Medical research

Affordable Health Care for America Act of 2009

hmoroz — Tue, 10 Nov 2009 13:04:32 -0500

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Number of uninsured Americans in 2008: 45.7 million

Estimated number of uninsured Americans after passage of the Affordable Health Care for America Act: 18 million

Percentage growth in the uninsured between 2004 and 2007 that came from lower- and middle-income families: 70

Average annual worker contribution to health insurance premiums in employer-sponsored coverage in 1999: $1,543

Average annual worker contribution to health insurance premiums in employer-sponsored coverage in 2008: $3,354

Savings to a low-income family and a higher-income family, respectively, from the Affordable Health Care for America Act because they do not have to buy private, nongroup insurance: $9,000, $1,260

Overview/Summary

Middle Class Position Analysis

Middle Class Supports. Skyrocketing health care costs have created a vicious and destabilizing trap for middle-class Americans in which employer-sponsored coverage is offered less frequently and private coverage is increasingly unaffordable. Meanwhile, successful public programs that effectively cover children (SCHIP), the poor (Medicaid), and the elderly (Medicare) are unavailable to middle-class adults. Almost 46 million nonelderly Americans lack health insurance, the majority of whom are low- and middle-income, and the rate of the uninsured has grown significantly since 2000. At the same time, the average worker’s health care premium has increased 128% (to $3,515) since 2009. One study has even found that just shy of two thirds of all bankruptcies are due to medical expenses even though the vast majority of these bankruptcies involve families who have health insurance. Because employers, too, have had to absorb similar premium increases, employer-sponsored insurance – the type of insurance most middle-class Americans obtain – has declined significantly in each of the last eight years. The economic downturn has exacerbated this situation and experts estimate that each percentage point increase in the unemployment rate results in substantial increases in the number of uninsured Americans. Given the high costs of obtaining insurance in the private, non-group market, which is nearly impossible without steady employment, many Americans have simply given up coverage over the last several years. In short, a perfect storm of increasing health care costs and a down economy has undermined the financial stability and endangered the wellbeing of the middle class and the aspiring middle class.

The Affordable Health Care for America Act would do much to relieve the financial stress placed on these households by high health insurance costs while also extending health coverage to millions of Americans. The nonpartisan Congressional Budget Office reckons that the bill would reduce the number of uninsured to 18 million, leaving just 4 percent of the population without health coverage. Expanding Medicaid to cover low-income adults is one of the most effective and cost-efficient means of covering more aspiring middle-class Americans. The expansion would enroll about 15 million individuals in Medicaid, providing an important public backstop for low-income families. Indeed, public programs have successfully kept millions of children from becoming uninsured, while the lack of such programs for low-income childless adults has led to increased numbers of the uninsured among this population. Similarly, coverage in the Health Insurance Exchange would reduce health care costs for tens of millions of households: the savings range from more than $9,000 for a low-income household of four which receives payment assistance to $1,260 for a higher-income family making more than $90,000 that does not receive such assistance. Such savings are targeted at the very groups that need the most help. The inclusion of a public option in the Exchange, in which a relatively meager 6 million individuals are expected to enroll, will create competition with the Exchange’s private insurance plans driving costs even lower.

At the same time as it helps reduce health care costs for middle-class and aspiring middle-class Americans, the Affordable Health Care for America Act greatly improves health coverage by enacting strict requirements for the type of insurance that is offered. The bill prevents the nightmare scenarios of being denied coverage just because you have become sick or being forced to pay higher premiums because of a preexisting condition (in many policies, being a woman is effectively considered a preexisting condition). Eventually, it will define minimum benefits and cost limits that must be included in all health insurance plans, not just ones offered by the Health Insurance Exchange. And it will ensure that health insurers do not use premiums to pay for administrative costs and profits, instead of medical care. In this way, affordable and adequate health insurance that protects individuals and their families during both normal medical events and extraordinary medical hardship will be available to all aspiring middle-class and middle-class households.

Finally, the Act contains cost-cutting strategies to reduce the impact of health care costs on the budget deficit and additional measures to reorient health care delivery to quality, preventive care and away from costly and unnecessary overtreatment. Eliminating overpayments to Medicare Advantage, the ill-advised, Bush-era privatization of a chunk of Medicare, and empowering the Secretary of Health and Human Services to negotiate Medicare drug prices are effective ways to cut costs without weakening coverage. The tax surcharge on the wealthiest Americans, who benefited most from the economic growth of the 2000s and who are weathering the current economic downturn best, is a sensible method of increasing access to and the affordability of health insurance coverage in a fiscally responsible manner.

Quotes from Experts

Beyond this Bill

Additional Resources

“Health Reform,” from the Kaiser Family Foundation

“House Health Reform Bill Expands Coverage And Lowers Health Cost Growth, While Reducing Deficits,” from the Center on Budget and Policy Priorities

“Competitive Health Care: A Public Health Insurance Plan That Delivers Market Discipline,” from the Center for American Progress Action Fund

“The Treatment,” A Health Care Reform Blog from The New Republic

American Recovery and Reinvestment Act of 2009 - Conference Report

hmoroz — Tue, 17 Feb 2009 19:06:44 -0500

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Unemployment rate in early 2010, if current laws and policies governing federal spending and taxes do not change, according to the Congressional Budget Office: 9.2%

Reduction in unemployment rate in 2010 if the American Recovery and Reinvestment Act is enacted, according to the Congressional Budget Office, Mark Zandi of Moody’s Economy.com, and White House economic advisers, respectively: 1.9%, 2.1%, 1.8%

Increase in GDP from spending $1 on extended unemployment insurance benefits, in dollars: 1.63

Increase in GDP from spending $1 on accelerated depreciation, which provides businesses a tax break for new investment, in dollars: 0.25

Percentage of spending and tax cuts that will take effect by the end of 2010, according to the Congressional Budget Office: 74%

Percentage reduction in aid to states made by the conference report of the American Recovery and Reinvestment Act compared to the House version: 32%

Overview/Summary

Middle Class Position Analysis

Middle Class Supports.Economic conditions are bleak. The Congressional Budget Office estimates that if the economy continues on its current course, both the length and depth of the current downturn will be the worst since the Great Depression. For middle-class Americans, this means job and wage cuts, loss of health insurance, and, simply, a daily struggle to keep up with everyday costs like mortgage payments and college tuition.

The Congressional Budget Office estimates that if current economic conditions persist the unemployment rate could reach as high as 9.2% by 2010. With 46 million Americans already uninsured, the Kaiser Family Foundation reckons that if unemployment averages just 7% in 2009 (the current rate is 7.2%), the number of uninsured will increase by 2.6 million with an additional 2.4 million individuals enrolled in Medicaid and SCHIP. Indeed, state governments are struggling to provide the increased services needed to keep the swelling ranks of unemployed, uninsured individuals from falling out of the middle class. But the current economic climate has left states with decreased revenue from income, sales, and property taxes: 46 states face budget shortfalls with combined budget gaps of $350 billion through 2011. To confront these gaping budget holes, more than 20 states have implemented or are considering cuts to health insurance programs; the same is true of K-12 and early education programs and of funds for public colleges and universities.

Beyond the decidedly dire short-term outlook, economic improvement is probably quite far off. Douglas Elmendorf, director of the Congressional Budget Office, has testified that “economic recovery is likely to be slow and protracted.” Thus, programs that address longer-term concerns – investment in infrastructure and green technology are two primary examples – are as important as an immediate, stimulative jolt to the economy.

The American Recovery and Reinvestment Act ties together measures designed to assist middle-class households struggling to make ends meet, provisions that will provide an immediate economic stimulus, and investment that can help set the stage for an economy built on energy efficiency and durable infrastructure. Economists generally agree that the legislation will save around 3 or 4 million jobs by 2010, while increasing economic output. Indeed, the Congressional Budget Office, Mark Zandi of Moody’s Economy.com, and White House economic advisers all project that the legislation will reduce the unemployment rate by around 2%. Extended unemployment insurance will allow 6.7 million people to collect benefits. Importantly, aid to state governments for Medicaid and education programs would shore up budget gaps and help prevent cuts to vital services.

While assisting those most at need during the economic downturn, extended unemployment insurance and state fiscal assistance also generate the most “bang for their buck” in terms of stimulus because they funnel money into the hands of the people most likely to spend it. Extended unemployment insurance generates an estimated $1.63 in economic activity for each dollar spent; aid to state governments generates $1.38. In contrast, though they act more quickly than spending measures, tax cuts generate less stimulus. The Making Work Pay, Child, and Earned Income tax credits will help keep more than 2.3 million Americans out of poverty and the American Opportunity credit will make 3.8 million more students eligible for a higher education tax break. These are important measures that will assist aspiring middle-class and middle-class Americans struggling to make ends meet. But the expansions are temporary and tax cuts, even when refundable and directed at the low-income individuals most likely to spend them, are less effective stimulus measures. Worst of all, though, are tax cuts for businesses like accelerated depreciation and carryback loss provisions that have little economic benefit.

Despite concern that the spending included in the American Recovery and Reinvestment Act will be delayed, perhaps a valid concern due to the legislation’s size and complexity, the Congressional Budget Office estimates that 74% of spending would occur between 2009 and 2010. Indeed, funds for investment in infrastructure and energy efficiency, though perhaps more complicated to spend, are a critical step in longer term economic recovery. Beyond its stimulative value – infrastructure spending’s “bang for the buck” is $1.59 – the United States desperately needs new infrastructure to compete in the global economy. The American Society of Civil Engineers estimates that $2.2 trillion in infrastructure spending is now necessary. The funding for infrastructure projects included in the legislation is a first step in addressing this deficiency and funds devoted to high-speed rail are particularly welcome. Similarly, spending on a modernized electricity grid, retrofitted low-income housing, and weatherized homes creates the framework for a future economy less reliant on fossil fuels and, indeed, based on green technology.

Limitations on executive compensation and bonuses are a first step in establishing the accountability that has been missing from the financial bailout. Still, the bill does not set forth a comprehensive plan to address the foreclosure crisis that includes a moratorium on foreclosures, a mechanism to require modification of mortgages, and a change to the bankruptcy code to permit modification of mortgages on primary residences. Funds for the Neighborhood Stabilization Program are a necessary, but insufficient, step in mitigating the widespread negative effects that foreclosures can have on entire neighborhoods and communities.

Quotes from Experts

Beyond this Bill

Additional Resources

Recovery.gov, the official website of the American Recovery and Reinvestment Act

“Recession and Recovery,” from the Center on Budget and Policy Priorities

“Impact of Economic Turmoil on Health Coverage and State Medicaid Programs,” from the Kaiser Commission on Medicaid and the Uninsured

American Recovery and Reinvestment Act of 2009 - House Version

hmoroz — Thu, 29 Jan 2009 11:59:07 -0500

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Unemployment rate in early 2010, if current laws and policies governing federal spending and taxes do not change, according to the Congressional Budget Office: 9.2%

Number of individuals that expanded health insurance benefits included in the legislation will keep from losing health insurance: 8.5 million

Increase in GDP from spending $1 on extended unemployment insurance benefits, in dollars: 1.63

Increase in GDP from spending $1 on accelerated depreciation, which provides businesses a tax break for new investment, in dollars: 0.25

Number of dollars spent on highways for every four dollars spent on transit: 10

Overview/Summary

Middle Class Position Analysis

Middle Class Supports. Economic conditions are bleak. The Congressional Budget Office estimates that if the economy continues on its current course, both the length and depth of the current downturn will be the worst since the Great Depression. For middle-class Americans, this means job and wage cuts, loss of health insurance, and, simply, a daily struggle to keep up with everyday costs like mortgage payments and college tuition.

The Congressional Budget Office estimates that if current economic conditions persist the unemployment rate could reach as high as 9.2% by 2010. With 46 million Americans already uninsured, the Kaiser Family Foundation reckons that if unemployment averages just 7% in 2009 (the current rate is 7.2%), the number of uninsured will increase by 2.6 million with an additional 2.4 million individuals enrolled in Medicaid and SCHIP. Indeed, state governments are struggling to provide the increased services needed to keep the swelling ranks of unemployed, uninsured individuals from falling out of the middle class. But the current economic climate has left states with decreased revenue from income, sales, and property taxes: 45 states face budget shortfalls with combined budget gaps of $350 billion through 2011. To confront these gaping budget holes, more than 20 states have implemented or are considering cuts to health insurance programs; the same is true of K-12 and early education programs and of funds for public colleges and universities.

The American Recovery and Reinvestment Act ties together measures designed to assist middle-class households struggling to make ends meet, provisions that will provide an immediate economic stimulus, and investment that can help set the stage for an economy built on energy efficiency and durable infrastructure. Economists generally agree that the legislation will save around 3 or 4 million jobs by 2010, while increasing economic output. Indeed, the Congressional Budget Office, Mark Zandi of Moody’s Economy.com, and White House economic advisers all project that the legislation will reduce the unemployment rate by around 2%. Extended unemployment insurance will allow 6.7 million people to collect benefits. Expanded COBRA and Medicaid insurance programs will keep 8.5 million individuals from losing insurance. Importantly, aid to state governments for Medicaid and education programs would shore up budget gaps and help prevent cuts to vital services.

While assisting those most at need during the economic downturn, extended unemployment insurance and state fiscal assistance also generate the most “bang for their buck" in terms of stimulus because they funnel money into the hands of the people most likely to spend it. Extended unemployment insurance generates an estimated $1.63 in economic activity for each dollar spent; aid to state governments generates $1.38. In contrast, though they act more quickly than spending measures, tax cuts generate less stimulus. The Making Work Pay, Child, and Earned Income tax credits will help keep more than 2.5 million Americans out of poverty and the American Opportunity credit will make 3.8 million more students eligible for a higher education tax break. These are important measures that will assist aspiring middle-class and middle-class Americans struggling to make ends meet. But the expansions are temporary and tax cuts, even when refundable and directed at the low-income individuals most likely to spend them, are less effective stimulus measures. Worst of all, though, are tax cuts for businesses like accelerated depreciation and carryback loss provisions that have little economic benefit.

Despite concern that the spending included in the American Recovery and Reinvestment Act will be delayed, perhaps a valid concern due to the legislation’s size and complexity, the Congressional Budget Office estimates that 85% of the spending will occur between 2009 and 2011. Indeed, funds for investment in infrastructure and energy efficiency, though perhaps more complicated to spend, are a critical step in longer term economic recovery. Beyond its stimulative value – infrastructure spending’s “bang for the buck” is $1.59 – the United States desperately needs new infrastructure to compete in the global economy. The American Society of Civil Engineers estimates that $2.2 trillion in infrastructure spending is now necessary. The $160 billion for infrastructure projects included in the legislation is a first step in addressing this deficiency. Similarly, spending on a modernized electricity grid, retrofitted low-income housing, and weatherized homes creates the framework for a future economy less reliant on fossil fuels and, indeed, based on green technology.

Quotes from Experts

Beyond this Bill

Additional Resources

“Recession and Recovery,” from the Center on Budget and Policy Priorities

“The State of the Economy and Issues in Developing an Effective Policy Response,” Statement of Douglas W. Elmendorf before the House Committee on the Budget

“Impact of Economic Turmoil on Health Coverage and State Medicaid Programs,” from the Kaiser Commission on Medicaid and the Uninsured

Paul Wellstone Mental Health and Addiction Equity Act of 2008

hmoroz — Fri, 07 Mar 2008 17:07:11 -0500

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Percent of Americans ages 18 and older who suffer from a diagnosable mental disorder in a given year: 26.2

Percentage of people who commit suicide who have a diagnosable mental disorder: 90

Percentage by which the cost-sharing for addiction benefits exceeded that for medical or surgical benefits, according to a 2007 Health Affairs study of employer-provided benefits: 46%

Out-of-pocket savings per user of mental health and substance-abuse services in the best of seven plans studies by the New England Journal of Medicine before and after the implementation of parity in the Federal Employees Health Benefits Program: $87.06

Percentage of insurance plans that contained at least one plan feature that was more restrictive for mental health benefits than for medical and surgical benefits two years after the implementation of the Mental Health Parity Act: 87

Date on which President Bush announced that “health plans should not be allowed to apply unfair treatment limitations or financial requirements on mental health benefits”: April 29, 2002

Approximate success rate for the treatment of depression, according to the National Institute of Mental Health: 80

Overview/Summary

Middle Class Position Analysis

The Middle Class Supports. While the Federal Employees Health Benefits Program has recognized the importance of providing equal coverage for mental health disorders and medical and surgical procedures since 1999, millions of middle-class Americans who are insured by other plans still struggle to afford mental health care services. Although approximately 26.2% of Americans older than 18 suffer from a diagnosable mental disorder and although mental disorders are the leading cause of disability in the United States for individuals ages 15-44, the General Accounting Office found that 87% of health care plans impose more severe restrictions on mental health benefits than they do on medical and surgical benefits. The Mental Health and Addiction Equity Act improves upon the financial parity requirements of the Mental Health Parity Act by preventing group insurers from inhibiting beneficiaries’ access to mental health services by restricting frequency and number of office visits and days of coverage. Such restrictions force individuals seeking mental health care to pay for expensive services out-of-pocket. The legislation not only does much to remedy the discriminatory practices of insurers, but will increase access to mental health care services for middle-class Americans already struggling with high health care costs. The Congressional Budget Office estimates that health insurance premiums will increase by only .4%. The Parity Act also helps to dispel the misguided notion that mental health care is less important than medical and surgical services.

Quotes from Experts

Beyond this Bill

Additional Resources

Testimony of David Wellstone, Co-Founder of Wellstone Action, before the House Committee on Education and Labor

"The Numbers Count: Mental Disorders in America", from the National Institute of Mental Health

Fact Sheet on Mental Health and Substance Abuse Parity from the Federal Employee Health Benefit Program of the U.S. Office of Personnel Management

Medical research

Affordable Health Care for America Act of 2009

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

American Recovery and Reinvestment Act of 2009 - Conference Report

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

American Recovery and Reinvestment Act of 2009 - House Version

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Paul Wellstone Mental Health and Addiction Equity Act of 2008

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources