The facts about healthcare reform

In April 2010, President Obama signed into law two bills that will bring landmark national healthcare reform to the United States.

The President signed the Patient Protection and Affordable Care Act (HR 3590) and the Reconciliation Act (HR 4872). CSEA supported both historic healthcare reform bills.

"This historic occasion is the beginning of meaningful healthcare reform," Association President Allan Clark said after the bills were signed. "CSEA continues to lead the fight to provide healthcare access to the millions of uninsured, cut costs for the insured and improve quality of care."

The bills will prohibit insurance companies from denying healthcare based on pre-existing conditions, and ban them from dropping coverage when people get sick. The healthcare reform bills will extend coverage to more than 95 percent of Americans, including 32 million who were previously uninsured.

Additionally, all insurance plans that provide dependent coverage will now be required to cover dependents up to age 26. The bills also cap out-of-pocket costs, and will close the Medicare prescription drug “donut hole” by the end of the decade.

"If you have health insurance, this reform just gave you more control by reining in the worst excesses and abuses of the insurance industry with some of the toughest consumer protections this country has ever known -- so that you are actually getting what you pay for," President Barack Obama said. "If you don’t have insurance, this reform gives you a chance to be a part of a big purchasing pool that will give you choice and competition and cheaper prices for insurance. And it includes the largest healthcare tax cut for working families and small businesses in history."

The healthcare reform signed into law also does the following:

• In 2014, it will set up a new competitive health insurance market, called the Exchange, giving millions of Americans the same choices of insurance that members of Congress will have.
• It brings greater accountability to healthcare by laying out common sense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.
• It puts the federal budget and national economy on a more stable path by reducing the deficit by more than $100 billion over the next 10 years by cutting government overspending and reining in waste, fraud and abuse.

CSEA continues to support universal healthcare
While the new national healthcare reform is a big step in the right direction, CSEA continues to support SB 810 (Leno). This bill would establish a single-payer, universal healthcare system that would provide affordable, comprehensive care to all Californians.

"We still have work to do in leading the way for SB 810," Clark said. “We need to keep working hard to secure healthcare for all.”

In late January, the state Senate passed SB 810, introduced by State Sen. Mark Leno, by a vote of 22-14. SB 810 would provide healthcare coverage to all Californians. It is the current version of SB 840, which CSEA helped pass through the Legislature twice, only to be vetoed by Gov. Arnold Schwarzenegger.

Timeline for implementing federal healthcare reform laws 

2010

• Bars insurance companies from denying coverage to children who have pre-existing conditions.
• Prohibits insurance companies from dropping your coverage because you get sick.
• Enables uninsured people with pre-existing conditions to get coverage through a high-risk pool.
• Eliminates lifetime coverage limits and restricts annual limits.
• Allows you to keep your children on your plan until they turn 26.
• Starts closing the Medicare prescription drug “donut hole” with a $250 rebate for people who fall into the donut hole.
• Helps companies offset the cost of providing coverage to early retirees.

2011

• Continues closing the Medicare prescription drug donut hole by providing a 50 percent discount on brand-name drugs in the donut hole.
• Provides grants to states for consumer assistance programs.

2012

• Begins payment reforms and incentives to encourage doctors and hospitals to provide more efficient and higher-quality care and reduce preventable hospital readmissions.

2014

• Bars insurance companies from denying coverage because of pre-existing conditions or charging more for groups with large numbers of women.
• Prohibits health plans from imposing annual limits on the amount of coverage you can get.
• Opens health insurance exchanges in each state to individuals and small employers, allowing people to comparison shop.
• Makes insurance affordable for lower-income people through tax credits and vouchers to use in the exchanges and by expanding access to Medicaid.
• Requires most people to have health insurance or pay a penalty.
• Requires employers with 50 or more employees that don’t provide health coverage to pay a fee for employees who have to get subsidies to buy their own insurance in the exchanges.

2018

• Begins the excise tax on employer-provided health plans costing more than $27,500 for family coverage and $10,200 for individual coverage. For retirees and workers in high-risk professions, the thresholds are $30,950 for family coverage and $11,850 for individual coverage. Thresholds will increase with inflation and if the group has a large number of older members or women. The work of union activists reduced the excise tax by 85 percent from the original proposal by raising the thresholds and pushing back the effective date.