8/21/2014 12:00:29 PM
By The People: Elections for the many, not the money
Health Care

Reforming America’s Health Care System

Congressman Sarbanes is a strong advocate for reforming our health care system, and he has introduced and supported several bills that will expand affordable health coverage and improve the quality of care for all Americans. He supports the health care reform law because he believes it is a crucial step in our effort to reduce the cost of health care for families and small businesses, as well as providing access for those who currently do not have insurance.

The health insurance reform legislation marked a new direction for the country – away from the influence of powerful special interests and towards common sense solutions for America’s families. 

The Patient Protection and Affordable Care Act

The health care reform law is already providing lower costs and better health coverage for millions of Americans, including 105 million individuals who have received one or more free preventive services, such as check-ups and cancer screenings; 6.1 million seniors in the "donut hole" who have saved $5.7 billion on their prescription drugs; and 360,000 small business owners who have used the Small Business Health Care Tax Credit to help them afford health insurance for 2 million employees.

This landmark legislation also provides deficit savings of more than $1 trillion over the next two decades. These are just a few examples of how the health reform law is already empowering people to get access to affordable, quality health care and below are a few more detailed explanations of the positive impact health care reform is having on our country.

Reining in insurance industry abuses

No more dropping coverage – Insurance companies can no longer cancel your coverage when you get sick and need it the most.

No more lifetime limits on coverage – Insurance companies can no longer put a lifetime limit on the amount of coverage they provide. Now families can live with the security of knowing that their coverage will be there when they need it most.

No More Discriminating Against Kids with Pre-Existing Conditions – Insurance companies are now prohibited from discriminating against kids with pre-existing conditions.

Enhancing benefit opportunities

Preventive care – Services like mammograms, colonoscopies, immunizations, pre-natal and new baby care are covered with no out-of-pocket costs and insurance companies are prohibited from charging deductibles, co-payments or co-insurance.

Covering young adults on parent's plan – Young adults are now allowed to remain on their parent's plan until their 26th birthday, unless they are offered coverage at work. This has helped 2.5 million young adults to keep their health insurance.

Lower costs for seniors on prescription drugs – Seniors now receive a 50 percent discount on brand-name drugs in the "donut hole" and a 14 percent discount on generics, saving seniors an average of $604. The health care law will permanently close the donut hole by 2020.

More premium dollars for care – Insurance companies are now required to spend at least 80 percent of collected premiums on medical services and quality improvements, rather than expenses that do not directly benefit policyholders, such as salaries, advertising, overhead and profits. Insurers must also publish justifications for any premium increases over 10 percent and outside experts will evaluate whether the increases are justified. Over $27 million dollars will be refunded to Marylanders this year by insurance companies that failed to comply with this rule; an average of $340 for each qualifying family.

Supporting small businesses

Tax credits for coverage – The health care reform law has provided $40 billion in tax credits to small businesses that choose to offer health insurance coverage to their employees. In 2011, 360,000 small employers took advantage of these tax credits and President Obama has proposed expanding the tax credit so more employers would qualify.

Access to quality health plans – In 2014, small businesses will have access to health insurance exchanges, or competitive marketplaces, where they will be able to purchase affordable coverage that has a guaranteed set of minimum benefits.

More changes on the way

Several important provisions of the health care reform law will be implemented beginning in 2014, including coverage for anyone with a pre-existing condition, a cap on out-of-pocket costs and access to health insurance exchanges where uninsured individuals and small business can choose from multiple private plans, thereby benefiting from access to the kind of group rates that are now available only to large employers. This approach will make health insurance more "portable" and give real relief to the millions of Americans who currently have nowhere to turn.

The health insurance law also had numerous provisions to slow the growth of health care costs – requiring new transparency and accountability for insurance companies; key delivery system reforms; fighting waste, fraud and abuse in Medicare; better coordinating care; and a renewed focus on preventing diseases before they happen.

Please visit the website managed by the U.S. Department of Health & Human Services at http://www.healthcare.gov if you would like more detailed information about the health care law.

Health care workforce

One of Congressman Sarbanes’ top priorities during the debate on health care reform was to address workforce shortages, particular those for primary care physicians.

He worked to include several provisions in the new law that will help to alleviate some of these shortages:
  • Additional scholarships and loan repayment programs for primary care providers in health shortage areas
  • Strengthened grant programs for primary care training
  • A 10 percent bonus under Medicare for primary care services
  • Redistribution of unused residency slots to medical programs that train more primary care physicians and general surgeons
The law also establishes a new advisory commission that will help align our health care workforce with the needs of the greater population – now and into the future.

To further address the country’s shortage of primary care physicians, Congressman Sarbanes introduced the Physician Reentry Demonstration Program, a bipartisan bill which will help combat America’s shortage of primary care physicians by encouraging mid-career and retired or retiring physicians to return to practice. This legislation would provide training and financial assistance to physicians returning to medical practice in exchange for their service as a public health provider.

  • Learn about insurance options, prevention and find resources at healthcare.gov.
  • Visit the IRS website for health care resources available to small businesses.
  • Immediate impact on Maryland fact sheet
More Information:

Blog: Health care reform is working
Maryland Physician Magazine: Supreme Court Ruling Should Spur Physician Leadership
Press Release: Sarbanes Introduces Legislation to Combat America’s Shortage of Primary Care Physicians

John Sarbanes
John Sarbanes
John Sarbanes
John Sarbanes
John Sarbanes