Podcast: Understanding the House Health Reform Bill

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November 17, 2009

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In this podcast, we will discuss the House health reform bill and the next steps for Congress in moving forward with reform. I’m Shannon Spillane and the Center’s Senior Health Fellow, Judy Solomon, is joining us today.

1. Judy, the House just passed a large, complex health reform bill. What are the most important elements for our listeners to know about?

A: The House bill makes significant progress in three key areas. First: expanding health coverage by ensuring that coverage is affordable. Second: slowing the growth in health care costs. And third: reforming the health insurance market.

2. Can you tell us a little bit more about how the bill expands health coverage and makes it more affordable?

A: Sure, Shannon. Over the next ten years the bill would dramatically reduce the number of uninsured people in the United States by 36 million, or two-thirds of those uninsured today. That means that 96 percent of non-elderly legal residents in the United States would have health insurance by 2019.

The bill accomplishes this dramatic reduction in the number of people without health insurance in two ways. First, it makes Medicaid coverage available to more Americans with modest incomes. Second, it provides tax credits to low- and moderate-income individuals and families that will make coverage affordable and to help them with out-of-pocket health costs, like co-pays and deductibles.

3. You also mentioned that the bill is expected to slow the growth of health care costs. How would it do so?

A: For example, one provision will lower the cost of drugs provided to Medicare beneficiaries. Another provision would reduce Medicare payments to hospitals that have high rates of readmitting patients. And a third provision would eliminate overpayments to private insurers who participate in Medicare. These changes would substantially slow the growth rate of Medicare costs.

4. Your third point was reforming the health insurance market. How would that market be reformed?

A: There are a number of important insurance reforms that not only will help people get insurance coverage, but will also help them avoid financial ruin if they get sick. For example, the bill would prohibit insurance companies from denying coverage or charging higher premiums to people with health problems – health insurance companies often call these health problems “pre-existing conditions.”

The bill would also limit insurance companies’ ability to charge higher premiums to individuals simply because they are older or sicker. And, it would set minimum standards on the kinds of policies insurers could offer. For example, health insurance could no longer include annual or lifetime limits on benefits. In addition, no one would have to pay more than a certain amount each year for out-of-pocket costs. These reforms would apply to all policies purchased in the individual market and, over time, they would apply to all employer-sponsored plans as well.

5. The Senate is expected to take up its own version of health reform in the weeks ahead, based heavily on a bill developed by the Senate Finance Committee. How does that bill measure up to this one?

A: The House bill is stronger than the Senate Finance bill in a number of areas. First, it does a better job of expanding coverage. The bill would cover 7 million more uninsured people by 2019 than the Senate Finance bill. It also provides more help to low- and moderate-income individuals and families to make health care more affordable for them. And the House bill also does a better job of making Medicare more efficient and reforming the health insurance market.

6. Are there any areas where the Senate version comes out on top?

A: Yes. The House bill does not have a key element of the Senate bill that would actually contribute to slowing the growth of health care costs over time — that is an excise tax on high-cost insurance plans. Adding an excise tax to the House bill would make a strong bill even stronger.

Thank you for joining me, Judy.

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