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The Obama Plan

Stability & Security For All

If You Have Health Insurance

More Stability and Security


*Ends discrimination against people with pre-existing conditions.  Over
the last three years, 12 million people were denied coverage directly or
indirectly through high premiums due to a pre-existing condition.  Under the
President’s plan, it will be against the law for insurance companies to deny
coverage for health reasons or risks.


*Limits premium discrimination based on gender and age.   The
President’s plan will end insurers’ practice of charging different premiums
or denying coverage based on gender, and will limit premium variation based
on age.


*Prevents insurance companies from dropping coverage when people are
sick and need it most.  *The* *President’s plan prohibits insurance
companies from rescinding coverage that has already been purchased except in
cases of fraud.  In most states, insurance companies can cancel a policy if
any medical condition was not listed on the application – even one not
related to a current illness or one the patient didn’t even know about. A
recent Congressional investigation found that over five years, three large
insurance companies cancelled coverage for 20,000 people, saving them from
paying $300 million in medical claims – $300 million that became either an
obligation for the patient’s family or bad debt for doctors and hospitals.


*Caps out-of pocket expenses so people don’t go broke when they get
sick.  *The President’s plan will cap out-of-pocket expenses and will
prohibit insurance companies from imposing annual or lifetime caps on
benefit payments. A middle-class family purchasing health insurance directly
from the individual insurance market today could spend up to 50 percent of
household income on health care costs because there is no limit on
out-of-pocket expenses.


*Eliminates extra charges for preventive care like mammograms, flu
shots and diabetes tests to improve health and save money.  The
President’s plan ensures that all Americans have access to free preventive
services under their health insurance plans. Too many Americans forgo needed
preventive care, in part because of the cost of check-ups and screenings
that can identify health problems early when they can be most effectively
treated. For example, 24 percent of women age 40 and* *over have not
received a mammogram in the past two years, and 38 percent of adults age 50
and over have never had a colon cancer screening.


*Protects Medicare for seniors. The President’s plan will extend new
protections for Medicare beneficiaries that improve quality, coordinate care
and reduce beneficiary and program costs.  These protections will extend the
life of the Medicare Trust Fund to pay for care for future generations.


*Eliminates the “donut-hole” gap in coverage for prescription drugs.  The
President’s plan begins immediately to close the Medicare “donut hole” – a
current gap in its drug benefit – by providing a 50 percent discount on*
*brand-name prescription drugs for seniors who fall into it.  In 2007,
over 8 million seniors hit this coverage gap in the standard Medicare
drug benefit.  By 2019, the President’s plan will completely close the
“donut hole”.  The average out-of-pocket spending for such beneficiaries who
lack another source of insurance is $4,080.


If You Don’t Have Insurance


Quality, Affordable Choices for All Americans


*Creates a new insurance marketplace – the Exchange – that allows
people without insurance and small businesses to compare plans and buy
insurance at competitive prices.*  The President’s plan allows Americans
who have health insurance and like it to keep it.  But for those who lose
their jobs, change jobs or move, new high quality, affordable options will
be available in the exchange.  Beginning in 2013, the Exchange will give
Americans without access to affordable insurance on the job, and small
businesses one-stop shopping for insurance where they can easily compare
options based on price, benefits, and quality.



*Provides new tax credits to help people buy insurance. *The
President’s plan will provide new tax credits on a sliding scale to
individuals and families that will limit how much of their income can be
spent on premiums.  There will also be greater protection for cost-sharing
for out-of-pocket expenses.



*Provides small businesses tax credits and affordable options for
covering employees.* The President’s plan will also provide small
businesses with tax credits to offset costs of providing coverage for their
workers.  Small businesses who for too long have faced higher prices than
larger businesses, will now be eligible to enter the exchange so that they
have lower costs and more choices for covering their workers.



*Offers a public health insurance option to provide the uninsured and
those who can’t find affordable coverage with a real choice.  The
President believes this option will promote competition, hold insurance
companies accountable and assure affordable choices. It is completely
voluntary. The President believes the public option must operate like any
private insurance company – it must be self-sufficient and rely on the
premiums it collects.



*Immediately offers new, low-cost coverage through a national “high
risk” pool to protect people with preexisting conditions from financial ruin
until the new Exchange is created.  For those Americans who cannot get
insurance coverage today because of a pre-existing condition, the
President’s plan will immediately make available coverage without a mark-up
due to their health condition. This policy will offer protection against
financial ruin until a wider array of choices become available in the new
exchange in 2013.


For All Americans


Reins In the Cost of Health Care for Our Families, Our Businesses, and Our
Government


*Won’t add a dime to the deficit and is paid for upfront.  The
President’s plan will not add one dime to the deficit today or in the future
and is paid for in a fiscally responsible way.  It begins the process of
reforming the health care system so that we can further curb health care
cost growth over the long term, and invests in quality improvements,
consumer protections, prevention, and premium assistance.  The plan fully
pays for this investment through health system savings and new revenue
including a fee on insurance companies that sell very expensive plans.


*Requires additional cuts if savings are not realized. Under the plan,
if the savings promised at the time of enactment don’t materialize, the
President will be required to put forth additional savings to ensure that
the plan does not add to the deficit.


*Implements a number of delivery system reforms that begin to rein in
health care costs and align incentives for hospitals, physicians, and others
to improve quality.  The President’s plan includes proposals that will
improve the way care is delivered to emphasize quality over quantity,
including:  incentives for hospitals to prevent avoidable readmissions,
pilots for new “bundled” payments in Medicare, and support for new models of
delivering care through medical homes and accountable care organizations
that focus on a coordinated approach to care and outcomes.


*Creates an independent commission of doctors and medical experts to
identify waste, fraud and abuse in the health care system.  The
President’s plan will create an independent Commission, made up of doctors
and medical experts, to make recommendations to Congress each year on how to
promote greater efficiency and higher quality in Medicare.  The Commission
will *not* be authorized to propose or implement Medicare changes that
ration care or affect benefits, eligibility or beneficiary access to care.
It will ensure that your tax dollars go directly to caring for seniors.


*Orders immediate medical malpractice reform projects that could help
doctors focus on putting their patients first, not on practicing defensive
medicine.  The President’s plan instructs the Secretary of Health and
Human Services to move forward on awarding medical malpractice demonstration
grants to states funded by the Agency for Healthcare Research and Quality as
soon as possible.


*Requires large employers to cover their employees and individuals who
can afford it to buy insurance so everyone shares in the responsibility of
reform.  Under the President’s plan, large businesses – those with more
than 50 workers – will be required to offer their workers coverage or pay a
fee to help cover the cost of making coverage affordable in the exchange.
This will ensure that workers in firms not offering coverage will have
affordable coverage options for themselves and their families.  Individuals
who can afford it will have a responsibility to purchase coverage – but
there will be a “hardship exemption” for those who cannot.



Ari Ne’eman
President
The Autistic Self Advocacy Network
http://www.autisticadvocacy.org
info@autisticadvocacy.org
732.763.5530


Disability Leadership Meet With White House Staff on Health Reform
From the Disability Representatives Present at the White House (8/31/09):

On August 27, as a follow-up to the meeting that President Obama had with
disability community representatives on July 24, a group of advocates for
home and community-based long-term services and supports met with Nancy-Ann
DeParle and other senior staff at the White House to discuss the Community
First Choice – Option<http://jfactivist. typepad.com/ files/community- first-choice- –option- proposal- 8-31-09-1. doc>


The disability representatives *thanked the President’s staff for his strong
leadership on enacting comprehensive health reform* that will help advance
the goals of the Americans with Disabilities Act by eliminating
disability-based discrimination in health care coverage and barring
pre-existing condition exclusions.


The meeting participants had a frank and productive discussion concerning
the possible opportunities and barriers of *including a Community First
Choice Medicaid State option (CFC Option) in the final health reform
legislation* . The CFC Option is an idea that emerged from discussions with
Senator Harkin’s office and Representative Davis’s office as a way to make
progress on home and community-based services and supports under Medicaid
and a way to lay the foundation for later enactment of the Community Choice
Act. It is *a proposal that has support from the cross-disability community
*, including leaders from the NCIL, ADAPT, the Consortium for Citizens with
Disabilities (CCD), AAPD, the National Coalition of Mental Health Consumer
Survivor Organizations, Autistic Self Advocacy Network and Self Advocates
Becoming Empowered (see below fact sheet on the CFC option)


The disability representatives thanked the White House Staff for their time
and support for expanding choices in long-term services and supports, and
all agreed to keep open the lines of communication as health care reform
heats up again when Congress returns from the August recess.


Attending the meeting from the White House were Nancy-Ann DeParle, Director
of the White House Office of Health Care Reform; Tina Tchen, Director of the
White House Office of Public Engagement; Jeff Crowley, Director of the White
House Office on National AIDS Policy and Senior Advisor on Disability Policy
within the Domestic Policy Council; Kareem Dale, Special Assistant to the
President for Disability Policy; and Keith Fontenot from the Office of
Management and Budget. Mr. Fontenot’s responsibilities for OMB include
long-term services and supports policy.


Attending the meeting from the disability community were Mike Oxford and
Cassie James from ADAPT, Kelly Buckland and Lou Ann Kibbee from the National
Council on Independent Living, Marty Ford of The Arc/UCP Disability Policy
Collaboration and CCD, Chester Finn of Self Advocates Becoming Empowered,
Daniel Fisher of the National Coalition of Mental Health Consumer Survivor
Organizations, Ari Ne’eman of the Autistic Self Advocacy Network, Suellen
Galbraith of ANCOR, Lee Page of Paralyzed Veterans of America, Andy Imparato
of the American Association of People with Disabilities, and Bob Williams,
President Clinton’s Deputy Assistant Secretary for Disability and Long-term
Care Policy who attended as a private citizen.



Ari Ne’eman
President
The Autistic Self Advocacy Network
http://www.autistic advocacy. org
info@autisticadvoca cy.org
732.763.5530


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