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Health Law and Policy Update

Headlines of the week

Historic health reform bill is signed into law
President Barack Obama signed the health care reform package into law Tuesday morning, an enormous political achievement and a huge victory for anyone concerned about health care access and affordability, and our nation's fiscal health. The bill will help American families and businesses by:

  • Covering an estimated 95 percent of the uninsured, including 525,000 Coloradans
  • Requiring insurance companies to offer coverage to everyone and eliminating preexisting condition exclusions.
  • Offering tax credits to small businesses so they can offer insurance to their employees.
  • Extending Medicaid to cover more people.
  • Providing assistance so low- and middle-income people (making up to $88,000 a year for a family of four) will be able to afford health insurance.
  • Establishing state-based insurance exchanges to reduce cost and improve access for individuals and small businesses.
  • Stopping the practice of gender rating, where women are charged more simply because they are women.
  • Providing relief from the cost to seniors of the Medicare "donut hole."
  • Establishing a voluntary program where people can save so that they can buy services that will help them "age in place" (CLASS Act provisions).
  • Reducing the federal deficit during the first ten years by $138 billion.

The New York Times offers valuable information in an online presentation titled "How different types of people will be affected by the health care overhaul."

The bill is pushing against the trend of the past three decades toward increasing income inequality, The New York Times reported.

The benefits for Colorado are huge, as the Colorado Center on Law and Policy demonstrated in a fact sheet issued Sunday, the day Congress voted.

Provisions that go into effect this year:

  • Small business tax credits of up to 35 percent of premiums to firms that choose to offer their employees health coverage.
  • A $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. The donut hole is a gap in prescription drug coverage that is financially devastating for many seniors.
  • Elimination of co-payments and deductibles for preventive services in the Medicare program.
  • Ban health plans from dropping people from coverage if they get sick.
  • Prohibit health plans from denying coverage to children for pre-existing conditions.
  • Restrict lifetime caps and annual limits on coverage.
  • Implement a temporary high-risk pool for the uninsured.
  • Increase funding for community health centers that provide essential primary care services across Colorado
  • Provide new investments in training programs for primary-care professionals.
  • Provide consumer assistance with the creation of an independent appeals process and offices of health insurance consumer assistance for complaints and appeals.

Senate begins to deliberate reconciliation package
The House passed two bills Sunday night. The first vote was on the bill passed by the Senate in December of last year (H.R. 3590). That bill, passed by both houses in exactly the same form, became law with the President's signature on Tuesday.

On Sunday evening, the House also passed a reconciliation package (H.R. 4872), designed to improve the health reform package by incorporating certain provisions of the bill passed by the House last fall. The Senate is now considering that reconciliation package. Under the "Byrd rule" only amendments that affect revenue or spending can be handled under the reconciliation process, which requires only a majority vote and is not subject to filibuster. Twenty hours of debate began Tuesday afternoon; the package should be final by Thursday.

Bill opponents may offer a number of procedural challenges to the bill and the process. If any challenges to the Byrd rule are upheld, 60 votes would be needed to overturn the ruling or the provision will fail. An unlimited number of amendments can be set aside for consideration after the final vote on the reconciliation package which likely will extend deliberations into the weekend. Any changes could send the bill back to the House for further modification and approval, extending the timeline and positioning the House for another difficult debate and vote. A final vote could happen Saturday or Sunday on the reconciliation package without amendments, meaning the Senate could complete its work and we could have a bill before their upcoming recess.

Anti-reform measures already underway
Some lawmakers and policymakers are trying to combat health insurance reform by arguing the measure is unconstitutional. Colorado Attorney General John Suthers weighed in Tuesday by joining with attorneys general from at least 11 states who are mounting a legal challenge to the health care overhaul. The move drew rebukes from some in the media.

Status report

A framework for evaluating health reforms
The Health Advocates Alliance presented to the House Health and Human Services Committee on March 18, offering some foundational health care principles for the committee to consider when developing legislation. The alliance is a coalition of consumers, providers and health care advocates committed to health care for all that is affordable, sustainable, timely, safe, equitable, effective, efficient and patient-centric.

The alliance has developed a framework for health care legislation that posits four questions to assist legislators in crafting productive reforms. The four framework questions are:

  • Does it increase access?
  • Does it protect vulnerable populations?
  • Does it improve quality?
  • Does it contain costs?

House committee approves Colorado False Claims Act
The Colorado House Judiciary committee on March 18 passed the Colorado False Claims Act on a 7-3 vote. The measure provides Colorado with an essential tool to combat fraud among government contractors.

Advancing the debate

Down in the weeds on health reform
Many resources about the health care legislation are available on the Committee on Energy and Commerce Web site.

Additional resources:

What you can do

Thank House members
Members of Colorado's delegation in the House of Representatives who voted for reform were: Reps Diana DeGette, Jared Polis, John Salazar, Betsy Markey and Ed Perlmutter. Call the representatives and thank them.

Tell the Senate not to change the bill
Once the House approves the reconciliation bill and sends it to the Senate, senators should pass the bill without amendments. Any changes to the bill would cause it to go back to the House for another vote. We cannot afford to risk these improvements to the bill that was signed into law Tuesday. As an example, the improvements include increased affordability protections for consumers. Tell your senators you want them to adopt the reconciliation package as-is.

Don't know who your representatives are? Find a list with detailed contact information at Project Vote Smart.

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Health Law and Policy Update is issued weekly by the health staff of the Colorado Center on Law and Policy. Subscribe by e-mail or read previous editions.

Health Care Director
Elisabeth Arenales   

Health Care Attorney
Adela Flores-Brennan   

Special Counsel
Ed Kahn   

Communications Director
Perry Swanson

Released March 24, 2010