Health Care Reform Proposals Emerging in Congress
The time for comprehensive health care
reform is now! Families and businesses
throughout the nation are
struggling to find health care
that they can afford. Millions of
Americans have no insurance at
all. Most people in this country
now agree that our health care
system is broken and needs to be
fixed. The President and leaders in
the House and Senate have made
health care reform a priority.
MEJP and MAIN have been following the
health care debate in Congress throughout the
summer and fall. Our focus is on protecting
and expanding coverage for people with low
income.
The current leading proposals in Congress
have similar plans for expanding access to
health coverage. They would:
- make important reforms to the health
insurance market,
- expand Medicaid coverage for people
with low income,
- provide subsidies for people with
low to moderate income to purchase
health coverage, and
- require most people to have some
form of health insurance coverage.
Insurance Reforms
Maine has been in the forefront in setting
important consumer protections in our
state’s health insurance market. Many of
the congressional proposals to reform the
insurance market would line up federal law
with our existing state law. This is important
for Maine consumers because it would mean
that Maine’s protections would be federal law.
They would no longer be at risk of
being weakened or eliminated in
the state legislature each session.
Maine consumers would also
benefit from the proposals to
stop insurance companies from
excluding coverage based on
preexisting conditions. In Maine,
this provision would eliminate
the current waiting period, which can be as
long as 12 months, for coverage of already
diagnosed conditions. Many consumers now
face this limit after signing up for health
coverage.
Expanding Medicaid Coverage
Proposals in the House and the Senate
would require all states to provide Medicaid
coverage to all non-elderly adults and children
with income up to 133% of the federal
poverty level. This expansion would fill
many of the existing gaps in the Medicaid
program nationwide. Maine has led the
country in expanding its Medicaid program
to help cover the uninsured, but we too have
gaps in our program.
The proposed expansion would mean that
ALL non-elderly childless adults with income
below 133% of the current poverty level
could be covered by MaineCare. It would
also mean that the eligibility cutoff for people
with disabilities would increase from 100%
of the federal poverty level to 133%. A single
person at 133% of the federal poverty level
has an annual income of $14,404.
The current proposals
would also help people
with low to moderate
income not covered
by Medicaid purchase
health coverage through a
‘Health Care Exchange’.
The Exchange would
allow people and small businesses to compare
health plans and purchase insurance coverage
based on cost and benefit packages.
People with low to moderate income would
receive subsidies to purchase coverage through
the health care exchange. These subsidies
would be on a sliding scale, based on household
income.
It is critical that people with low to moderate
income get the financial assistance they need
to cover the cost of their premiums and other
out of pocket expenses. If people with low
to moderate income continue to be unable to
afford coverage, health care reform will not be
successful.
Public Plan Option
The House bill would include the option of
a public plan in the health care exchange.
There has been much debate about including a
public plan in health care reform. We believe
that people should have the choice of a high
quality public plan that competes with private
insurance in the exchange. The public plan
with lower administrative costs and power
to bargain lower prices would force private
insurers to lower their costs over time. There
are two Senate Committee bills. One calls for a
public option and one does not.
Individual Mandate
All of the proposals include an “individual
mandate”. This individual mandate would
require everyone, except people with very low
income, to purchase health coverage. If people
do not purchase coverage, they would have to
pay a fee. An individual mandate would help
bring the cost of health coverage down for
everyone. It means that people will participate
in the health insurance market, whether they are
healthy or not. When everyone has coverage
and is paying into the system, the overall cost of
our health care system will be less.
The individual mandate, however, could be
extremely unfair and burdensome if people
cannot afford to purchase coverage. Final
health care reform legislation MUST provide
subsidies that are deep enough to ensure that
people can truly afford coverage through the
exchange.
Next Steps
As you all know from listening
to the radio and TV this issue
is complex and controversial.
Many powerful corporations
and institutions are trying to
protect their interests
will be challenging to get agreement on a
health care reform bill that really protects
consumers, particularly those with low
income. But that is what CAN and MUST be
done. The millions of people in this country
without access to affordable health coverage
can wait no longer. We at MEJP will continue
to advocate for a bill that makes health care
accessible and affordable to all. We urge
you to join us.
Contact Maine’s Congressional
Delegation TODAY!
Urge them to support national health care
reform legislation that makes health care
coverage accessible and affordable for
everyone. Tell them that health care reform
should expand Medicaid coverage and
provide deep subsidies to people with low to
moderate income to ensure that they can
afford coverage.
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Maine’s Congressional Delegation
Senator Snowe
Toll free in Maine: (800) 432-1599
TDD - Maine Relay Service: 1-955-3323
Senator Collins
Augusta (207) 622-8414
Bangor (207) 945-0417
Biddeford (207) 283-1101
Caribou (207) 493-7873
Lewiston (207) 784-6969
Portland (207) 780-3575
Representative Michaud
Bangor 207-942-6935
Lewiston 207-782-3704
Presque Isle 207-764-1036
Waterville 207-873-5713
Representative Pingree
Portland 207-774-5019
Outside of Portland (toll free) 1-888-862-6500
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