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Affordable Health Care for America

Health Care Reform

Healthy students are crucial for great public schools




HIGHLIGHTS


The House is scheduled to vote on Thursday, March 23 on the American Health Care Act, the GOP’s “replacement” for the Affordable Care Act (also known as Obamacare). NEA strongly opposes  the bill because it threatens health care for the 36 million children now covered by Medicaid and could undermine public education as well. The bill radically restructures the way Medicaid is funded and rolls back subsidies for premiums and out-of-pocket costs while providing huge tax cuts for high earners and insurance companies. “Bottom line, working Americans will pay more for less coverage while insurance executives and the wealthy get handouts,” said NEA president Lily Eskelsen García.


A Historic Victory for Working Families



On March 23, 2011 President Obama signed the Patient Protection and Affordable Care Act into law. Even though many critical benefits will go into effect this year, some pieces of the health care reform picture will take longer to take shape.

NEA will continue to analyze the law’s provisions and will pass on information to its members as it becomes available.

Key Benefits for Active and Retired NEA Members, Children, and Families

  • Provides Uninsured Children and Families With Access to Coverage. An estimated 32 million children and adults who could not afford and/or were denied insurance due to a pre-existing medical condition(s) will be able to obtain quality, affordable coverage.
  • Maintains Employer-sponsored Coverage for Most Americans Who Currently Have It. Nothing in the bill requires employers to drop or change coverage, so employees who currently have employer-sponsored coverage should continue to get their health benefits in the same manner that they do.
  • Allows Young Adults to Stay on a Parent’s Plan. Young people who cannot afford and do not have access to quality health care coverage can stay on a parent’s plan until they reach the age of 26.
  • Immediately Establishes a Plan for the Uninsured. Adults and children who have been uninsured for six months or more due to a pre-existing condition can obtain coverage right away through a special insurance program that will include premium and cost- sharing help for lower-income families.
  • Establishes a Competitive Health Insurance Market. People will have the same choice of health plans that Members of Congress will have. Members of Congress and their employees will be required to purchase coverage from the newly established Health Insurance Exchange.
  • Ends Insurance Company Abuses. Health insurers can no longer apply lifetime limits on the dollar value of health care coverage and cannot cancel a policy when someone gets sick.
  • Assists Employers Providing Retiree Health Benefits. A reinsurance program will assist employers with high medical costs for early retirees age 55 and older who are not eligible for Medicare coverage.
  • Eliminates the Doughnut Hole. Medicare-eligible people who fall into Medicare’s prescription drug “doughnut hole” receive $250 right away to help them pay for the gap. It also provides deep discounts for prescriptions purchased in the doughnut hole and eventually closes the gap.
  • Eliminates Cost-Sharing for Preventive Services. Cost-sharing for covered preventive care services will be prohibited under Medicare and eventually all plans.
  • Stops Excessive and Unnecessary Payments to Private Insurers Who Run Medicare Plans. The bill reduces unnecessary and expensive subsidies made to private insurers who offer Medicare Advantage plans and limits the cost-sharing requirements imposed by these plans.

Provisions that took effect immediately (PDF)

The Excise Tax on High-Cost Health Plans

The National Education Association and other groups fought vigorously against the provision, leading to important improvements in—if not the removal of—the tax.

Below are the key changes to the excise tax in the Health Care and Education Affordability Reconciliation Act of 2010.

  • the tax will not take effect until 2018
  • dollar thresholds were increased to $10,200 for single coverage and $27,500 for family coverage ($11,850 and $30,950 for retirees and employees in high risk professions)
  • the dollar thresholds are indexed to inflation and will be automatically increased in 2018 if the Congressional Budget Office is wrong in its forecast of the premium inflation rate between now and 2018
  • stand-alone dental and vision plans are exempt
  • employers will be permitted to reduce the cost of the coverage when applying the tax if the employer’s age and gender demographics are not representative of the age and gender demographics of a national risk pool

TAKE ACTION

CONTACT YOUR MEMBERS OF CONGRESS

Oppose the American Health Care Act


Sky High Medical Costs
Keep Rising

Sky High Medical Costs Keep Rising is a report by NEA staff members from Campaigns and Elections, Collective Bargaining and Member Benefits, and Center for Communications.


RELATED LINKS

NEA President Dennis Van Roekel: "Our 3.2 million members declare victory."

How the Plan Works for America (PDF) (House of Representatives)

Longterm Care in New Health Law

Benefits for Early Retirees