Rockefeller's Health Care List

[sandnsea]

This is the most pertinent list I've seen so far and really shows how much can be accomplished with this bill. The House bill is better. I am disappointed to see the Medicaid benefit is only at 133%, I had read they increased it to 150%. Still, this is a very good bill and we should get it to conference, hash it out with the House, and get it passed.

http://obama-mamas.com/blog/?p=828

The following are key benefits for West Virginia included in the Patient Protection and Affordable Care Act:

Top 10 Benefits FOR WEST VIRGINIANS THAT Begin in 6 Months or Less

Making Health Coverage More Affordable for West Virginia’s Small
Businesses. Within six months of enactment, small businesses in
West Virginia will have access to tax credits for up
to 35 percent of the cost of health coverage for their employees.; While
small businesses make up 82 percent of businesses in West Virginia, only 37
percent of them offered health coverage to their employees in 2008.; This
bill could help as many as 20,000 small businesses in West Virginia afford to
offer health coverage.
Significant Help for West Virginians
Denied Coverage Due to Pre-existing Conditions.; Within 90 days of
the bill’s enactment, individuals with pre-existing conditions who are
denied health coverage will have access to affordable and meaningful health
coverage through a high-risk pool.; West Virginians
have the highest rates of diabetes and heart disease in the country, with
one-third of the total population of the state exhibiting high blood
pressure.; These are all pre-existing conditions for which health coverage
can be, and often is, denied. A complete prohibition on insurance company
pre-existing condition exclusions will begin in 2014, when the state health
insurance exchanges are operational.
New Immediate Protections for West Virginia�s Children Suffering
from a Pre-existing Condition.; Effective immediately, health
insurers will be prohibited from denying coverage for children under age 19
due to a pre-existing condition.; Almost one-third of children and youth
with special health care needs are considered to be underinsured�- many of
them because they are denied the coverage they need due to a pre-existing
condition.
Stable Coverage for West Virginia’s Children and Young Adults.;
For plan years beginning six months after enactment, health insurers that
provide dependent coverage for children are required to continue providing
that coverage until the child turns 26 years of age. Young adults just
starting out will no longer be ignored by our health care system.
Protection for West Virginians
against Abusive Health Insurance Rescissions.; Within six months of
enactment, insurance companies in all markets are banned from dropping your
coverage once you get sick (rescissions).; All 1.8 million
West Virginians can rest assured that their health insurance
coverage will not be rescinded when they need it most.
Protection of Health Coverage for West Virginia’s Early Retirees.;
As soon as practicable upon enactment, the Secretary of Health and Human
Services is required to create a new, temporary reinsurance program to help
companies that provide early retiree health benefits for those ages 55-64 to
offset the expensive cost of that coverage.; An estimated 41,500 people from West Virginia have early
retiree coverage through their former employers, but early retiree coverage
has eroded over time.; A reinsurance program provides a backstop of
additional federal funding in the event an employer is liable for
significant health insurance claims that they simply cannot afford to pay.;
The reinsurance program included in the health reform bill would stabilize
early retiree coverage and provide premium relief to both early retirees and
the workers in the firms that provide their health benefits.; This could
save West Virginia families up to $1,200 on premiums.
Providing Value for the Health Insurance Premiums that
West Virginians Pay.; Beginning in 2010, insurers in
the large group market are required to spend a minimum of 85 cents of every
premium dollar paid on medical care, rather than on marketing campaigns or
profits.; Insurers in the small group and individual market are required to
spend a minimum of 80 cents of every dollar on medical care.; Insurers that
do not abide by these minimum limits would be required to refund consumers
the balance of the premium that should have gone towards medical care.;
Insurers in West Virginia currently spend an average of 65 cents of every dollar
on medical care in the individual market and only about 75 cents of every dollar
on medical care in the small group market.; West Virginians
can rest assured that the vast majority of the hard-earned dollars they pay
to private health insurance companies will go towards actual medical care.;
No Annual or Lifetime Dollar Limits on Health Coverage for
West Virginians.; Within six months of enactment, the
bill bans lifetime dollar limits on coverage, and tightly restricts the use
of annual dollar limits to be sure individuals can access needed care.; The
bill will completely prohibit annual dollar limits on coverage beginning in
2014, when the state health insurance exchanges are operational.
Access to Free Preventive Health Services for
West Virginians.; Within six months of
enactment, all new health plans must include coverage of preventive services
and immunizations free of charge (i.e. health insurers cannot charge a
co-payment).; An estimated 45 percent of West Virginians have not had a colorectal screening, and
23 percent of women over 50 have not had a breast cancer screening. This
provision will make life-saving health screenings more affordable for West Virginians.
Substantial Reduction in West Virginia Seniors�
Prescription Drug Costs.; In 2010, West Virginia seniors who fall
into the Medicare prescription drug coverage gap (the �doughnut hole�) will
receive $500 towards their prescription drug coverage.; Also, starting in
2010, West Virginia seniors who fall into the coverage gap will receive a 50
percent discount on brand name drugs and biologics. According to West
Virginia AARP, roughly 135,000 West Virginias fall into this coverage gap
each year.
ADDITIONAL BENEFITS FOR WEST VIRGINIA IN 2010 AND 2011

Increased Medicare Payments for All Primary Care Doctors.
Beginning in 2011, West Virginia’s primary care doctors (including family
physicians and geriatricians) and general surgeons will receive a 5 to 10
percent bonus in Medicare payments.; Roughly 2,300 doctors in
West Virginia practice primary care and would qualify for this new bonus.

Free Preventive Services for West Virginia�s 372,000
Seniors.; Seniors enrolled in Medicare will receive free annual
wellness visits under Medicare starting in 2011. These visits will give seniors
a chance to develop personalized prevention plans with their doctors in order to
address health conditions and other risk factors for disease.; The bill
will also provide recommended preventive services and screenings for seniors �
such as mammography and colonoscopy screenings�- free of charge.;
Currently, seniors in Medicare must pay part of the cost of preventive services
on their own.; For a colonoscopy that costs $647, a senior must pay $150 �
a price that many seniors cannot afford.

Expanded Primary Care, Nursing, and Public Health Workforce.
Nearly 169,000 people, or 9 percent of West Virginia’s population,
cannot access a primary care provider due to shortages in their
communities.; The bill will expand and improve programs to increase the
number of health care providers - including doctors, nurses, and dentists -
especially in rural and other underserved areas.

New Authority for West Virginia to Begin Covering Vulnerable Adults
in Medicaid.; In 2011, a new option will allow West Virginia to
cover parents and childless adults up to 133 percent of the federal poverty
level (FPL) and receive current law federal matching payments.; Currently,
West Virginia Medicaid covers parents up to 35 percent of the FPL ($6,408.50 for
a family of three);but adults without children are not eligible for Medicaid
coverage unless they are pregnant, elderly or disabled.

Increased Funding for West Virginia�s Community Health Centers.;
In order to support West Virginia’s safety-net providers and improve access to care,
the health reform bill includes an additional $10 billion in mandatory funding for community
health centers (CHCs) and the National Health Services Corps.; The 28 organizations and
188 delivery sites for CHCs in West Virginia served almost 350,000 West Virginians in 2008.

Improvements to the Black Lung Benefits Process for West Virginia
Miners. To address unacceptable delays in the administration of black
lung benefits, the bill eliminates the prohibition against requiring eligible
survivors to�file a new claim.; The bill also simplifies the process by
eliminating certain exceptions to the rebuttable presumptions for those claims
filed after the Black Lung Benefits Amendments of 1981. This provision
starts upon date of enactment and will apply to pending Black Lung claims filed
after January 1, 2005.

even more benefits for West Virginia when reform is fully implemented

Extension of the Children�s Health Insurance Program (CHIP) so that
West Virginia Children Will Continue to Have Access to Coverage that Meets Their
Needs. �At Senator Rockefeller�s urging, the Senate health reform
bill continues the successful, bipartisan Children�s Health Insurance Program
for an additional two years beyond its current reauthorization�- until 2015.;
CHIP currently covers more than 7 million children nationwide, including 37,645
children in West Virginia last year.;
By 2013, more than 14.1 million children will be enrolled in the program.;
For the first time, the children of West Virginia’s state employees
will also be able to enroll in CHIP.;

Premium Subsidies to Help West Virginians
Afford the Cost of Coverage. Individuals and families in West Virginia currently spend $1.8 billion
out-of-pocket to cover premiums, deductibles, and co-payments. That number
is expected to increase in 2019 without reform. Starting in 2014, this
bill will provide premium subsidies to help with the cost of health insurance
coverage for approximately 204,000 West Virginians between 133 percent and 400
percent of poverty.

Better Health Insurance Coverage for West Virginians.
Beginning January 1, 2014, West Virginians will have access to health insurance
coverage that is more affordable, comprehensive, and reliable. In addition
to the insurance reforms required prior to 2014, private health insurance
companies will be required to achieve guaranteed availability and renewal of
health coverage, no discrimination in health coverage based on health status,
limitations on increasing the cost of coverage based purely on age, prohibitions
on excessive waiting periods for employer-based coverage, minimum coverage
requirements for health plans available in the exchange, limitations on
cost-sharing, reforms to better spread risk and make health coverage more
affordable, and comprehensive information on health coverage options for
consumers.

Coverage for More than Half of All Uninsured West Virginians. Currently,
there are more than 271,000 West Virginians who
do not have health insurance. �That number is expected to increase to more
than 307,000 by 2019 if nothing is done.� According to a December 2009
report by Families USA, an additional 177,000 West
Virginians will have health insurance coverage as a result of this
health reform bill. That is more than half of West Virginia’s �uninsured � a significant step
forward.

Medicaid Coverage for Nearly 100,000 Low-Income
West Virginians. �In 2014, the
bill will increase Medicaid eligibility for all non-elderly parents and
childless adults, children, and pregnant women in West Virginia with annual
income up to 133 percent of poverty ($29,300 for a family of four). From
2014 through 2016, the federal government will pay 100 percent of the cost of
covering newly-eligible individuals. �New federal dollars for
Medicaid will act as a stimulus to West Virginia�s
economy�- by reducing uncompensated care and by increasing jobs, wages, and
business activity in West Virginia.

Protecting Health Benefits of West Virginia’s Coal Miners.
Beginning in 2013, health insurance companies will be taxed on high end health
insurance plans. Senator Rockefeller helped secure special protections (higher
benefits) for those in high risk professions, including coal miners.

An End to the “Hidden” Tax on Individuals and Families in West
Virginia. Nearly half a billion dollars is spent on uncompensated
care each year in West Virginia. �Uncompensated care often
gets passed on to individuals and families that have insurance in the form of
increased premiums. By expanding coverage to the majority of uninsured
West Virginians, health reform will eliminate the uncompensated care burden on
West Virginians who already have insurance.

Setting Medicare on a Path to Long-term Solvency.
Health care reform will finally begin to take politics and lobbyists out of the
business of deciding Medicare payment rates. Rockefeller secured the
establishment of an independent Medicare advisory board to improve Medicare
quality and keep it solvent for the long term.

[Cha]

1. Thank you, sandnsea..and this should help the

economy in West Virginia and anywhere else that small businesses benefit from Health Care being more affordable.

"Making Health Coverage More Affordable for West Virginia’s Small
Businesses. Within six months of enactment, small businesses in
West Virginia will have access to tax credits for up
to 35 percent of the cost of health coverage for their employees.; While
small businesses make up 82 percent of businesses in West Virginia, only 37
percent of them offered health coverage to their employees in 2008.; This
bill could help as many as 20,000 small businesses in West Virginia afford to
offer health coverage."

I wonder how this bill helped the states where the repukes said "NO"?