Did You See: It’s Time to Set Up Exchanges

On Friday the New York Times published an editorial urging states like New Mexico to stop stalling on setting up insurance exchanges for the citizens in those states. The insurance exchanges that allow consumers to choose from private health insurance plans must be up and running and open for business for consumers no later than January 1, 2014 when the Affordable Health Care law goes into effect. States must inform the Secretary of Health and Human Services whether they intend to set up an exchange by November 16, 2012 or the Federal government will step in create the exchange for that state.

In its’ editorial the New York Times wrote, “States that were dawdling or refusing to set up exchanges in expectation that the Supreme Court would strike down the law have little time left to meet tight deadlines. If they fail, the federal government will establish an exchange to serve their residents, who otherwise would have no way to obtain subsidies to reduce the cost of their insurance.”

Unfortunately, thanks to the opposition of Governor Susana Martinez, New Mexico is one of those states that has failed, so far, to act. It’s well past time for Governor Martinez and her fellow New Mexico Republicans to stop playing games with the health of New Mexicans and get to work.

Read the full text of the New York Times editorial:

“Now that the health care reform law has been ruled constitutional, it is imperative that as many states as possible move aggressively to establish a centerpiece of the reform structure: new insurance policy exchanges for people who lack affordable coverage through an employer. Federal subsidies will be available for those with low or moderate incomes.

“States that were dawdling or refusing to set up exchanges in expectation that the Supreme Court would strike down the law have little time left to meet tight deadlines. If they fail, the federal government will establish an exchange to serve their residents, who otherwise would have no way to obtain subsidies to reduce the cost of their insurance.

“The exchanges will essentially be online marketplaces for private plans that provide a package of essential benefits and consumer protections like guaranteed coverage for pre-existing conditions. They will compete to sell policies to individuals, families and small businesses. Anyone can use the exchanges to gain the benefits of comparative shopping, but most customers are expected to be individuals and families with incomes between 133 percent and 400 percent of the federal poverty level. They will be eligible for federal tax subsidies to make insurance affordable.

“Many states are well on the way toward setting up exchanges, a complicated process in which governance procedures must be established, standards must be set for the plans that will compete and new information technologies put in place. The big uncertainty is how many Republican-led states will refuse to set up exchanges either because they adamantly oppose all aspects of the reform law or because they are reluctant to spend any time, effort or money to set up a mechanism that they hope Republicans will repeal after the November elections. That sounds like wishful thinking. States would be foolish to rely on it with deadlines fast approaching.

“States must tell the secretary of health and human services by Nov. 16, just 10 days after the election, whether or not they plan to set up their own exchanges. The secretary must then certify by Jan. 1, 2013, whether states are on track to start enrolling people by Oct. 1, 2013, and to actually open for business on Jan. 1, 2014.

“The Obama administration, which is eager to see the law implemented effectively, seems willing to accommodate any states that will make a good-faith effort. On Friday, the secretary, Kathleen Sebelius, announced that, in addition to grants already made to 34 states and the District of Columbia to plan their exchanges, she would open up additional financing sources that could be used even after the original start-up deadline. She also pledged to work closely with the states to tailor a federal exchange to meet their needs and a plan for transition to state control.

“That sounds like a deal that no responsible elected official should pass up in the quixotic hope that the reform law will somehow go away.”

Weekly Address: An All-Hands-On-Deck Approach to Fighting the Colorado Wildfires

President Obama speaks to the American people from Colorado, where he toured areas impacted by the devastating Waldo Canyon fire and met with first responders as well as families affected by the fires. The President thanks the brave firefighters and countless volunteers who are providing food, water, and shelter to those in need, and makes clear that his administration will continue to bring all resources available to assist efforts to combat the fires.

In the news: Obamacare upheld

Newspaper editorials across the country yesterday explained why Thursday’s Supreme Court ruling is good for America:

Milwaukee Journal Sentinel: “Supreme Court ruling means a healthier America”

The details of the U.S. Supreme Court’s decision will be parsed and debated for months, probably years. The votes and motives of individual justices, especially the apparent swing vote of Chief Justice John Roberts, will be the favorite subject of talk shows and pundits for weeks. But the bottom line today is this: The essential provisions of the Affordable Care Act stand, and the United States will be healthier for it.

The 2010 health care law is expected to bring coverage to about 30 million uninsured people; roughly 9 in 10 eligible Americans will be covered. Young adults will be able to stay on their parents’ insurance up to age 26. Insurers won’t be able to deny coverage based on pre-existing conditions, nor will they be able to deny coverage to children with health problems. Limits on how much policies will pay out to each person over a lifetime have been eliminated. Improved Medicare prescription benefits will reduce health care costs for older Americans. And co-payments for preventive care for all ages have been eliminated.

Despite the claims by detractors that the law will break the national bank, insuring most Americans should, over time, help reduce the cost of health care as people are seen by primary care physicians instead of in expensive emergency rooms and as people are treated before their conditions worsen.

The Des Moines Register: “Health care ruling was a ‘win’ for Americans”

The public finally began to understand what the law contained—and what they would lose if it disappeared. They don’t want anyone taking away free preventive care, including mammograms. They don’t want to lose the opportunity to start their own business and be able to buy their own health coverage without an employer.

Americans should remember what is at stake going forward—when they vote. The public is already hearing from politicians promising to “repeal” the law and “do what the Court would not do.” That is a promise to reinstitute a system where Americans lose their health insurance when they lose a job or get sick. It is a promise to maintain a system that leaves millions of us uninsured.

Though the health reform law may need some tweaking, promises to repeal it should be met with resistance from all the Americans who will benefit from its protections and opportunities.

The News & Observer: “Supremely right”

… [No] longer will the United States remain just about the only advanced country lacking universal coverage. No longer will the worst aspects of our often outstanding health care system work against us, bankrupting some unfortunate people who are badly hurt or fall seriously ill.No longer will children in families that make too much to qualify for existing Medicaid but too little to afford private insurance go uncovered in the face of unaffordable medical costs. No longer will “pre-existing” ills disqualify people from coverage. No longer will those who lose or change their jobs—and employer-provided health insurance—be left out in the cold. Real, tangible benefits will reach tens of millions more Americans.

Los Angeles Times: “Vindication for Obamacare”

The highly polarized debate about the constitutionality of “Obamacare” was so overwrought that it obscured what the Patient Protection and Affordable Care Act actually does. Far from being a government takeover of health care, as its critics claim, the measure seeks to improve the current system while leaving private insurers, doctors and hospitals largely intact. Its three main, interdependent goals are to significantly reduce the number of Americans who have no health insurance, promote higher-quality care and find ways to slow the growth of health care costs.

The Health Care Law and Seniors

The President’s health law gives hard working, middle-class families the security they deserve. The Affordable Care Act forces insurance companies to play by the rules, prohibiting them from dropping your coverage if you get sick, billing you into bankruptcy through annual or lifetime limits, and, soon, discriminating against anyone with a pre-existing condition.

For seniors, the new health care law, the Affordable Care Act, not only means more time with their doctor and important new benefits like free preventive services like cancer screenings and annual wellness visits, but it also means more money in their pocket. The new health care law strengthens Medicare. Already, more than 5.1 million seniors and people with disabilities saved over $3.2 billion in drug costs. That comes to an average savings of $635 per person for seniors caught in the coverage gap known as the donut hole. And, 32.5 million people with Medicare have received preventive service without a deductible or copay, thanks to the new law.

Here are more ways the law helps seniors:

  1. You get free preventive services. Medicare now covers certain preventive services, like mammograms or colonoscopies, with no cost sharing. You also can get a free annual wellness visit.
  2. You get cheaper prescription drugs. If you’re in the donut hole, you will receive a 50 percent discount when buying brand-name prescription drugs covered by Medicare Part D. The discount is applied automatically when you fill your prescription—you don’t have to do anything to get it. These changes are already saving seniors billions of dollars. And by 2020, the donut hole will be closed.
  3. Your doctors are supported to better coordinate your care.  Many doctors, hospitals, and other providers are taking advantage of new programs to help them work better as teams to provide you the highest quality care possible. They are working to get you the care you need at the time you need it.
  4. The law fights fraud and strengthens Medicare. The Affordable Care Act builds on our efforts to combat fraud and abuse. These efforts are saving billions of dollars in money that was being stolen from people with Medicare. And thanks to these efforts and other improvements, the life of the Medicare Trust fund has been extended.
  5. Your Medicare coverage is protected. Under the new health care law, your existing Medicare-covered benefits won’t be reduced or taken away. As always, you will be able to choose your own doctors.

Visit http://www.healthcare.gov/seniors to learn more.