Affordable Care Act to improve quality of care for people with Medicare
"The U.S. Department of Health and Human Services (HHS) today released proposed new rules to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs). ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower health care costs while meeting performance standards on quality of care and putting patients first. Patient and provider participation in an ACO is purely voluntary.

The proposed new rules will help doctors, hospitals, and other providers form ACOs and are now available for public comment. HHS also announced it will hold a series of open-door forums and listening sessions during the comment period to help the public understand what the Centers for Medicare & Medicaid Services (CMS), the agency administering the ACO program, is proposing to do and to ensure that the public understands how to participate in the formal comment process..."

OBAMACARE: A BUDGET-BUSTING, JOB-KILLING HEALTH CARE LAW
"This report details the economic and fiscal consequences of the Patient Protection and
Affordable Care Act (PPACA,) signed into law by President Barack Obama on March 23,
2010. Several rationales were offered in support of this legislation, including that it would
lead to the creation of jobs and the reduction of the federal budget deficit. This report
shows that the health care law will achieve neither effect.

Economic Consequences. Consistent with respected economists‟ forecasts, the health
care law contains a number of provisions that will eliminate jobs, reduce hours and wages,
and limit future job creation. Specifically, the law:

 Penalizes employers for failing to offer coverage deemed acceptable by the
government;
 Imposes burdensome mandates on small businesses, including new paperwork
requirements; and
 Compounds the uncertainty employers and entrepreneurs are facing amid a
challenging economic climate..."

At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans:129 Million People Could Be Denied Affordable Coverage Without Health Reform
"According to a new analysis by the Department of Health and Human Services, 50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition. Up to one in five non-elderly Americans with a pre-existing condition – 25 million individuals – is uninsured. Under the Affordable Care Act, starting in 2014, these Americans cannot be denied coverage, be charged significantly higher premiums, be subjected to an extended waiting period, or have their benefits curtailed by insurance companies.

As many as 82 million Americans with employer-based coverage have a pre-existing condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease. Without the Affordable Care Act, such conditions limit the ability to obtain affordable health insurance if they become self-employed, take a job with a company that does not offer coverage, or experience a change in life circumstance, such as divorce, retirement, or moving to a different state. Older Americans between ages 55 and 64 are at particular risk: 48 to 86 percent of people in that age bracket have some type of pre-existing condition. And 15 to 30 percent of people in perfectly good health today are likely to develop a pre-existing condition over the next eight years, severely limiting their choices without the protections of the Affordable Care Act..."

H.R. 2, the Repealing the Job-Killing Health Care Law Act
"Dear Mr. Speaker:
The Congressional Budget Office (CBO) has reviewed H.R. 2,
the Repealing the Job-Killing Health Care Law Act, as introduced
on January 5, 2011. That bill would repeal the Patient Protection and
Affordable Care Act (PPACA, Public Law 111-148) and the provisions of
the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152)
that are related to health care. Both of those laws were enacted in
March 2010.."

HHS Strengthens Health Information Privacy and Security through New Rules
"HHS Secretary Kathleen Sebelius today announced important new rules and resources to strengthen the privacy of health information and to help all Americans understand their rights and the resources available to safeguard their personal health data. Led by the Office of the National Coordinator for Health Information Technology (ONC) and the HHS Office for Civil Rights (OCR), HHS is working with public and private partners to ensure that, as we expand the use of health information technology to drive improvements in the quality and effectiveness of our nation’s health care system, Americans can trust that their health information is protected and secure.

“To improve the health of individuals and communities, health information must be available to those making critical decisions, including individuals and their caregivers,” said HHS Secretary Kathleen Sebelius. “While health information technology will help America move its health care system forward, the privacy and security of personal health data is at the core of all our work.”

Through the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, current health information privacy and security rules will now include broader individual rights and stronger protections when third parties handle individually identifiable health information.

The proposed rule announced today would strengthen and expand enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Enforcement Rules by:

expanding individuals’ rights to access their information and to restrict certain types of disclosures of protected health information to health plans.
requiring business associates of HIPAA-covered entities to be under most of the same rules as the covered entities;
setting new limitations on the use and disclosure of protected health information for marketing and fundraising; and
prohibiting the sale of protected health information without patient authorization..."

U.S. Departments of Health and Human Services, Labor, and Treasury Issue Regulation on “Grandfathered” Health Plans under the Affordable Care Act
"The U.S. Departments of Health and Human Services, Labor and Treasury today issued a new regulation that makes good on President Obama’s promise that Americans who like their health plan can keep it.

The new regulation protects the ability of individuals and businesses to keep their current plan while providing important consumer protections that give Americans – rather than insurance companies – control over their own health care. The new regulation also provides stability and flexibility to insurers and businesses that offer health insurance coverage as the nation transitions to a more competitive marketplace in 2014 when businesses and consumers will have more affordable choices through exchanges.

“The Affordable Care Act gives American families more control over their health care by providing greater benefits, cost savings and protections,” said Secretary of Health and Human Services Kathleen Sebelius. “Today, with the announcement of the new ‘grandfather’ rule, we’re providing the market stability and flexibility to ensure that families and businesses can make the choices that work best for them.”

While the Affordable Care Act requires all health plans to provide important new benefits to consumers, under the law, plans that existed on March 23, 2010 are exempt from some new requirements. The “grandfather rule” issued today makes it clear that these plans can continue to innovate and contain costs by allowing insurers and employers to make routine changes without losing grandfather status. Plans will lose their “grandfather” status if they choose to significantly cut benefits or increase out-of-pocket spending for consumers – and consumers in plans that make such changes will gain new consumer protections..."

HealthReform.gov
Find update-to-date information on enactment of the recently passed health reform law (the Patient Protection and Affordable Care Act, PL-111-148)

Sebelius Continues Work to Implement Health Reform, Announces First Steps to Establish Temporary High Risk Pool Program
"U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today issued a letter to governors and independent insurance commissioners asking each state to express their interest in participating in the temporary high risk pool program established by the new health insurance reform law. The temporary high risk pool program was created to help provide coverage to people who are uninsured because of pre-existing conditions. States may choose whether and how they participate in the program. HHS is committed to working closely with states as the program is implemented.

“The establishment of a temporary new high risk pool program is one of our first tasks in implementing the new health reform law and will help provide affordable insurance for Americans who have been locked out of the insurance market for too long,” said Sebelius. “This letter marks the first step in that process and demonstrates one of our core principles of implementation -- building on effective programs that already exist. In the coming days, we will work closely with states to answer their questions.”

In her letter, Sebelius writes, “We are interested in building upon existing state programs in this important initiative to provide expanded access to health coverage for individuals who cannot otherwise obtain health insurance. To that end, I am writing you today to request an expression of your state’s interest in participating in this temporary high risk pool program, consistent with one of the implementation options described below.”

The new health insurance reform law provides $5 billion in federal funds to support this new program. States have a number of options for how they may participate. Options include:

Operate a new high risk pool alongside a current state high risk pool;
Establish a new high risk pool (in a state that does not currently have a high risk pool);
Build upon other existing coverage programs designed to cover high risk individuals;
Contract with a current HIPAA carrier of last resort or other carrier, to provide subsidized coverage for the eligible population; or
Do nothing, in which case HHS would carry out a coverage program in the state."

Putting Americans in Control of Their Health Care (President Obama's health care proposal)
"What will the President's proposal mean for you?
Take a few minutes to find out what health insurance reform would mean for you and your family. To begin, select which one describes your situation:

"I have insurance through my work."
"I own a small business."
"I have Medicare."
"I do not have insurance."
"I buy my own insurance.""

Sebelius Unveils New Report on Requested Premium Increases in States Across the Country
"U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today unveiled a new report, Insurance Companies Prosper, Families Suffer: Our Broken Health Insurance System. The report highlights health insurance premium increases in states across the country and comes shortly after Anthem Blue Cross announced plans to raise rates on its California customers by as much as 39 percent, even after its parent company took in a profit of $2.7 billion in the previous quarter. The complete report is available at www.HealthReform.gov.

“Over the last year, America’s largest insurance companies have requested premium increases of 56 percent in Michigan, 24 percent in Connecticut, 23 percent in Maine, 20 percent in Oregon, and 16 percent in Rhode Island, to name just a few states,” said Sebelius. “Premium increases have left thousands of families that are already struggling during the economic downturn with an unpleasant choice between fewer benefits, higher premiums, or having no insurance at all. Hard-working families deserve better.”

The report examines requested insurance premium increases and notes:

Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state.
Anthem in Maine had an 18.5 percent premium increase rejected by the state last year as being “excessive and unfairly discriminatory” – but is now requesting a 23 percent increase this year.
In 2009 Blue Cross Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market.
Regency Blue Cross Blue Shield of Oregon requested a 20 percent premium increase.
UnitedHealth, Tufts and Blue Cross requested 13 to 16 percent rate increases in Rhode Island.
Rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations..."

Sebelius Releases New Report: Protecting Families and Putting More Money in Your Pocket: How Health Insurance Reform Will Lower Costs and Increase Choices
"HS Secretary Kathleen Sebelius today released a new report, Protecting Families and Putting More Money in Your Pocket: How Health Insurance Reform Will Lower Costs and Increase Choices. The report highlights how health insurance reform will benefit families across the country and is available now at www.HealthReform.gov.

“Health insurance reform isn’t about politics, it’s about families. Every day, millions of families across the country wonder how they will pay their skyrocketing medical bills or what they will do if their children get sick,” Secretary Sebelius said. “Those families are our priority and we are fighting to give them the affordable, secure, stable coverage they need.”

Under the health care status quo, the average premium for a family plan purchased through an employer is $13,375, more than double the premium in 2000 and premiums have grown more than three times faster than wages. The number of people in working families who spend more than ten percent of their income on health care has more than tripled. Additionally, a recent survey estimated that 72 million non-elderly adults have accumulated medical debt or had difficulty paying medical bills in the past year -- and 61 percent of them had insurance.

Health insurance reform will ensure that every American can find affordable health care coverage, control costs for families and provide Americans with unprecedented stability and security. Reform will also help strengthen the American economy and put more money in the pockets of American families. Lowering health care costs by 1 percent will create 320,000 jobs nationwide and raise median family income by $6,800 by 2030. Reform will also drive down premiums for families and limit out-of-pocket costs that eat into the family budget."

House Report 111-330 to accompany for H.R. 3962,the Affordable Health Care for America Act
"PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 3962) TO PROVIDE AFFORDABLE,
QUALITY HEALTH CARE FOR ALL AMERICANS AND REDUCE THE GROWTH IN HEALTH CARE SPENDING, AND FOR OTHER PURPOSES, AND PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 3961) TO
AMEND TITLE XVIII OF THE SOCIAL SECURITY ACT TO REFORM THE MEDICARE SGR PAYMENT SYSTEM FOR PHYSICIANS."

Health Reform and the 111th Congress
"..The health reform bills being considered by the House and Senate committees of principle jurisdiction focus on simultaneously expanding private and public coverage options. Some of the other bills introduced in the 111th Congress take a similar approach to health reform. Additionally, other bills have focused on other solutions, attempting to expand coverage using one of the following approaches:

• Largely replace existing coverage with a national government-provided health
insurance program (or a national health service).
• Expand existing public programs for certain individuals.
• Expand privately sponsored coverage.
• Encourage state-based reforms.
• Simultaneously expand private and public coverage options.

This report presents basic background on health insurance that may be useful to legislators considering health insurance reforms. It describes reform approaches and provides brief descriptions of health insurance reform bills introduced in the 111th Congress, as well as some of the general principles currently being considered by the Congress. The potential impact of the various approaches and bills is not analyzed in this report, however. As a result, it does not provide evaluations of how well different bills, once enacted, would meet their objectives. This report will be updated periodically to reflect recent congressional activity in health reform."

A Preliminary Analysis of a Substitute Amendment to H.R. 3962, the Affordable Health Care for America Act
"This evening, CBO released a preliminary analysis of a substitute amendment to H.R. 3962, the Affordable Health Care for America Act, proposed by Representative John Boehner, the Republican Leader in the House of Representatives. CBO and the staff of the Joint Committee on Taxation (JCT) estimate that the amendment would reduce federal deficits by $68 billion over the 2010-2019 period; it would also slightly reduce federal budget deficits in the following decade, relative to those projected under current law, with a total effect during that decade that is in a broad range between zero and one-quarter percent of gross domestic product..."

Lower Premiums, Stronger Businesses: How Health Insurance Reform Will Bring Down Costs for Small Businesses
"Across the country, America’s businesses are struggling as the cost of health care continues to skyrocket. Premiums for employer-based health insurance have more than doubled since 2000, a growth rate three times that of wages.1 By 2025, one in every four dollars in our nation’s economy will be spent on health care2 – money that could have been invested in our nation’s businesses. Rising health care costs cut into employee wages and impede hiring and business growth.

Small businesses, the backbone of job creation in our economy, are disproportionately burdened by the financial strains caused by rising health care costs.3 On average, small businesses pay up to 18 percent more than large firms for the same health insurance policy. 4 This difference is due in part to high broker fees (which can be up to 10 percent of premiums),5 and health plan administrative costs that are three to four times those in the large group market.6 These higher costs discourage small businesses from covering their employees. In a recent national survey, nearly three-quarters of small businesses that did not offer benefits cited high premiums as the reason..."

Fighting Back Against Cancer: Health Insurance Reform & Cancer in America
"Rising health care costs leave a growing number of Americans either uninsured or with insurance that does not provide the coverage they need and deserve – especially the 11 million Americans with cancer. 1 The results of a recent survey estimated that 72 million, or 41 percent, of non-elderly adults have accumulated medical debt or had difficulty paying medical bills in the past year – and 61 percent of those with difficulty had insurance. 2 Any medical event, like the diagnosis of cancer, could place a person at risk of taking on a potentially devastating financial burden, even if they have health insuranc.."

Secretary Sebelius to Deliver Health Insurance Reform Address, Release New Report on Insurance Insecurity
" in 6 Americans with Health Insurance Provided by an Employer Lost Coverage

HHS Secretary Kathleen Sebelius today will address the University of Chicago’s dialogue on health care reform and education and issue a new report on the employer-sponsored insurance market. The new report, Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage is available at www.HealthReform.gov and highlights problems in the status quo that have left Americans who receive health insurance from an employer at risk of losing their insurance coverage and joining the ranks of the uninsured.

“I share the President’s optimism that we can achieve reform this year. Americans have never understood this clearly -- our health insurance system is broken -- for the insured, for the uninsured, for all of us,” said Sebelius. “Now it’s time to deliver for the American people.”

The new report indicates:

A full one in six Americans with employer-sponsored insurance in 2006 lost that coverage by 2008.
When an employee and his or her family lose employer coverage, the family must seek alternative coverage and frequently turn to the individual market. However, a family that buys insurance on the individual market pays nearly 60 percent more in out-of-pocket costs such as deductibles and co-payments than a family that gets insurance through work
Almost 75 percent of individuals looking for coverage on the individual market never bought a plan, with 61 percent of those who did not purchase the insurance citing premium cost as the primary reason.
The complete report can be read at www.HealthReform.gov."

THE OBAMA PLAN: STABILITY & SECURITY FOR ALL AMERICANS

"It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government."
– President Barack Obama

If You Have Health Insurance

More Stability and Security

Ends discrimination against people with pre-existing conditions. Over the last three years, 12 million people were denied coverage directly or indirectly through high premiums due to a pre-existing condition. Under the President’s plan, it will be against the law for insurance companies to deny coverage for health reasons or risks.
Limits premium discrimination based on gender and age. The President’s plan will end insurers’ practice of charging different premiums or denying coverage based on gender, and will limit premium variation based on age.

Prevents insurance companies from dropping coverage when people are sick and need it most. The President’s plan prohibits insurance companies from rescinding coverage that has already been purchased except in cases of fraud. In most states, insurance companies can cancel a policy if any medical condition was not listed on the application – even one not related to a current illness or one the patient didn’t even know about. A recent Congressional investigation found that over five years, three large insurance companies cancelled coverage for 20,000 people, saving them from paying $300 million in medical claims - $300 million that became either an obligation for the patient’s family or bad debt for doctors and hospitals..."

"If You Don't Have Insurance

Quality, Affordable Choices for All Americans

Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices. The President’s plan allows Americans who have health insurance and like it to keep it. But for those who lose their jobs, change jobs or move, new high quality, affordable options will be available in the exchange. Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality..."

New State-by-State Reports Show How Health Insurance Reform Will Benefit All Americans
"HS Secretary Kathleen Sebelius today released Stable and Secure Health Care for America, a series of new state-by-state reports outlining how health insurance reform will improve health care for all Americans. Sebelius announced the availability of the new reports as part of a Webcast -- “Health Insurance Reform: What’s In It For You?” -- where Sebelius and top HHS officials took questions from the American people and discussed the importance of health insurance reform. The new reports are available at www.HealthReform.gov.

“These reports show how health insurance reform will help Americans save money, get better care, strengthen their insurance if they already have it, and afford insurance if they don’t,” said Sebelius. “Every American will benefit when we pass health insurance reform.”

The reports released today show reform will:

Lower health care costs;
Increase health care choices by protecting what works and fixing what’s broken; and
Assure quality, affordable care for all Americans.
Today’s reports are the second in a series of state-by-state reports on health care across the country. Earlier this summer, Sebelius released The Health Care Status Quo in Your State, a series of state by state reports on the current state of health care in America..."

House Democrats’ Health Reform Proposal: Preliminary Analysis of Major Provisions Related to Insurance Coverage
"CBO and the staff of the Joint Committee on Taxation (JCT) worked together to produce a preliminary analysis of the major provisions related to health insurance coverage that are contained in draft legislation called the America’s Affordable Health Choices Act, which was released today by several House committees. Among other things, those provisions would establish a mandate for most legal residents to obtain insurance, significantly expand eligibility for Medicaid, and set up insurance “exchanges” through which certain individuals and families could receive federal subsidies to substantially reduce the cost of purchasing that coverage. The analysis issued today does not take into account other parts of the proposal that would raise taxes or reduce other spending (particularly in Medicare) in an effort to offset the federal costs of the coverage provisions..."