_{President Obama signs Health Reconciliation bill - The Washington Post}

_{This will be the last news post on Health Care Voices. The site, and CWA's Strategic Industry Fund Health Care Campaign, are being closed down, although you can still find information about health reform on CWA's redesigned Web site.}

_{Yesterday, President Obama signed the bill of fixes to the health reform law he signed last week. "The health insurance bill won't fix every problem in one fell swoop, but it does represent some of the toughest health insurance reforms in history," the president said during a signing ceremony, according to MedPage Today. "It enshrines the principle that when you get sick, you've got a society there, a community that's going to get you back on your feet."}

_{It's a community that has gotten us to this point. CWA built the structure for a network of activists. We worked hard in 2008 to elect a president and a Congress that was committed to health reform. Then, with hundreds of coordinators educating and mobilizing us, thousands of us wrote letters and emails, made phone calls and marched at rallies. We pushed the people we elected to deliver on their promises.}

_{This site is called Health Care Voices. Our voices helped make health care reform a reality.}

_{Those of us who already had good health coverage have gained a sense of security. Whatever happens to our employers or to the economy, whatever happens to our own health, we now have a right to available and affordable health insurance.}

– 03/31/10

Both houses of Congress yesterday approved the so-called reconciliation bill, making "fixes" to the health reform bill originally passed by the Senate in December and passed by the House on Sunday.

The reconciliation bill represents significant improvements in the flawed Senate bill. Here are some of the key changes in health reform made by the reconciliation bill, as summarized by the office of the Speaker of the House and in a side-by-side comparison by the Kaiser Family Foundation:

• Benefits tax. Sharply reduces the number of working families impacted by the so-called "Cadillac tax" on high-premium health plans by raising the tax trigger from $8,500 for individual plans and $23,000 for families to $10,200 for individuals and $27,500 for families. Also increases the exemption for over-55 workers and for workers whose premiums are high because they are in high-risk occupations. Delays effective date of tax from 2013 to 2018. The changes in the benefits tax came from a January meeting between labor leaders and the White House.
• Employer penalties. Increases the penalty on employers whose workers get subsidized coverage from $750 per worker to $2,000 per worker.
• Revenue changes. Increases fees on drug companies from $23 billion to $33 billion. Extends Medicare tax to capital gains and dividend income; increases payroll tax for individuals making more than $200,000 and families making more than $250,000.
• Medicare. Completely closes the prescription "donut hole" by 2020, beginning help with $250 rebate for seniors this year and 50% discounts on brand-name drugs next year.
• Affordability. Decreases amounts paid for coverage for families up to 400% of the poverty level (about $88,000 for a family of four).
• Special deals. Removes special deals, such as extra Medicaid funding for Nebraska.
• Medicaid. Increases federal assistance, reducing costs to states. Increases payments to primary care physicians without additional cost to states.

– 03/26/10

In the congressional district represented by John Boehner, the House Republican leaders, health reform will mean coverage for 22,000 uninsured residents, improved benefits for 99,000 Medicare beneficiaries and premium help for 161,000 families and 11,600 small businesses.

Where do these numbers come from? They're from a district-by-district analysis prepared by the House Energy and Commerce Committee.

That's just one of a number of new resources and tools for learning more about the reform law. Some others:

• The office of the Speaker of the House and House committee leaders have prepared four fact sheets we've posted on Health Care Voices: one on what health care reform does for you, one on reform features that take effect almost immediately, one on details of the reconciliation bill of "fixes" to the original Senate bill, and a section-by-section analysis of the new law.
• Kaiser Health News presents a consumer Q-and-A.
• The New York Times has an interactive graphic on what the new law means for various categories of people.
• The Washington Post offers a calculator where you can enter your income and insurance status and see the impact on you and your family.
• The Kaiser Family Foundation has an implementation timeline.
• For the impact on Medicare beneficiaries, check out an issue brief by the Commonwealth Fund, a fact sheet on Medicare prescription benefits by the Kaiser Family Foundation, or information from AARP.
• If those aren't enough, you can read the whole Senate bill and the bill adding fixes.

– 03/26/10

Yesterday, we talked about some of the immediate gains from health care reform - important rights, protections and benefits that take effect in the first year. These include a programs to help those who can't get insurance because of pre-existing conditions, tax credits for small businesses, free preventive care and more help with prescriptions for seniors on Medicare, allowing parents to cover children up to age 26 on their policies, and bans on insurance companies canceling policies and imposing lifetime limits on coverage.

Many of the key reform features, however, will take longer to set up and put into operation. The net effect of these will be to provide security in health coverage. Those of us who have coverage won't have to worry that we'll lose it with a layoff or job change or at the whim of an employer. And those who don't have coverage will be able to get it, at an affordable cost and regardless of pre-existing medical conditions.

Here's how it will work, with many of the provisions taking effect in 2014:

• Insurance exchanges. These would serve as insurance markets for individuals without employer coverage and for small employers. Being grouped in the exchange, they would be able to get the discounts now available to large employers. Insurance companies who offer policies through the exchange have to meet standards for adequate benefits and can't deny coverage for pre-existing conditions.
• Existing large employer plans. Plans offered by large employers won't change much as a result of reform. Additional rights, such as buying coverage for children up to age 26, will be available, however. Of course, employers have had the right, pre-reform, to change or drop benefits, so a union contract remains the best protection. If an employer with more than 50 workers doesn't offer coverage and some workers get subsidized plans through the exchanges, the employer will be penalized $2,000 per worker. If the employer's coverage isn't adequate, the worker can choose better coverage from the exchanges.
• Small employers. Small employers would immediately receive a tax credit to help them buy coverage. Small employers could also buy coverage through the exchanges, getting discounts not currently available to them.
• Individuals and families without employer coverage. People without employer coverage can buy through the exchanges, where they know they will get standard benefits and can't be denied for pre-existing conditions. They would get premium subsidies on a sliding scale to make the insurance affordable.
• Medicare. Seniors will begin getting help for prescriptions in the "donut hole" this year. Starting next year, they'll get extra discounts during the donut hole, and the donut hole will be closed entirely by 2020. Preventive care, which has not always been covered at all, will be covered for free - no deductibles or co-pays. Medicare cost growth will be slowed, making the program solvent longer. This will be accomplished without reducing standard Medicare benefits or cutting payments to doctors. There will be cuts in subsidies to insurance companies, who offer private "Medicare Advantage" plans, so those plans may change benefits or premiums.

– 03/25/10