The Congressional Budget Office, our national independent, non-partisan “referee” that by law examines each bill considered by Congress to assess the cost, released its “scoring” of the bill we will vote on Sunday. Based on an analysis from CBO, the legislation the bill:
- Cuts the deficit by $138 billion in the first ten years (2010 – 2019).
- Cuts the deficit by $1.2 trillion in the second ten years.
- Reduces annual growth in Medicare expenditures by 1.4 percentage points per year—while improving benefits and lowering costs for seniors.
- Extends Medicare’s solvency by at least 9 years.
- Expands health insurance coverage to 32 million Americans.
- Helps guarantee that 95 percent of Americans will be covered.
- $940 billion over a decade. (Americans spend nearly $2.5 trillion each year on health care now and nearly two-thirds of the bill is paid for by reducing health care costs).
But, let’s get specific to what this bill will do in our District. If passed the bill will:
- Improve coverage for 369,000 residents with health insurance.
- Give tax credits and other assistance to up to 171,000 families and 14,300 small businesses to help them afford coverage.
- Improve Medicare for 98,000 beneficiaries, including closing the donut hole.
- Extend coverage to 58,500 uninsured residents.
- Guarantee that 12,200 residents with pre-existing conditions can obtain coverage.
- Protect 1,500 families from bankruptcy due to unaffordable health care costs.
- Allow 49,000 young adults to obtain coverage on their parents’ insurance plans.
- Provide millions of dollars in new funding for 7 community health centers.
- Reduce the cost of uncompensated care for hospitals and other health care providers by $68 million annually.
Affordable High-Quality Health Care for the Middle Class
Essential health insurance reforms. Approximately 59% of the District (369,000 residents) receives health care coverage from an employer or through policies purchased on the individual market. Under the legislation, individuals with insurance can keep the coverage they have now, and it will get better. The insurance reforms in the bill prohibit annual and lifetime limits, eliminate rescissions for individuals who become ill while insured, ban coverage denials for pre-existing conditions, and reduce the cost of preventive care. To rein in soaring insurance costs, the reforms also limit the amount insurance companies can spend on administrative expenses, profits, and other overhead.
Historic health care tax cuts. Those who do not receive health care coverage through their employer will be able to purchase coverage at group rates through new health insurance exchange. To make this insurance affordable, the legislation contains the largest middle-class tax cut for health care in history, providing middle class families with incomes up to $88,000 for a family of four with tax credits to help pay for coverage in the exchange. For a family of four making $50,000, the average tax credit will be approximately $5,800. There are 171,000 households in the District that could qualify for these credits if they purchase health insurance through the exchange or, in the case of households with incomes below 133% of poverty, receive coverage through Medicaid.
Coverage for individuals with pre-existing conditions. There are 12,200 uninsured individuals in the District who have pre-existing medical conditions like cancer, heart disease, and diabetes. Under the bill’s insurance reforms, they cannot be denied affordable coverage.
Financial security for families. There were 1,500 health care-related bankruptcies in the District in 2008, caused primarily by the health care costs not covered by insurance. The bill caps annual out-of-pocket costs at $6,200 for individuals and $12,400 for families who purchase insurance through the exchange or who are insured by small businesses. It also eliminates annual and lifetime limits on all insurance coverage. These reforms ensure that no family will have to face financial ruin because of high health care costs.
Security for Seniors
Improving Medicare. There are 98,000 Medicare beneficiaries in the District. The legislation improves their benefits by providing free preventive and wellness care, improving primary and coordinated care, and enhancing nursing home care. The bill also strengthens the Medicare Trust Fund, extending its solvency from 2017 to 2026.
Closing the Part D donut hole. Each year, 9,300 Medicare beneficiaries in the District enter the Part D donut hole and are forced to pay the full cost of their prescription drugs. Under the bill, these beneficiaries will receive a $250 rebate in 2010, 50% discounts on brand name drugs beginning in 2011, and complete closure of the donut hole within a decade. A typical beneficiary who enters the donut hole will see savings of over $700 in 2011 and over $3,000 by 2020.
New Coverage Options for Young Adults
New lower-cost health care options for young adults. The legislation will allow young adults to remain on their parents’ policies until they turn 26. There are 49,000 young adults in the District who could benefit from this option. For individuals under age 30, the bill creates new, inexpensive policies that allow them to obtain protection from catastrophic health care costs.
Helping Small Businesses
Helping small businesses obtain health insurance. Under the legislation, small businesses with 100 employees or less will be able to join the health insurance exchange, benefiting from group rates and a greater choice of insurers. There are 16,400 small businesses in the District that could benefit from this provision.
Tax credits for small businesses. Small businesses with 25 employees or less and average wages of less than $50,000 will qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 14,300 small businesses in the District that could qualify for these credits.
Covering the Uninsured
Coverage of the uninsured. The legislation would extend coverage to 95% of all Americans. If this level of coverage is reached in the District, 58,500 residents who currently do not have health insurance will receive coverage.
Relieving the burden of uncompensated care. In 2008, health care providers in the District provided uncompensated care to individuals who lacked insurance coverage and were unable to pay their bills.
Under the legislation, these costs of uncompensated care will be reduced by $68 million.
