Once again, the Congressional Budget Office has found that repealing the health care law will increase the federal budget deficit by more than $100 billion in the first decade and more than a trillion dollars in the next decade.  CBO also found that 30 million Americans would remain uninsured without the Affordable Care Act.

And CBO projects that most Governors will choose to expand their Medicaid programs. The Medicaid expansion is completely paid for by the Federal government in the first three years, and the Federal government will cover at least 90 percent of these costs in the years ahead. According to CBO “…states and local governments will probably realize savings in existing programs that provide direct care to people who are uninsured or that cover uncompensated costs incurred by providers serving uninsured residents.” Other independent analysts have also found that states that fully implement the Affordable Care Act could save money through reductions in the amount they spend to care for the uninsured.

We hope states will take advantage of the options in the health care law to improve access to affordable coverage.  And history suggests that they will act.  All but two states implemented Medicaid and the Children’s Health Insurance Program (CHIP) within five years of enactment – despite less generous financial support than the Affordable Care Act provided for this Medicaid expansion.

As the President has said, this law is here to stay, and we will continue our efforts to work with States to deliver the benefits of the law to the American people.

Questions about what the decision means for you? Check out an infographic showing how the Affordable Care Act benefits Americans 

Today, the Supreme Court's decision to uphold the Affordable Care Act ensures hard-working, middle class families will get the security they deserve and protects every American from the worst insurance company abuses. The Court has issued a clear and final ruling on this law.

For a comprehensive overview of the Affordable Care Act, visit WhiteHouse.gov/HealthReform and HealthCare.gov. 

Let’s take a look at what today’s ruling means for the middle class:

• Insurance companies no longer have unchecked power to cancel your policy, deny you coverage, or charge women more than men. 
• Soon, no American will ever again be denied care or charged more due to a pre-existing condition, like cancer or even asthma.
• Preventive care will still be covered free of charge by insurance companies--including mammograms for women and wellness visits for seniors. 
• By August, millions of Americans will receive a rebate because their insurance company spent too much of their premium on administrative costs or CEO bonuses. 
• 5.3 million seniors will continue to save $600 a year on their prescription drugs. 
• Efforts to strengthen and protect Medicare by cracking down on waste, fraud, and abuse will remain in place.
• 6.6 million young adults will still be able to stay on their family's plan until they're 26.

A major impact of the Court's decision is the 129 million people with pre-existing conditions and millions of middle class families who will have the security of affordable health coverage. 

We should also remember that under today’s ruling, having health insurance is and will continue to be a choice. If you can’t afford insurance or you’re a small business that wants to provide affordable insurance to your employees, you’ll get tax credits that make coverage affordable. But if you can afford insurance and you choose not to purchase it, the taxpayers will no longer subsidize your care for free.

Given today’s ruling, it’s now time to focus on implementing this law in a smart and non-bureaucratic way that works for the middle class. 

As we’ve said, the Court has issued a clear and final ruling on this law. The last thing Congress should do is refight old political battles and start over on health care by repealing basic protections that provide security for the middle class. The President refuses to go back to the way things were.

Right now, Congress needs to work together to focus on the economy and creating jobs. Right now in congress, what’s at stake is how--at this make or break moment for the middle class--we break through Washington gridlock to move our country forward. Right now in Congress, what’s at stake is our chance to seize this moment to build an economy not from the top-down, but one based on a strong and secure middle class.  We need to create secure middle class jobs and an economy built to last where hard work and responsibility are rewarded, everybody gets a fair shot, pays their fair share, and plays by the same set of rules.

Right now, Congress should act on the President’s concrete plans to create an economy built to last by reducing the deficit in a balanced way and investing in education, clean energy, innovation, and infrastructure. It’s time for folks in Washington to work together on behalf of the American people.

Please check back periodically for additional information on today’s decision. 

Read the President's full remarks here

President Barack Obama delivers remarks regarding the U.S. Supreme Court decision upholding the “Patient Protection and Affordable Care Act,” in the East Room of the White House, June 28, 2012. (Official White House Photo by Pete Souza)

Thanks to the Affordable Care Act, the new health care law, health insurers generally have to spend at least 80 percent of your premium dollars on health care and quality, not administrative overhead.  This minimum percentage is called a medical loss ratio.  If your insurer doesn’t meet or exceed this standard, they must rebate you the difference.

The rule encourages insurers to give you better value for your premium dollar and holds them accountable if they don’t. Last week, insurers were required to report the refunds that will go to consumers and small businesses later this summer and we have already started to see the effects:

• BlueCross BlueShield of Tennessee has announced that it will pay $8.6 million to about 73,000 individual policyholders in August because they spent less than 80 percent of premiums on health care. 
• In Arizona, more than $36 million in refunds will go to both consumers and small businesses. One insurer in the state, Blue Cross Blue Shield of Arizona, alone will pay out an estimated $8.7 million to more than 77,000 individual policyholders, and another $3.2 million to more than 3,700 small businesses. United Healthcare's Golden Rule Insurance will refund nearly $8.7 million to more than 30,000 additional Arizona policyholders.
• Two insurers in California will pay out more than $50 million in rebates to nearly 1 million customers statewide.

This is just one way the new health care law is helping American families and businesses get a fair deal when it comes to their health care. Learn more at obamawhitehouse.archives.gov/healthreform.

We are committed to using these new tools to fight Medicare and other health care fraud, and we are getting results:  The Administration’s anti-fraud efforts recovered $4.1 billion in taxpayer dollars last year, the second year recoveries hit this record-breaking level. Total recoveries over the last three years were $10.7 billion. Prosecutions are way up, too: the number of individuals charged with fraud increased from 797 in fiscal year 2008 to 1,430 in fiscal year 2011 – a more than 75 percent increase.

Just last week, the Department of Health and Human Services and the Department of Justice announced “a nationwide takedown by Medicare Fraud Strike Force operations in seven cities has resulted in charges against 107 individuals, including doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $452 million in false billing.”  And on Monday, the Departments announced that, as a part of their Health Care Fraud Prevention and Enforcement Action Team initiative, they had resolved an investigation into a pharmaceutical company’s unlawful promotion of a prescription drug.  The Justice Department reported that, “the resolution – the second largest payment by a drug company – includes a criminal fine and forfeiture totaling $700 million and civil settlements with the federal government and the states totaling $800 million.” 

The infographic also shows how the Affordable Care Act is making Medicare stronger and providing new benefits. For example:

• 32.5 million people with Medicare received at least one free preventive service thanks to the health care law.
• People with Medicare who hit the prescription drug donut hole have already saved $3.4 billion on their prescription drugs.
• By 2021, the average person with Medicare will save nearly $4,200 thanks to the new health care law.

Click here to download a PDF of the graphic

You can learn more about these efforts and our work to implement the Affordable Care Act by visiting whitehouse.gov/healthreform.

We met Nathan and his son, Thomas, in 2009. Thomas was born with hemophilia, and he hit lifetime limits on his health coverage with two different insurance companies before he turned seven years old. Two years ago, Nathan was hopeful about what the Affordable Care Act would mean.

Last week we spoke with Thomas’s family again and they made it clear: Health reform has improved their quality of life. It means they can focus on making sure Thomas has the best possible care. It's changing their lives for the better.

Thomas is not alone. He's just one of the 105 million Americans who no longer has lifetime dollar limits on his coverage.

The Affordable Care Act gives hard working, middle class families the security they deserve. Because of health reform, 54 million Americans with private insurance have been able to access more preventive services. In the 2011 tax year, two million workers will benefit from the small business health insurance tax credit. And 2.5 million young people under age 26 have gained coverage on their parents’ plan.

Behind each of those numbers is a person like Thomas. Two years after President Obama signed the Affordable Care Act, life is a little better for millions of Americans from all over the country. You can find stories from more people who are benefiting from the Affordable Care Act with our map that shows the impact of reform, state by state.

Learn more about how the Affordable Care Act is helping Americans:For more information:

• MarkCare: How health reform is making health insurance more affordable for small businesses
• StevenCare: How health reform enables Steven, a 23-year-old, two-time cancer survivor, to keep the insurance he needs
• HelenCare: How health reform is giving Helen, a senior from Philadephia, peace of mind and more money in her pocket
• VanessaCare: How health reform is helping Vanessa and her family
• Tell us your story: How is the Affordable Care Act improving your care?

Achieving these goals takes serious work. That’s why the Affordable Care Act is designed to learn from the best health systems and experts in the country to find better ways to improve health care.  Under health reform, we will reward doctors and hospitals that focus on spending time with patients, that better coordinate care, and that improve the quality of care patients are receiving while lowering costs.

Health reform also establishes the Independent Payment Advisory Board (IPAB). IPAB will be composed of fifteen experts including doctors, consumers and patient advocates who will be recommended by Congressional leaders, nominated by the President, and confirmed by the Senate.  It will recommend policies to Congress to help Medicare provide better care at lower costs.  Congress could pass these or other changes to strengthen Medicare.  Starting in 2015, if Medicare cost growth per beneficiary exceeds a growth rate target, IPAB recommendations would take effect only if Congress fails to act.

Today, Congressional Republicans are working to repeal and dismantle the Independent Advisory Board before it even gets started even though experts like former Bush Administration Medicare Official Mark McClellan called for “[strengthening] and [clarifying] the authority and capacity of the Independent Payment Advisory Board (IPAB).”  And a coalition of economists including Nobel Prize Winners said “…the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending. These provisions include…An Independent Payment Advisory Board with authority to make recommendations to reduce cost growth and improve quality within both Medicare and the health system as a whole”

At the same time, House Republicans passed a plan for Medicare last year that does nothing to reduce overall health care costs.  Instead, the Republican plan shifts costs to seniors and empowers insurance companies. Below is a table on how the Republican plan and IPAB compare.

Rather than revisiting the past and trying to repeal the Affordable Care Act, Congress should work on strengthening Medicare and creating jobs.

Since President Obama signed his Executive Order, FDA has prevented 114 drug shortages. In part, this resulted from the Administration’s call for voluntarily notification to the FDA of potential shortages. Notification of a potential shortage is crucial: with enough advance warning, FDA can take action to help stop a potential drug shortage. And since President Obama signed his Executive Order, voluntary notifications have increased six-fold.

Today, the FDA is announcing the steps it has taken to end the shortage of two important drugs that fight cancer:

• To avert an impending shortage of methotrexate, a drug used to treat children with leukemia, the FDA has worked with manufacturers to help ramp up production and has approved a new application to produce the version of the drug that is most needed , which will further bolster supply and ensure patients have access to this lifesaving medicine. 
• To end the shortage  of the cancer drug Doxil, the FDA will allow the temporary importation of a replacement drug. This action should address patient needs and end this drug shortage.

The FDA is also responding to President Obama’s Executive Order by releasing new draft guidance for the drug industry on requirements for both mandatory and voluntary notification to FDA of issues that could result in a drug shortage.

There is more work to do to prevent drug shortages. Congress still has not acted on legislation that would make notifying the FDA of potential drug shortages mandatory in more cases. And we know that there is no one single cause of drug shortages: everyone has a role to play to prevent shortages from happening.

But today’s announcement shows that we’re making a difference and protecting the health of the American people. And we’ll continue our aggressive efforts to prevent drug shortages and ensure patients get the medicines they need. 

Those predictions turned out to be wrong. Medicare Advantage is stronger than ever – offering more seniors better benefits, higher quality care and lower costs.  As reported last year, 99.7 percent of people with Medicare still have access to Medicare Advantage plans.

In fact, premiums have been consistently lower – and enrollment has been higher.  Today, the Centers for Medicare & Medicaid Services announced that average premiums for Medicare Advantage enrollees in 2012 are 7 percent lower compared to last year, exceeding the 4 percent decrease that was projected in September. Since the Affordable Care Act was enacted, premiums have gone down by nearly 16 percent. In addition, enrollment increased by nearly 10 percent from 2011. That means that Medicare Advantage enrollment is up by 17 percent since enactment of the Affordable Care Act in 2010. In August of 2010, CBO projected that Medicare Advantage enrollment would be 10.2 million in 2012, down from 10.4 million in 2009. Actual enrollment is over 2 million people higher than that projection, at 12.8 million in February of this year.

And further, the Affordable Care Act strengthened consumer protections and improved plan choices for people with Medicare Advantage. The law is paring back overpayments to plans.  It requires health plans to pay at least 85 percent of what they collect in payments on health care, not on overhead and profits.  Plans can no longer charge higher cost sharing than a senior in traditional Medicare pays.  And proven preventive services are covered for free. 

And when seniors choose a Medicare Advantage plan, a new five-star rating system shows them which plans in their area are doing a better job of caring for patients.  Plus, a new, value-based purchasing system is encouraging all plans to improve their quality by paying plans with excellent overall quality more, and lower-quality plans less. It’s the kind of smart reform we’ve implemented throughout Medicare since enactment of the Affordable Care Act.

This is another myth from opponents of health reform debunked by results. Under the Affordable Care Act, Medicare is stronger than ever.

This story could have ended very differently if Republicans in the House had their way.  One year ago today, on January 19, 2011, the House of Representatives voted to repeal the health reform law, and take us back to the days when insurance companies had the power to decide what care residents of the United States could receive – allowing them to once again deny coverage to children with pre-existing conditions, cancel coverage when people get sick, and place lifetime or low annual dollar limits on the amount of care people can get, even if they need it.  What’s more, without the law, insurance companies could overcharge for insurance just to boost their profits. And if House Republicans had gotten their way:

•             2.5 million young adults wouldn’t have health insurance.

•             2.65 million seniors would have paid $1.5 billion more for prescription drugs

•             24.2 million seniors would pay for preventive services they are getting for free.

Thankfully, the Affordable Care Act is the law of the land and it’s helping Gail and millions like her. Check out the short report we’ve done about some of the Americans who are being helped by the law and what would have happened if the law has been repealed here.

• 2.5 million more young adults have health insurance.
• As of October 2011, more than 2.65 million seniors got a 50 percent discount on their prescription drugs when they hit the donut hole.
• Insurance companies can no longer drop your coverage when you get sick or put a lifetime cap on the amount of care you can receive.

Of course, there is more to come in the years ahead. Starting in 2014, consumers in every state will have access to Affordable Insurance Exchanges – State-based one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs.  Exchanges will offer consumers the same kinds of insurance choices that members of Congress now have. And millions of middle class families will get tax credits to make it easier to buy insurance in the Exchanges.

Under the health reform law, States have the first opportunity to set up and manage an Exchange and States are taking action.  Today, we released a new report which finds 28 States have taken important steps toward establishing their own Exchanges. Some of the examples in the report include:

• Alabama Governor Robert Bentley, a physician, issued an Executive Order that created the Alabama Health Insurance Exchange Study Commission on June 2, 2011, which recommended that Alabama establish its own Exchange called the “Alabama Health Insurance Marketplace. The legislature, which meets in February, is expected to take up legislation to establish an Exchange, with legislative leaders already indicating their support.
• Colorado passed a bipartisan bill to establish the independent Colorado Health Insurance Exchange, which was signed into law on June 1, 2011. The Colorado Exchange has started public education about health reform and the Exchange at its website, www.getcoveredco.org. Organizations such as the Colorado branch of the National Federation of Independent Business (NFIB) and the Colorado Association of Commerce and Industry have been active participants in creating the small business component of the Exchange. 
• In Nevada, unanimous, bipartisan legislation authorized the Silver State Health Insurance Exchange, which was signed into law by Governor Brian Sandoval on June 16, 2011.  Its board has been appointed, executive director named, and application submitted for its next round of funding for building the Exchange.

Today’s report also outlines some of the steps the Department of Health and Human Services has taken to ensure all Americans have access to an Exchange beginning in 2014. These include developing the information technology and business systems necessary to facilitate Exchanges in multiple States.  No matter where you live, on January 1, 2014, an Exchange will be up and running.

As we move forward, we’ll continue to build on our strong partnerships with State leaders nationwide and help ensure all Americans can access high quality, affordable health care and have the security they need and deserve.

Nancy-Ann DeParle is Assistant to the President and Deputy Chief of Staff 

The Affordable Care Act was signed into law by President Obama on March 23, 2010. These numbers do not take into account all of the cost saving provisions in the Affordable Care Act that are still being implemented. But they do show why the Affordable Care Act is so important. And we’re confident the law will continue to help hold down cost growth in the years ahead. Here are some important facts to remember if you’re looking at the new stats:

• The analysis shows that we need the kind of policies included in the Affordable Care Act to keep insurance companies in check. In 2010, the net cost of health insurance – which includes the overhead and insurance company profits – increased by 8.4 percent. That’s more than twice the increase in the cost of health care and represents $11.3 billion more than was spent on insurance overhead in 2009. But starting in 2011, insurance companies are required to publicly disclose and justify any premium increases larger than 10 percent. Many states have the authority to reject unreasonable premium increases and the Affordable Care Act gives states $250 million to strengthen their rate review programs. Additionally, insurers are required to spend at least 80 percent of your premium dollars on health care expenses instead of overhead and profits. Insurers that do not meet that standard must pay rebates to their customers. 
• The report released today found no spike in health care costs due to health reform. Of a total increase of 3.9% in national health spending, less than 0.1% was related to the law’s first-year provisions, such as the $250 in assistance to nearly 4 million Medicare beneficiaries who hit the Medicare prescription drug “donut hole.” And this modest increase will be offset over time. The Medicare Trustees project that the Affordable Care Act savings to Medicare will more than cover these initial costs while extending the life of the Medicare Trust Fund. Moreover, the important Patient’s Bill of Rights protections – such as policies that ensure preventive service coverage and certain choice of doctors and end lifetime dollar limits on coverage and pre-existing condition exclusions for children – did not have a measurable effect on health spending. 
• The analysis also suggests that health care cost growth can be kept down. The report noted: “U.S. health spending grew more slowly in 2009 and 2010 – at rates of 3.8 percent and 3.9 percent, respectively – than in any other years during the fifty-one year history of the National Health Expenditures Accounts.” The Affordable Care Act includes numerous policies to continue this slow growth. By fighting fraud, better coordinating care, preventing disease and illness before they happen and creating a new state-based insurance marketplace, we are helping to keep health care cost growth low. And experts agree these policies will work. Dr. Mark McClellan, President Bush’s pick to run Medicare recently said, “These reforms really have the potential for a longer term impact on healthcare costs.”
•  Early evidence from 2011 and 2012 suggest that these policies are beginning to take hold. Medicare spending growth in 2011 was even slower than in 2010. On September 20th, 2011, Mercer, a well-known independent benefits consulting firm released a survey of employers showing that their health insurance cost increases will average 5.4 percent for 2012, the smallest increase it has measured since 1997. States are reporting that very few insurers are proposing double-digit rate increases for 2012. In fact, some are providing rebates and premiums lower in 2012 than they were in 2011.

Keeping health care costs down will take work. We will continue to test and adopt best practices that lower costs and improve quality through the Affordable Care Act’s Innovation Center. We will increase transparency and accountability in the insurance industry this year through the implementation of simple summaries of coverage and benefits by insurers, improved notices on the 80 / 20 medical loss ratio, and State-specific thresholds for rate review. And we will step up our work with States to create Affordable Insurance Exchanges, competitive private insurance marketplaces. But thanks to the Affordable Care Act, we’re keeping costs down and making health care more affordable.

Record High Number of Health Care Fraud Prosecutions

The Obama Administration is committed to fighting health care fraud and a new independent report shows just how serious we are about cracking down on criminals. The independent Syracuse University Transactional Records Access Clearinghouse examined data from the Justice Department and reported:

“Federal health care fraud prosecutions reached an historic high last year. During the twelve months of fiscal year 2011, the government reported 1,235 new health care fraud prosecutions -- the largest number reported since separate tracking of this offense began twenty years ago. This number is up 68.9% over the past fiscal year when the number of criminal prosecutions totaled 731.”

Health care fraud is a crime and when fraudsters steal from the health care system, we all pay the price in the form of higher health care costs. This news builds on the Vice President’s announcement earlier this week on a new Medicare initiative to crack down on fraudulent prescriptions for drugs like OxyContin. And the record number of prosecutions is yet another sign that President Obama’s team is serious about fighting fraud and it sends a strong message to anyone who would think about committing these crimes.

Relief for Families and Small Businesses

Our second piece of good news came when we learned that Highmark Blue Cross Blue Shield will provide more than 4,200 small businesses in West Virginia with rebates worth an average of $2,500 per business.

Highmark is providing the rebates because of a new rule in the Affordable Care Act. Under the law, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality rather than advertising, overhead and bonuses for executives, they have to provide you a rebate for those excessive profits.  

When Highmark determined they wouldn’t meet the standard, they cut their premiums, giving consumers some welcome health care cost relief. We expect more consumers across the country to benefit from this provision of the law in the weeks and months ahead.

The Bottom Line

President Obama is committed to controlling health care costs and the latest news shows his work is making a difference.

Nancy-Ann DeParle is the Assistant to the President and Deputy Chief of Staff
 

Today, we got more good news for people with Medicare. Released today, a new report from the Government Accountability Office requested by Senators Baucus and Harkin finds that more seniors are enrolling in Medicare Advantage and that premiums are going down. The report examined changes in the Medicare Advantage program between 2010 and 2011. Here are a few of the highlights:

Access to Medicare Advantage Remains Strong, with more people enrolled in Medicare Advantage this year:

“Enrollment in the MA plans GAO analyzed increased by about 6 percent--from 7.9 million to 8.4 million beneficiaries--from April 2010 through April 2011.”

Medicare Advantage premiums are going down:

“The average monthly premium for beneficiaries in MA plans decreased from $28 in 2010 to $24 in 2011, about a 14 percent reduction.”

President Obama is committed to making Medicare stronger and today’s report is another sign that the Affordable Care Act is working for America’s seniors. In addition to lower premiums, seniors can get free preventive services like mammograms and other cancer screenings and a free annual wellness visit. And in the years ahead, the prescription drug coverage gap known as the donut hole will be eliminated.

You can learn more about Medicare and the Affordable Care Act at www.healthcare.gov. And click here to read the full report from the GAO, entitled MEDICARE ADVANTAGE: Enrollment Increased from 2010 to 2011 While Premiums Decreased and Benefit Packages Were Stable.

Nancy-Ann DeParle is the Assistant to the President and Deputy Chief of Staff

 

Today, Secretary Sebelius announced that we are making it easier for doctors and other health professionals to adopt health IT and receive incentive payments that were made available under the Health Information Technology for Economic and Clinical Health (HITECH) Act. At the same time, we remain vigilant in ensuring your health data remains private, confidential and secure. 

Here’s how it works:

• The HITECH Act offers doctors and hospitals the opportunity to earn financial incentives from Medicare and Medicaid if they show that they have adopted health IT and are using it to make a meaningful difference in patient care.
• Under the current rules, providers who adopt health IT this year, and register through the end of February, must meet new standards for using health IT in 2013.  If they do not adopt health IT until 2012, they don’t have to meet the new standards until 2014, and are still eligible for the same amount of incentive payment.
• To spur greater innovation and improvement, Secretary Sebelius announced that she intends to adjust the deadline for meeting the new standards for providers that start this year to 2014, removing the disincentive for providers to adopt and use health IT right away.

During her visit today to Cuyahoga Community College in Cleveland OH, Secretary Sebelius will also release new 2011 CDC data that show that over half of office-based physicians say they intend to take advantage of the incentive payments available for doctors and hospitals that meaningfully use health IT. That’s impressive progress, but we know we can do more to improve the health care system through the use of health IT. 

And we know that health IT can have a real impact on the lives of patients nationwide. The Sacramento Business Journal recently reported on one way health IT is improving care:

Evelyn Lyons gets up hungry and wants to eat — but is supposed to check her blood sugar first.

Daily testing was hit-or-miss until she agreed to take text messages at 7:30 every morning to remind her do the test, record the results and take her medicine.

Lyons is participating in a pilot program that helps diabetes patients and their doctors at Sacramento Family Medical Center manage a chronic condition that affects one in 12 Americans. It’s about one in seven at Sacramento Family Medical, which operates nine clinics in the region that serve patients on Medi-Cal, the government health care program for the poor.

Launched in August, the program has had a few bumps along the way, but it’s beginning to change behavior.

“I’m glad to be part of it,” Lyons said. “Before, I wasn’t taking it as serious as I should.”

Ultimately, the program is expected to lower costs.

We also know that this work won’t just make health care better – it will also create jobs. More than 50,000 health IT-related jobs have been created since the enactment of the HITECH Act.  And the Bureau of Labor Statistics found that the number of health IT jobs will rise 20 percent from 2008-2018, faster than the average for all occupations in that period.  

Our Administration has launched workforce development programs that are training more than 10,000 students for careers in health IT and over 1700 are expected to graduate by July 2013.  When they graduate, they will have training to get quality jobs and the work they will do will make the health care system better for all of us. 

Read more about  how health IT can lead to safer, better, and more efficient care.

For more information about the Medicare and Medicaid EHR Incentive Programs.

The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions. But thanks to discounts and other provisions in President Barack Obama's health care overhaul law, that cost fell to $901, according to Medicare's Office of the Actuary, which handles economic estimates.

So far this year, more than 2.2 million people with Medicare have saved more than $1.2 billion on their prescriptions. The Associated Press spoke with two of them:

For retired elementary school teacher Carolyn Friedman, it meant she didn't need a loan to pay for drugs that keep her epilepsy under control.

"What a change for the better," said Friedman, 71, of Sunrise, Fla. "This year it was easier to pay my bills, whereas last year I had to borrow money to pay for my medications when I was in the doughnut hole."

…

Joan Gibbs thought her pharmacy had made a mistake. Her total cost for a brand-name painkiller in the doughnut hole came out lower than her co-payment earlier in the year, at a time her plan was picking up most of the tab.

"I reluctantly called the insurance company," said Gibbs, 54, who lives near Cleveland. "If they had made a mistake, I knew they would catch it sooner or later. I was very surprised that it turned out to be such a good discount."

Gibbs is on Medicare because of an auto-immune disorder and other medical problems that left her unable to work.

Thanks to the Affordable Care Act, seniors will receive bigger discounts in the years ahead. By 2020, the donut hole will be closed completely. 

And even if you don’t hit the donut hole, there’s still good news for beneficiaries with Medicare Part D.  Prescription drug premiums will not rise next year, and thanks to health reform, seniors can get preventive services like mammograms and other cancer screenings for free.

Nancy-Ann DeParle is the Assistant to the President and Deputy Chief of Staff
 

Before the Affordable Care Act became law, many insurance companies could raise your premiums without any transparency or accountability. If you wanted to know why your rates were going up, they were under no obligation to tell you.

Thanks to the Affordable Care Act, that’s all changing. Starting September 1, 2011, in every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. The Affordable Care Act also included $250 million to help States strengthen their rate review procedures so they can successfully fight high premium hikes and help keep costs under control.

Making the insurance marketplace more transparent and holding insurance companies accountable is good for consumers. Accountability and transparency can help drive costs down and give you more information about your health insurance choices.

We’ve known for a long time that rate review works, but this week alone, we’ve received more news about how rate review is helping States fighting high premium hikes and saving money for consumers:

• In New Mexico, the State Insurance Superintendent rejected Blue Cross and Blue Shield’s plan to raise rates by 9.9 percent.
• In New York, the State Superintendent of Financial Services is requiring insurers justification of high rate hikes to be made available to the public for the first time.
• In California, Kaiser Permanente is decreasing premiums for small businesses and providing credits to those who had paid higher rates. The premium credits will total $13.7 million.

These are just three examples that we learned about this week. We expect to hear more stories like this in the future. And when we do, we’ll post them here on the White House blog.

You can also visit HealthCare.gov to see if any insurers in your State have proposed an increase of 10 percent or more and why.  And if you don’t think the reason for the increase is justified, you can submit comments by emailing ratereview@hhs.gov.

Nancy-Ann DeParle is Assistant to the President and Deputy Chief of Staff for Policy

First, the Office of Personnel Management announced that the average premium for the 8 million people enrolled in the Federal Employees Health Benefits (FEHB) program will increase by 3.8 percent in 2012, nearly half of the 7.3 percent increase in premiums for 2011.  The premium increase for the popular Blue Cross Blue Shield Standard Plan will be only 1.6 percent for 2012. 

Second, the Kaiser Family Foundation released its annual survey on health insurance premiums, which found that that premiums increased by 9 percent in 2011.When evaluating the Kaiser study, it’s important to remember a few important facts:

• High Insurance Company Profits. The Kaiser report shows that premiums increased 9 percent in 2011. These premiums were generally set in 2010, when insurance companies thought medical costs would be significantly higher than they turned out to be. The Bureau of Labor Statistics found that the health insurance employer cost index (a measure of the price of health care services) was the lowest it has been in over 10 years in the first half of 2011. Additionally, some insurers assumed  that the Affordable Care Act would dramatically raise their costs. In the end, both assumptions were wrong – but insurance companies still charged high premiums and earned impressive profits. Wall Street analysts’ review of results from the first quarter of 2011 found that 13 of the top 14 health insurers exceeded their earnings expectations, with profits that were over 45 percent higher than estimated.
• Policies to Hold Insurance Companies Accountable Kicking In. Key Affordable Care Act policies are starting to take effect that make insurance more affordable. For example, insurance companies that want to raise premiums for 2012 by more than 10 percent will have to publicly justify their rate hikes. And a growing number of States have the power to reject unjustified premium hikes. Additionally, insurers are required to spend at least 80 percent of your premium dollars on medical care, rather than advertising, overhead and bonuses for executives. If they fail to meet that standard, they will be required to provide a rebate to their customers.
• Premium Growth is Slowing. The data released by Kaiser cover 2011, but signs indicate that premium growth will slow significantly in 2012. On September 20^th, Mercer, a well-known independent benefits consulting firm released a survey of employers showing that  their health insurance cost increases will average 5.4 percent for 2012, the smallest increase it has measured since 1997.  Goldman Sachs reported “Widespread anecdotal observations suggest health reform may be a factor contributing to slower growth in per capita health spending.”
• Exchanges Work. The Affordable Care Act established Affordable Insurance Exchanges – State-based marketplaces where consumers will be able to purchase affordable, private health insurance. Examples of these kinds of marketplaces already exist and in two important cases, premium growth is falling.
  • As noted earlier, the average premium for 8 million Americans who get their insurance through the Federal Employees Health Benefits (FEHB) program will increase by 3.8 percent in 2012. The FEHBP was a model for the Affordable Insurance Exchanges included in the Affordable Care Act. 
  • CalPERS which insures 1.3 million California workers and retirees through a marketplace that is similar to the Exchanges reported that premium growth in 2012 would be 4.1 percent, down from 9 percent in 2011.

These examples only underscore what independent experts have already told us: Exchanges and other tools in the law will help save money for middle-class families.

• Other Key Statistics: Millions Already Helped by Reform. Other key statistics from the Kaiser report include:
  • 2.3 million young adults were added to their parents’ plan as a result of health reform.  This number is larger than the 1 million uninsured young adults who gained insurance since it includes those switching from an individual market plan. 
  • 47 million Americans who get insurance at work were helped by the Affordable Care Act rule that ensures preventive care is covered without a co-pay or deductible. 31 percent of workers were in plans that added preventive services and 23 percent were in plans that lowered their cost sharing due to the Affordable Care Act. 
  • Contrary to what opponents of the Affordable Care Act claimed would happen, 60 percent of employers continue to offer health insurance to their employees – compared to 59 percent in 2009. And when the law is fully implemented, employers will have new tools that will make it easier for them to provide benefits to their workers.

The Kaiser report is informative, but it’s a look backwards. When we look to the future, we know that the Affordable Care Act will help make insurance more affordable for families and businesses across the country.

The report concludes that:

Average annual growth in national health spending is expected to be 0.1 percentage point higher (5.8 percent) under current law compared to projected average growth prior to the passage of the Affordable Care Act (5.7 percent) for 2010 through 2020. Simultaneously, by 2020, thirty million Americans are expected to gain health insurance coverage as a result of the Affordable Care Act.

The bottom line from the report is clear: more Americans will get coverage and save money and health expenditure growth will remain virtually the same.  But the report doesn’t tell the whole story.

The Affordable Care Act creates changes to the health care system that typically don’t show up on an accounting table. We know these new provisions will save money for the health care system, even if today’s report doesn’t credit these strategies with reducing costs. These provisions include:

• The Administration’s Partnership for Patients: Better Care, Lower Costs, a new private-publicpartnership to achieve two goals: reduce preventable hospital-acquired conditions by 40 percent and reduce hospital readmissions by 20 percent between 2010 and 2013.  Over 2,000 hospitals as well as employers, physicians, nurses, and patient advocates have committed to these goals which, over the next ten years, could reduce costs to Medicare by about $50 billion and help put our nation on the path toward a more sustainable health care system.
• Support for voluntary Accountable Care Organizations that make it easier for health care providers to work together to coordinate care for an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Affordable Care Act rewards ACOs that lower health care costs while providing high quality care, and could generate as much as $960 million in Medicare savings over three years.
• Bundled payment programs that will reward doctors and hospitals for working together to provide higher quality care to patients rather than bill for each individual procedure or test.
• Demonstrations launched by the new Innovation Center that will build and test models that will save money for both Medicare and the private sector, and then expand the use of the models that work.
• Important investments in programs that save money over the long-term like prevention and wellness programs.

Americans know that these common-sense strategies will reduce health care costs. Preventing disease and illness before it happens can keep people out of the hospital or the doctor’s office in the first place. Making health care more efficient improves the quality of care and saves money. And investing in new innovations can help generate new ideas and new delivery system reforms that reduce costs. Further, these provisions of the law represent ideas that hospitals, doctors, and employers all over America have been putting into practice for years, where they’ve been able to increase the quality of health care and reduce costs. 

We are confident that these reforms – in addition to those in the law – will help make our health care system more efficient, provide better health care to millions of Americans, and bring down health care costs for all of us.

Nancy-Ann DeParle is White House Deputy Chief of Staff

Today, McKinsey acknowledged that this report is at odds with these independent analyses and said the report was not intended to predict whether or not employers would offer health insurance. Here’s what McKinsey said today:

The survey was not intended as a predictive economic analysis of the impact of the Affordable Care Act… We understand how the language in the article could lead the reader to think the research was a prediction, but it is not.  

And the new information makes clear that the survey is flawed and raises new questions: 

• Nearly 50 percent of all survey respondents admitted they were not at all familiar or had only heard about the employer responsibility provisions in the Affordable Care Act – nearly one-fourth were “not at all familiar” with the law.
• 6.7 percent of the respondents couldn’t  even answer the most basic question “What medical plans does your company currently offer employees?”
• 58.3 percent of respondents did not know how much their companies spend per employee on medical and prescription drug benefits, raising questions about the on-line survey results.
• Only around half of the survey’s respondents described themselves as a “primary decision maker” on employee benefits. Around 49 percent said that they have some influence in the decision-making process.
• The survey that “educated respondents” left out or failed to explain crucial pieces of information about the Affordable Care Act and other existing laws. For example, health insurance benefits are not taxed. Employers who drop health insurance coverage and provide other benefits to their workers would lose this preferred tax treatment. This important fact was unexplained and other key points went unmentioned.

And hidden in the results are some points that didn’t make it into the report:

• 44.5 percent of small businesses report that they definitely or are likely to join the small employer purchasing part of Health Insurance Exchanges where they will be able to secure health insurance coverage for their workers.
• When asked about their company’s overall view of U.S. healthcare reform, 77.8 percent reported that they were positive, neutral, were not sure, or that it is too early to tell.

The Affordable Care Act will make health insurance more affordable and make it easier for employers to offer coverage to their workers. In fact, a new study released today from Avalere Health, a respected consulting firm, looked at the validity of the various analyses published on the subject and found that the employer-sponsored health insurance market will be stable after 2014 and that “large employers are unlikely to stop offering coverage …” And as we learn more, it’s become clear that this one flawed study from McKinsey is truly an outlier. 

Nancy-Ann DeParle is the Assistant to the President and Deputy Chief of Staff

The McKinsey Study is an Outlier

Respected independent organizations have examined whether employers will continue to offer coverage. Here’s what they found:

The Rand Corporation: "The percentage of employees offered insurance will not change substantially, but a small number of employees in small firms (defined as those with under 100 employees in 2016) will obtain employer-sponsored insurance through the state insurance exchanges."

The Urban Institute: "Some have argued that the Patient Protection and Affordable Care Act would erode employer-sponsored insurance (ESI) by providing incentives for employers to stop offering coverage. Others have claimed that most businesses would face increased costs as a result of reform. A new study finds that overall ESI coverage under the ACA would not differ significantly from what coverage would be without reform."

Mercer: "In a survey released today by consulting firm Mercer, employers were asked how likely they are to get out of the business of providing health care once state-run insurance exchanges become operational in 2014 and make it easier for individuals to buy coverage. For the great majority, the answer was 'not likely.'"

Employers Have No Incentive to Drop Coverage

Economists agree that employers offer health insurance to help attract and retain the most talented employees. Employers will continue to seek out top talent: and the new law makes it easier for them to do so by tackling health costs and supporting small businesses. Additionally, dropping coverage is unlikely to save money for employers. As Tracy Watts of Mercer said:

“Employers are reluctant to lose control over a key employee benefit. But beyond that, once you consider the penalty, the loss of tax savings and grossing up employee income so they can purchase comparable coverage through an exchange, for many employers dropping coverage may not equate to savings.”

At Odds With History

Health reform in Massachusetts uses a similar structure as the Affordable Care Act. It includes exchanges where people can purchase health insurance, a personal responsibility requirement to bring everyone into the health insurance system and an employer responsibility requirement. The result? Since reform was enacted in Massachusetts more than five years ago, the number of individuals with employer-sponsored insurance in Massachusetts has increased.  And job growth in Massachusetts has kept pace with other New England State and the nation.

Unanswered Questions

McKinsey says they obtained their data after they “educated respondents” about reform and that their survey used proprietary research. We don’t know what respondents were told or whether they had the chance to check with their colleagues or crunch the numbers for their business before responding.

The Bottom Line

A central goal of the Affordable Care Act is to reduce the cost of providing health insurance and make it easier for employers to offer coverage to their workers. We have implemented the law at every step of the way to minimize disruption and maximize affordability for businesses, workers, and families.  And we agree with experts who project that employers will continue to offer high quality benefits to their workers under the new law.  This one discordant study should be taken with a grain of salt.

At the same time we have helped improve Medicare’s finances, we have also extended important new benefits to everyone on Medicare. Thanks to the Affordable Care Act:

• Key preventive services are free for people on Medicare.
• All Medicare beneficiaries may receive a free annual physical.
• If you hit the prescription drug donut hole, you will receive a 50 percent discount on your brand name prescription drugs and lower cost generic drugs. And the donut hole will be closed by 2020.

While we’ve made real and significant progress, there is more work to do to strengthen Medicare for future generations.  That’s why the President’s framework for shared prosperity and shared fiscal responsibility includes reforms that would save at least an additional $200 billion for Medicare over the next decade. The framework would:

• Bend the long-term cost curve by setting a more ambitious target of holding Medicare cost growth per beneficiary to GDP per capita plus 0.5 percent beginning in 2018, through strengthening the Independent Payment Advisory Board (IPAB).
• Reduce Medicare’s excessive spending on prescription drugs and lower premiums for beneficiaries without shifting costs to seniors or privatizing Medicare.

We’re committed to protecting Medicare and in the weeks and months ahead, we will continue to build on the Affordable Care Act and ensure Medicare remains strong for generations to come.

Nancy-Ann DeParle is White House Deputy Chief of Staff.

The President’s framework instead builds on the improvements made by the Affordable Care Act.  It tackles Medicare fraud and excessive payments for prescription drugs, proposes a stronger Federal-State partnership in Medicaid, and includes a series of health care reforms that would save $340 billion by 2021, $480 billion by 2023 and at least an additional $1 trillion in the following decade.

Key to these savings is a proposal to strengthen the Independent Payment Advisory Board – IPAB, which was created by the Affordable Care Act. Here’s how IPAB works:

• 15 experts including doctors and patient advocates would be nominated by the President and confirmed by the Senate to serve on IPAB.

• IPAB would recommend policies to Congress to help Medicare provide better care at lower costs.  This could include ideas on coordinating care, getting rid of waste in the system, incentivizing best practices, and prioritizing primary care. 

• IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare.

• Congress then has the power to accept or reject these recommendations. If Congress rejects the recommendations, and Medicare spending exceeds specific targets, Congress must either enact policies that achieve equivalent savings or let the Secretary of Health and Human Services follow IPAB’s recommendations.

IPAB is a backstop – it would only take effect if Medicare costs grow too fast.  We’re already implementing a series of reforms that will improve the quality of care and reduce costs. In fact, according to Congressional Budget Office projections, Medicare spending won’t hit the targets that would cause IPAB’s recommendations to take effect in the next decade. But independent experts agree that IPAB will offer constructive ideas and help keep Medicare cost growth per enrollee affordable in the long run:

• Experts including former Bush Administration Medicare Official Mark McClellan called for “[strengthening] and [clarifying] the authority and capacity of the Independent Payment Advisory Board (IPAB).”

• Former Congressional Budget Office Director Former CBO Director Robert Reischauer called IPAB a “big deal” that “could generate substantial savings.”

• Experts from the Commonwealth Fund wrote “the Affordable Care Act includes important provisions that will finally begin to control unchecked health care costs, such as…the creation of the Independent Payment Advisory Board. Building on and extending these provisions across the health system has the greatest promise of slowing the growth of government health care budget outlays, private insurance premiums, and underlying health care cost trends.”

• A coalition of economists including three Nobel laureates said “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending” including an Independent Payment Advisory Board.

Under the President’s framework, seniors will have their guaranteed Medicare benefits. People on Medicare won’t be saddled with thousands of dollars in additional health care costs. And Medicare beneficiaries will be able to choose the health care plan and doctor that work for them.

The same can’t be said for the Republican plan. Under their proposal, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 for health care, more than doubling what he or she would pay if the plan were not adopted. Guaranteed Medicare benefits would be eliminated. Big health insurance companies would decide which benefits and insurance plans are available and could limit seniors’ choice of doctor. And in some cases, seniors might not have any health care choices at all.

As with deficit reduction, there is a right way and a wrong way to strengthen Medicare.  The wrong way is to simply slash benefits, leave seniors with higher premiums and hope for the best. 

The right way is to identify and implement what works on an ongoing basis to lower costs and improve care, set spending goals, and have a way to ensure that they are met – which is what IPAB does.  Reducing our deficit and debt is a goal we all share, and we can achieve that goal and ensure our seniors get the quality, affordable health care they need and deserve.

Nancy-Ann DeParle is White House Deputy Chief of Staff

This year, Vice President Biden has recorded a new video looking at the work to pass reform and how the law is already helping the American people.

Passing the law wasn’t easy, but we knew that we were working to end the worst insurance company abuses and give Americans more freedom and control over their health care choices. And the law that is one year old today is already making the health care system better for millions of Americans. Thanks to the new law millions of Americans are already enjoying:

Lower health care costs

• Seniors have the freedom to get the care they need, including free preventive care, lower cost prescription drugs, and Medicare they can count on. Nearly 4 million Americans who hit the Medicare prescription drug coverage gap known as the “donut hole” received $250 tax-free rebates, and will receive a 50% discount on brand name prescription drugs if they hit the donut hole this year.
• Up to 4 million small businesses could receive tax credits to make employees’ health coverage more affordable.
• Insurance companies can no longer overcharge consumers just to boost profits and CEO salaries.

Better quality coverage

• People with insurance are free from worrying about losing their insurance due to a mistake on their application – protecting 15 million Americans who purchase individual-market insurance as well as those insured through their employers.  All Americans with private insurance are also free from having coverage  capped unexpectedly due to a lifetime limit if someone is in an accident or becomes sick.
• All Americans in new insurance plans will receive preventive services without being charged a deductible, co-payment, or co-insurance.

New coverage options

• Parents have the choice of providing health coverage for a child until their 26th birthday. An estimated 1.2 million young adults could gain insurance coverage as a result of the law.
• Children with pre-existing conditions cannot be denied coverage.
• Adults who have been locked out of the insurance marketplace because of a pre-existing condition can now buy coverage through a new Pre-Existing Condition Plan.

To find out more about how the law impacts you, check out www.HealthCare.gov and its special section on Better Benefits, Better Health.

Nancy-Ann DeParle is Assistant to the President and Deputy Chief of Staff.

The pay cut wouldn't have just hurt doctors – seniors and families across America would have suffered as well. Many doctors would have simply stopped seeing Medicare patients and military families if this pay cut took effect, effectively denying patients the chance to see the doctor they know and trust.

That wasn't acceptable to President Obama or leaders in Congress and the law the President signed today delays the pay cut from taking effect for another year.

The law wouldn’t have been possible without volunteers like Brenda Kelley of Woodbridge, Virginia and Robert Sargeant of Fairfax, Virginia. Brenda and Robert were two of the thousands of AARP members who worked hard to make this legislation a reality. They made phone calls, wrote letters, and helped ensure this important legislation was enacted.

They weren’t alone. American Medical Association President Cecil Wilson and Board Chair Ardis Hoven, along with doctors from across the country spoke out about the importance of ensuring doctors knew how much they would be paid for treating seniors on Medicare. Together with AARP CEO Barry Rand, AARP Board Chair Lee Hammond and Military Officers Association of America President Admiral Norbert Ryan, these individuals who helped protect seniors, military families and doctors celebrated with President Obama as he signed this legislation into law in the Oval Office.

They were also joined by some of the bipartisan leaders in Congress who helped pass this law including:

• Senator John Barrasso, R-WY
• Senator Max Baucus, D-MT
• Representative Henry Waxman, D-CA

Today was an important milestone, but signing this law is just the first step. For years, Congress and Presidents from both parties have acted to stop pay cuts for doctors called for by the Sustainable Growth Rate. Each solution was temporary, forcing Congress to continually deal with this matter and leaving doctors to wonder if they would be forced to take a pay cut in the future.

After years of temporary measures, the President believes it's time for a permanent solution. Over the next year, the President and his team will work with Congress to address this matter once and for all. We all agree that this formula needs to be changed. Now's the time to get it done.

Nancy-Ann DeParle is the Director of the White House Office of Health Reform

The work in Connecticut shows the power of premium review – a process used by states to evaluate and approve proposed health insurance premium increases. Today, some states have stronger premium review processes than others, so the Affordable Care Act included $250 million in grants to states that will help them strengthen their premium review efforts and protect consumers. We’ve already seen premium review hold down rate hikes in California, Massachusetts, Maine and now, Connecticut and we expect to hear more good news from other states in the months ahead.

Supporting state efforts to crack down on premium hikes is just one of the steps the Affordable Care Act takes to help control health care costs for families nationwide. In addition to setting up exchanges -- new competitive health insurance marketplaces where Americans can shop for affordable coverage options – the law:

• Requires insurance companies to publicly justify any unreasonable premium increases beginning in 2011.
• Requires insurance companies to spend at least 80 percent of premium dollars on health care instead of overhead, salaries or administrative expenses, in 2011. If they don’t, they will be required to provide a rebate to consumers.
• Insurance companies who unreasonably raise rates between now and 2014 may be denied the opportunity to participate in the new exchanges.

The Affordable Care Act is making our health care system more transparent, giving consumers new rights and benefits and helping states control costs for families. We are committed to implementing the law quickly and carefully and delivering the benefits of reform to the American people.
 

Nancy-Ann DeParle is the Director of the White House Office of Health Reform

The Affordable Care Act marks a crucial turning point for our health care system and will help make affordable, high-quality care accessible to millions of Americans. Under the Affordable Care Act, millions of Americans will be able to purchase better coverage in the new competitive private health insurance exchanges where individuals and small businesses will be able to choose coverage from a range of insurance options – the same options members of Congress will have. The law also helps cover millions of Americans who have been priced out of the market.  Taken together, the provisions in the law will expand coverage to 32 million Americans.  For more information on the new law please visit: www.HealthCare.gov. 

And whether you have insurance today or not, your care will get better. On the six month anniversary of the Affordable Care Act being signed into law, landmark reforms and consumer protections begin to take effect.  These new protections include:

• Requiring insurance companies to allow young adults to stay on their parents’ plan until they turn 26. 
• Prohibiting insurance companies from imposing lifetime limits on the dollar amount health plans will spend on benefits, such as cancer treatment, and restricting annual limits on benefits until 2014, when they too will be banned. 
• Banning insurance companies from canceling your coverage, a practice known as “rescission,” if you get sick or make a technical mistake on your application.  
• Prohibits Discriminating Against Children With Pre-Existing Conditions

And if you purchase or join a new plan after September 23:

• Insurance companies must cover recommended preventive services, including mammograms, colonoscopies, immunizations, pre-natal and new baby care without charging deductibles, co-payments or co-insurance.
• Insurance companies will be prohibited from denying coverage for needed care without a chance to appeal to an independent third party. 
• You will be guaranteed your choice of primary care provider within your plan’s network of doctors, including OB-GYNs and pediatricians, without a referral, as well as out-of-network emergency care. 

And the new law is already extending coverage to Americans who have been uninsured because of a pre-existing condition through the new Pre-Existing Condition Insurance Plan, providing tax credits to small businesses who offer insurance to their workers and making it easier for companies to offer health benefits to their early retirees.

Here are some of the striking numbers featured in today’s Census report and how the Affordable Care Act begins to address them: 

Nancy-Ann DeParle is the Director of the White House Office of Health Reform

Today’s report by the Office of the Actuary confirms a central point of the Affordable Care Act passed by Congress and signed by President Obama:  The Act will make health care more affordable for Americans. In fact, the Actuary’s report indicates that total health care spending per insured American will be more than $1000 lower thanks to the provisions of the new law than it would have been if Congress and the President had not acted.

Specifically, by 2019, overall health spending per insured person will average $14,720 instead of the $16,120 projected by the Actuary before the Act was enacted into law.  This is great news for many Americans.  More good news for American consumers:  The Actuary predicts out of pocket spending on health care services per person will decline an average of 6% to $1,310, a savings of $80 per person per year.  This means more money in people’s pockets.

Finally, the Actuary’s report confirms that 33 million Americans who are living without health insurance today will gain coverage.  While this will result in a short-term increase in spending (as uninsured people begin to receive the care they have postponed or gone without), the rate of growth in spending will slow in the second half of this decade. A close look at this report’s data suggest that for average Americans, the Affordable Care Act will live up to its promise.
 

Nancy-Ann DeParle is the Director of the White House Office of Health Reform

This morning, the Social Security and Medicare Boards of Trustees released a new report that demonstrates how the Affordable Care Act is helping to reduce costs and make Medicare stronger. The report shows that the Affordable Care Act will extend the life of the Medicare Trust Fund by 12 additional years – the biggest extension ever –  and help preserve Medicare for generations to come. 

But the Affordable Care Act isn’t just about saving money for Medicare. It’s about providing better services and giving seniors higher quality care.  Many of the provisions on the Affordable Care Act are specifically designed to improve care and lower costs - like providing free preventive care and avoiding hospital readmissions. 

Forty -five years ago, President Johnson signed Medicare into law – making a solemn commitment to provide to our seniors and some of the most vulnerable Americans with health care coverage.  President Obama will always uphold that commitment.  That’s why we fought for the Affordable Care Act in first place – to ensure that Medicare is protected for years to come.

Today we also learned that the Affordable Care Act is actually expected to strengthen Social Security and improve its solvency by bringing down health premiums, resulting in higher take-home pay for America’s workers. Social Security is a critical bedrock of economic security not just for America’s seniors but for people with disabilities and survivors and our Administration is committed to working to keep it that way not just for the current generation but for generations to come.

You can learn more about ways the Affordable Care Act is cutting costs and improving health care for seniors and all Americans at HealthCare.gov. 

Nancy-Ann DeParle is Director of the White House Office of Health Reform

Starting September 23, the new law makes it illegal for insurance companies to discriminate against children under 19 with preexisting conditions. In 2014, discriminating against anyone with a pre-existing condition will be illegal, but we know Americans need relief now. That’s why the new law created the Pre-Existing Condition Insurance Plan. This plan offers coverage to uninsured Americans who have been uninsured for at least six months and unable to obtain health coverage because of a pre-existing health condition like cancer, diabetes or lupus.

Coverage will be available at the same rate as it is for an average person who does not have such a condition and the program is entirely funded by the federal government.  The program is temporary and will last until 2014 when discriminating against anyone with a pre-existing condition will be illegal. If you’re interested in joining the program, you can click here to learn more about the program in your state.

Today, HHS issued an interim final regulation laying out the rules for the PCIP program.  The regulation describes the options for determining who has a pre-existing condition, how to verify citizenship, and how an individual can appeal a PCIP decision.  It also details how Federal funding will be allocated, ways to prevent “dumping” of already-insured people into the program, and strategies for preventing fraud.

The regulation also lists the benefits that can and can’t be covered under this temporary federal program.  Covered benefits include hospitalization, outpatient care, maternity care, and, hospice, and home health care. 

The list of services not covered parallels that of the Federal Employees Health Benefit Plan (FEHBP), which serves government workers and their families, including Members of Congress. And like this program, PCIP prohibits the use of federal funds for abortion services, except in cases of rape or incest, or where the life of the woman would be endangered.  This policy meets the President’s commitment throughout the health reform debate to neither expand nor scale back current restrictions on federal funding for abortion and ensures that no federal funds will be used to cover abortion services other than the exceptions mentioned above

Much has been made of this policy by both sides of the debate.  But, in reality, no new ground has been broken.  The program’s restriction on abortion coverage is not a precedent for other programs or policies given the unique, temporary nature of the program and the population it serves.  It does not restrict private insurance choices and the implementation of the Affordable Care Act will continue to be guided by the law and the President’s Executive Order.

What is new is the benefits from this program detailed in the regulation.  Studies have estimated that 200,000 to 400,000 uninsured people with pre-existing conditions could be helped, doubling the number of Americans insured through existing high risk pools.  And this new coverage will help all of us by reducing medical debt, improving health and worker productivity and reducing the amount of uncompensated care provided to the uninsured, potentially by billions of dollars. 

Every day, the Affordable Care Act is making it easier for Americans to take control of their health care by giving them easier access to better health coverage choices.  The Pre-Existing Condition Insurance Plan helps meet that goal.
 

One important change in the new law is a provision that prevents insurance companies from discriminating against children with pre-existing conditions. This new provision takes effect on September 23 and will bring welcome relief to parents of children with medical conditions who often were denied access to health insurance.

Since this policy was announced, we have had helpful discussions on how to ensure children with pre-existing conditions have access to care, while not disrupting the insurance marketplace.   Some state insurance commissioners expressed concern that, without an open enrollment period that was widely communicated, people might wait until their children got sick to enroll them in coverage, causing plans’ costs to increase. And we were concerned when last week, some indicated that insurance companies would choose to stop offering policies for children rather than cover kids with pre-existing conditions.

Today, the Administration is releasing new guidance to health insurance plans to help ensure children get the high-quality care they need. The new FAQ document notes that insurance companies may establish an open enrollment period for children with pre-existing conditions and makes clear that the Administration will not hesitate to issue regulations if insurance companies unfairly limit access to insurance for children who need it most.   The document also signals that kids with pre-existing conditions should not be shifted from the Children’s’ Health Insurance Program to the individual market in an attempt to reduce State health care spending and that these policies will apply to health plans that start on or after September 23.

Insurance companies have pledged to conduct a significant consumer education campaign to ensure more Americans and their children know about the coverage options that are available to them. And some of the companies that reportedly planned to stop offering policies for children have reversed course and committed to continuing to provide coverage for the youngest Americans.

The Blue Cross Blue Shield Association said the “policy will ensure that children get the comprehensive coverage they need,” and pledged to “work with our Blue Cross and Blue Shield companies on outreach efforts to educate consumers about this new provision.” Blue Cross Blue Shield of Florida said they were “pleased to announce that it will establish a process to resume the sale of Child Only policies.”  

For too long, parents have been forced to worry about what they would do if their child developed a serious medical condition. Others have found that children born with illnesses were forever ineligible for insurance. Thanks the Affordable Care Act, kids will get the care they need and parents will have one less thing to worry about.

To learn more, read the FAQ document.

Nancy-Ann DeParle is Director of the White House Office of Health Reform