By Congressman Jim McDermott
Three years ago, on March 23, the Patient Protection and Affordable Care Act, or ObamaCare, was passed. It was the most significant reform to our health care system since the passage of Medicare and Medicaid in 1965 and has faced as much controversy. Only a year ago, the law was threatened by both a looming election and a potentially negative Supreme Court ruling, but both supported this landmark legislation.
There was no debating that reform was needed. For years medical bills have been the number one source of personal bankruptcy in America and rising health care costs were the biggest driver of our national debt. Health insurance companies dropped enrollees when they became ill and many couldn’t get insurance to begin with. Financially and morally, we were on an unsustainable path.
Since its passage, the health law has helped slow the growth in premium increases by requiring insurers to justify large rate hikes and spend at least 80% of individual’s premiums on health care benefits and quality improvement. Soon, lifetime caps on care will be a thing of the past and preexisting conditions will no longer be used to deny coverage. And that’s not to mention the health benefits seniors have received through free preventive services such as checkups or cancer screenings and the billions of dollars saved on prescription drugs.
This year we will implement some of the most significant reforms, and while they will arguably have the largest impact on the uninsured, many people are unaware of these benefits. “Health Insurance Marketplaces,” sometimes called exchanges, will open for enrollment nationwide starting October 1. Online or through an agency, the marketplace will be a one-stop-shop to find insurance plans to fit an individual’s or family’s needs and budget. Purchasing will be easier than ever, with new regulations which require clear terms, a simplified price structure and a minimum set of essential health benefits.
In addition to making the hunt for insurance a little easier, these marketplaces will lessen the financial burden on consumers as well. Plans will be required to limit enrollee’s out-ofpocket spending for covered services and must keep administrative costs under control. New age and community rate restrictions put limits on how much more insurers can charge the elderly and ill compared to their young, healthy customers. Many of those currently uninsured should now be eligible either for subsidies in the Exchange or an expanded Medicaid program.
Though these reforms will make insurance more accessible, the marketplace’s success hinges on Americans having the tools they need to participate.
That’s why we’re getting started early. Washington State is ahead of the curve when it comes to Affordable Care Act implementation and we need to stay that way. Reforms can’t improve our health care system if the people who need reforms don’t know about them.
Though many PSARA members might already get their insurance from Medicare, your businesses and networks may benefit from certain insurance changes. Trusted friends and family will always be better educators than a Congressional newsletter or event, so I am asking you to help us spread the word.
To find out about Washington State’s marketplace, visit Washington HealthPlanFinder’s website: wahbexchange.org.
More information is available at healthcare.gov, where you can find out if you, your family, or your business is eligible for tax credits and sign up to get email and text updates.
As ranking member on the Ways and Means Health Subcommittee, I will continue to fight to build on Obamacare so that we are able to bring everyone into the “house of health” and to make quality health care truly affordable for all. It’s important, however, that we embrace the positive changes that have already been made.
Legislators can’t change this system alone. It will take a community effort to make health insecurity a thing of the past, but it is essential to the health of our citizens, infrastructure, and economy.
Jim McDermott, D-Wash., is the ranking member on the Ways and Means Health Subcommittee.