.  BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE  Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1, 2010.  
 
2.  IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL
Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions.  
 
3.  BANS LIFETIME LIMITS ON COVERAGE
Prohibits health insurance companies from placing lifetime caps on coverage
 
4.  ENDS RESCISSIONS
when they file a claim for benefits, except in the case of fraud.  
 
5.  EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27  BIRTHDAY THROUGH PARENTS INSURANCE Requires health plans to allow young people through age 26 . 
 
6.  ELIMINATES COST-SHARING FOR PREVENTIVE SERVICES IN MEDICARE
Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program.  
 
7.   IMPROVES HELP FOR LOW-INCOME MEDICARE BENEFICIARIES
Improves the low-income protection programs in Medicare to assure more individuals are able to access this vital help.       
 
8.  PROVIDES NEW CONSUMER PROTECTIONS IN MEDICARE ADVANTAGE Prohibits Medicare Advantage plans from charging enrollees higher cost-sharing for services in their private plan than what is charged in traditional Medicare.
 
9.  IMMEDIATE SUNSHINE ON PRICE GOUGING
Discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases. 
 
10. CONTINUITY FOR DISPLACED WORKERS
Allows Americans to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage.        
 
11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM
Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.  
   
12.  HELP FOR EARLY RETIREES
Creates a $10 billon fund to finance a temporary reinsurance program to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64.  
 
13.  COMMUNITY HEALTH CENTERS
Increases funding for Community Health Centers to allow for a doubling of the number of patients seen by the centers over the next 5 years.         
 
14. INCREASING NUMBER OF PRIMARY CARE DOCTORS 
Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals


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After reading all of the above, I honestly do not see how anyone could possibly object with a clear conscience.

Good Night Everyone!   

XOXO
Me