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Congress is currently working on legislation to reform and improve America's health care system by lowering costs and expanding access to affordable health care.  This page will serve as a resource to constituents of Virginia's 8th Congressional District on this important issue.

Read the bill: HR 3962, America’s Affordable Health Choices Act

Easy-to-read synopsis of the House bill

Health insurance reform and Northern Virginia

Myths vs. Facts in the Health Care Debate

Dear Constituent:
Our country has a health system that is not working for many Americans. Not only do we need to address the millions who do not have access or cannot afford health insurance, we also need to address escalating health costs. When President Clinton initiated his (unsuccessful) health reform efforts in 1993, the average costs for health care for a family of four was $7,000. Today that same family spends $15,000. If we continue to do nothing, that family will be paying $36,000 for health care in ten years. Our economy—and our citizens—cannot sustain these costs.

Many components of our current health care system are not cost effective. To finance the cost of health reform, the Affordable Health Care for America Act (AHCAA), the reform measure being considered in the House of Representatives, proposes new efficiencies in the way Medicare and Medicaid operate. These include eliminating fraud and abuse and reducing overpayments in the Medicare Advantage program that currently subsidize private insurers and do nothing to increase patient care. These efforts will account for about half the cost of reform. Another major funding component will be generated from a surcharge on the highest income bracket.

Employees unable to obtain insurance through their employer can obtain insurance through the proposed Health Insurance Exchange that will be financed in part through a fee on employers who do not offer insurance. Small businesses with operating budgets under $750,000 will not be subject to these fees, but their employees will still be able to access insurance through the Exchange. The Exchange will be a sort of marketplace where those who are unemployed or work for companies too small to offer insurance can compare options and purchase insurance.

When the legislation is enacted and fully implemented, all new insurance offerings will be required to offer minimum coverage, or an “essential benefits package.” Among these basic requirements are: no co-pays for preventative care, an annual out-of-pocket limit, mental health parity, no gender bias and a prescription drug plan.

Another essential benefit and one of the most important features of this reform proposal is the elimination of exclusions for pre-existing medical conditions. Someone who survived cancer early in life should not be forced out of the insurance market for the rest of his/her life. Insurance is about sharing risk. Eliminating these people from the risk pool may be profitable, but it is not morally right. Under this legislation, insurers will not be able to drop coverage if a beneficiary develops a serious illness and the lifetime cap for benefits is eliminated. In fact, there will be no caps on coverage, which is critically important for people with costly chronic diseases such as cancer.

On October 29th, a revised health bill was introduced in the House of Representatives, H.R. 3962. This new draft is a consolidation of the bills approved by the Ways and Means, Energy and Commerce, and Education and Labor Committees in the House and some new key provisions. The AHCAA will reduce the deficit by $30 billion over the first ten years and will continue to reduce the deficit over the second ten years.

Medical malpractice and anti-trust exemptions, which were not included in the original House bill, H.R. 3200, are addressed in H.R. 3962. The new bill would establish a voluntary state incentive grant program to encourage states to implement malpractice insurance reforms. The bill also ends the blanket exemption from anti-trust laws that health insurance providers now enjoy. This provision will help ensure a truly competitive insurance marketplace.

Since the reforms enacted in any legislation will take several years to implement, H.R. 3962 would allow individuals to keep their COBRA coverage until the new health insurance exchange is fully operational. The exchange will enable those unable to obtain health insurance through an employer to purchase a policy at competitive rates with full transparency on policy provisions.

For Medicare beneficiaries, the new draft bill accelerates the closure of the Part D “donut hole” and also directs the Secretary of Health and Human Services to negotiate Medicare drug prices—which is a huge step forward in controlling the costs of prescription drugs.

A public insurance option is included. The public option will be but one choice in the proposed health insurance exchange. Beneficiaries will pay premiums and the system will be self sustaining. The administrator for the public option will be the Department of Health and Human Services, but will otherwise function the same as any private insurance policy. Payments for services through the public option will be negotiated within the individual market—the same as private insurers. The public option will be fair competition with full transparency in the health insurance marketplace.

I am strongly committed to health care reform. I will be working to ensure a fair, robust and responsible bill can be presented to the President in the fall. The cost of doing nothing is simply too high for the American people to carry who today pay more than twice what people everywhere else on earth pay but yet live no longer nor healthier lives.

Sincerely,

James P. Moran

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