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Myth vs Fact: What Health Reform Means - 3/26/2010

While numerous organizations have spent millions of dollars to spread extreme rhetoric and patently false statements, we wanted to arm you with the following information about what the health care reform package really means, how it affects you, and why more than 360 key organizations supported reform.

Sources to separate MYTH VS FACT:

In Arizona’s 5th District, the health care reform package will:

  • Strengthen Medicare for 84,000 beneficiaries in the district, including closing the prescription drug “donut hole.”
    • It improves benefits by providing no-cost preventative and wellness care, improves primary and coordinated care and enhances nursing home care.
    • Begins to close the Medicare Part-D “donut hole” on prescription drug plans. Each year, approximately 10,100 Medicare beneficiaries in the district hit the donut hole and must spend thousands of dollars out of pocket on medicines.
    • Over 65, both Harry and Marianne count on Medicare for their health insurance and he wouldn’t vote to weaken it.
    • It has been endorsed by AARP, Alliance for Retired Americans, and the National Committee to Preserve Social Security and Medicare.
  • Improve coverage for 469,000 district residents with health insurance.
    • Approximate 69 percent of the 469,000 residents receive coverage through their employer or through individual plans.
    • Reform will not kick you off your current insurance. It will prohibit your insurance company from denying you coverage based on pre-existing conditions or from denying you coverage if you become sick.
    • It allows families and small businesses to qualify for tax credits to help cover costs of providing insurance.
    • It has been endorsed by Families USA, Consumers Union – publisher of Consumer Reports, League of Women Voters, National Council of Churches, United Methodist Church and the Children’s Defense Fund.
  • Allow 68,000 young adults living in the district to obtain coverage on their parents’ insurance plans.
    • It will allow young people to remain on their parents’ policies until age 26.
    • It will also allow young people under age 30 to purchase inexpensive coverage private coverage for catastrophic health care costs.
    • It has been endorsed by Consumers Union, publisher of Consumer Reports, Lance Armstrong’s LIVESTRONG Foundation, and the United States Students Association.
  • Guarantee that nearly 12,000 residents with pre-existing conditions can obtain coverage.
    • There are approximately 11,800 uninsured individuals in our district who have pre-existing medical conditions like cancer, heart disease and diabetes.
    • It will ban insurance companies from denying you coverage for a pre-existing condition.
    • It has been endorsed by the American Cancer Society, American Heart Association, American Diabetes Association, Autism Society of America, Epilepsy Foundation, and the Arthritis Foundation.
  • Protect 1,400 families in the district from bankruptcy due to unaffordable health care costs.
    • There were 1,400 health care-related bankruptcies in Arizona’s 5th district in 2008 caused primarily by costs not covered by insurance.
    • It will cap annual out-of-pocket costs at $6,200 for individuals and $12,400 for families for private insurance purchased through a state exchange and eliminates annual and lifetime limits on all insurance coverage to ensure that no family faces financial ruin due to health care costs.
  • Give tax credits and other assistance to up to 143,000 families and 15,700 small businesses to help them afford coverage.
    • It allows families and small businesses to qualify for tax credits to help cover costs of providing insurance.
    • Small businesses with 100 employees or less will be able to ‘pool’ their purchasing power, comparison shop and negotiate better rates, benefiting from group rates and a greater choice of providers. There are 17,800 small businesses in the district that could benefit. 
    • Small business with 25 employees or less and average wages of less than $50,000 will qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 15,700 small businesses in the district that could qualify for these credits.
    • Small businesses with 50 employees or less are not required to provide employer-based coverage.
    • It has been endorsed by the Main Street Alliance and Small Business Majority.
  • Reduce the cost of uncompensated care for hospitals and other health care providers by $50 million annually.
    • It is estimated that the average American family is already paying an extra $1,100 a year in premiums to pay for costs associated with treating the uninsured.
    • In 2008, health care providers provided care to individuals that lacked insurance coverage, who were unable to pay their bills.
    • By providing access to coverage for approximately 50,000 uninsured residents in the 5th district, the cost incurred by health care providers will be reduced by $50 million.
    • It has been endorsed by the American Medical Association, American Nurses Association, Federation of American Hospitals, Catholic Health Association, National Association of Children’s Hospitals, National Association of Community Health Centers and the American Hospital Association.

Some key provisions that WILL take effect within the first year include:

·       Banning insurance companies from dropping people from their coverage when they get sick.

·       Banning insurance companies from denying coverage to children with pre-existing conditions.

·       Creating an interim high-risk pool to provide immediate access to people who lack coverage due to pre-existing conditions.

·       Allowing young people to stay on their parents’ insurance policy until they are 26 years old.

·       Beginning to close the Medicare Part-D prescription drug donut-hole and eliminates co-payments for preventative services for seniors.

·       Providing tax credits for small businesses that will help make current coverage more affordable.

·       Creating a temporary program that help employers offset costs for providing coverage for early retirees age 55-64. 

·       Investing in training programs to increase the number of primary care doctors, nurses and public health professionals.

Sources: The U.S. Census (data on insurance rates, small businesses, and young adult population); The Centers for Medicare and Medicaid Services (data on Medicare and Part D enrollment); The Department of Health and Human Services (data on health care-related bankruptcies, uncompensated care, and pre-existing conditions); and the Congressional Budget Office (estimates of the percentages of citizens with health insurance coverage under health care reform legislation).

 
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