Bill to Provide Quality, Affordable Health Care for All Americans Heading to House Floor

Legislation Covers 96 percent of Americans, Reduces the Deficit

Washington, DC - Rep. Linda Sánchez, member of the House Ways and Means Committee, which has jurisdiction over healthcare, joined House Speaker Nancy Pelosi at a press conference today to unveil a new health reform bill.

The Affordable Health Care for America Act (H.R. 3962) blends and updates the three versions of previous bills passed by the House committees of jurisdiction in July. It will slow the growth in out-of-control costs, introduce competition into the health care marketplace to keep coverage affordable and insurers honest, protect people's choices of doctors and health plans, and assure all Americans access to quality, stable, affordable health care.

"I am proud that for the first time in our history, all Americans will have access to quality, affordable health care under health insurance reform legislation unveiled by House Democrats today," said Rep. Linda Sánchez. "But I am most pleased that insurance companies will no longer be able to discriminate against women on the basis of gender."

The bill includes Rep. Sánchez' provision to prohibit health insurance companies from engaging in "gender rating," a practice which charges women more for health insurance premiums than men. The Gender Equity in Health Premiums Act would amend the Public Health Service Act to prohibit gender rating in both the group and individual markets.

"Never again will a woman be denied insurance or charged one and a half times the amount of a man, simply because she is a woman," continued Sánchez. "Never again will women be denied coverage for such "pre-existing conditions" as pregnancy, C-section, or being a domestic violence victim."

The bill also includes a provision encouraging healthcare providers to participate in "Collaborative Care Networks," to deliver higher quality, more coordinated care to low-income and vulnerable patients. The provision, based on the Sánchez' DSH Collaborative Care Network Pilot Program Act (H.R. 3043), will allow providers to better track patients who have chronic conditions like diabetes and asthma, and to provide necessary services like interpreters or transportation to appointments, while keeping patients out of expensive emergency rooms.

The legislation will ensure that 96 percent of Americans will be covered by a quality, affordable health plan. The Congressional Budget Office estimates the cost of expanding coverage at $894 billion, consistent with the $900 billion coverage mark laid out by President Obama. And the legislation will be paid for. CBO estimates the bill reduces the deficit by at least $30 billion over 10 years.

"For too long, health care in America has been a privilege - not a right," said Sánchez. "I have worked long and hard to help develop this consensus bill that incorporates feedback from my constituents and delivers reform that will protect and strengthen coverage for those who have it and help cover those who are currently uninsured."

The key components of the Affordable health Care for America Act include:

Increasing choice and competition. The bill will protect and improve consumers' choices.
* If people like their current plans, they will be able to keep them.
* For individuals who aren't currently covered by their employer, or are self-employed, the proposal will establish a new Health Insurance Exchange where consumers can comparison shop from a menu of affordable, quality health care choices including private plans, health co-ops, and a new public health insurance option. The public health insurance option will play on a level playing field with private insurers, spurring additional competition.
* This Exchange will create competition based on quality and price that leads to better coverage and care. Patients and doctors-not insurance companies-will have control over decisions about their health care.

Giving Americans peace of mind. The legislation will ensure that Americans have portable, secure health care coverage - so that they won't lose care if their employer drops their plan or they lose their job.
* Every American who receives coverage through the Exchange will have a plan that includes standardized, comprehensive and quality health care benefits.
* Insurance companies won't be able to increase premiums or deny care based on pre-existing conditions, race, or gender, and will be limited in the premium increases they can impose due to age.
* Co-pays for preventive care are eliminated, and out-of-pocket expenses are capped to protect every American from bankruptcy.

Improving quality of care for every American. The legislation will ensure that Americans of all ages, from young children to retirees, have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.
* Guarantees that every child in America will have health care coverage that includes dental, hearing, and vision benefits.
* Provides better preventive and wellness care. Every health care plan offered through the exchange and by employers after a grace period will cover preventive care at no cost to the patient.
* Increases the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
* Strengthens Medicare and Medicaid and closes the Medicare Part D donut hole' so that seniors and low-income Americans receive better quality of care and pay lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. The bill will ensure that individuals, employers, and the federal government share responsibility for a quality and affordable health care system.
* Employers can continue offering coverage to workers, and those who choose not offer coverage contribute a fee of eight percent of payroll.
* All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income, subject to a hardship exemption.
* The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families, to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. The legislation will put the interests of consumers first, protect them from problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.
* Provides transparency in plans in the Health Exchange so that consumers have the clear, complete information, in plain English, needed to select the plan that best meets their needs.
* Establishes consumer advocacy offices as part of the Exchange in order to protect consumers, answer questions, and assist with any problems related to plans.
* Simplifies paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer-friendly system.
* Increases funding of efforts to reduce waste, fraud, and abuse; creates enhanced oversight of Medicare and Medicaid programs.

Reducing the deficit and ensuring the solvency of Medicare and Medicaid. The legislation will be entirely paid for¬ - it will not add a dime to the deficit. It will also put Medicare and Medicaid on the path to a more fiscally sound future, so seniors and low-income Americans can continue to receive the quality health care benefits for years to come.
* Pays for the entire cost of the legislation though a combination of savings achieved by making Medicare and Medicaid more efficient ¬- without cutting seniors' benefits and revenue generated from placing a surcharge the top 0.3 percent of all households in the U.S.(married couples with adjusted gross income of over $1,000,000) and other tax measures.
* The Congressional Budget estimates the bill will reduce the deficit by at least $100 billion over ten years.
* Estimates also show the bill will slow the rate of growth of the Medicare program from 6.6 percent annually to 5.3 percent annually.


To view a copy of the Affordable Health Care for American Act, H.R. 3926, click here.