Patients Action Network

Growing the problem is not the solution

User — Wed, 19 May 2010 19:56:59 +0000

The six-month Medicare patch Congress passed in June is a very temporary reprieve for seniors and baby boomers who rely on the promise of Medicare. Delaying the problem is not a solution. It doesn’t solve the Medicare mess Congress has created with a long series of short-term Medicare patches over the last decade – including four to avert the 2010 cut alone.

In December, the Medicare physician payment cut will be a whopping 23 percent, increasing to nearly 30 percent in January. Congress is playing a dangerous game of Russian roulette with seniors’ health care. Sick patients can’t wait. Congress must replace the broken payment system before the damage is done and cannot be reversed.

Seniors are already experiencing access problems as a result of the complete congressional mismanagement of Medicare over the years. The baby boomers begin entering Medicare in six months, and if the physician payment problem isn’t fixed, these new Medicare patients won’t be able to find a doctor to treat them.

Failure by Congress and the Obama Administration to properly solve this issue will intensify access problems for seniors and military families enrolled in the TriCare program, and severely undermine implementation of recently enacted health system reform legislation. An existing physician shortage will be magnified and steeper cuts will prevent practice and delivery innovations.

Tell your members of Congress that it is time to end their mismanagement of these important health care programs, and honor their commitment to military families and older Americans. It is long past time for Congress to find a long-term solution to the SGR that does not create an even bigger problem in the future.

About one in four Medicare patients looking for a new primary care physician are having trouble finding one. About one in five physicians are already limiting the number of Medicare patients they treat because of the instability and uncertainty of Medicare payment. Couple these facts with a government-predicted shortage of 85,000 physicians by 2020 and the future for Medicare patients’ access to care is bleak—unless we take steps to turn the tide.

Please contact your members of Congress. Urge them to avert the 23% cut without increasing the cost of a permanent solution, and preserve access to medical services for Medicare patients and military families. Tell them enough is enough! Growing the problem is not the solution!

How health system reform affects patients

User — Wed, 31 Mar 2010 18:23:27 +0000

The Patient Protection and Affordable Care Act (H.R. 3590)—health system reform legislation signed into law by President Obama on March 23—contains a number of key provisions for patients. Some provisions may have an immediate impact, while others will not take effect for some time.

While we have compiled a number of resources about What Could Health System Reform Mean for You?, below is a snapshot of the benefit timeline.

Patient benefits that take effect in 2010

For patients with private health insurance:

Your insurer can no longer drop you from your plan if you get sick.
Children ages 18 and younger can no longer be denied private insurance coverage if they have a pre-existing medical condition.
For adults with pre-existing medical conditions who cannot obtain private insurance coverage, a temporary national “high-risk pool” will be established to provide coverage, with financial subsidies to make premiums more affordable, until all insurers are required to cover people with pre-existing conditions in 2014.
Young adults up to age 26 can remain as a dependent on their parents’ private health insurance plan.
Your health insurance benefits can no longer run out because of a long or expensive illness because insurers can no longer impose lifetime financial limits on benefits.
Preventive services for women, such as mammograms, and immunizations for children must be covered by insurers, with no co-payments or deductibles required.

In addition, Medicare patients who will hit the coverage gap known as the “doughnut hole” this year under the prescription drug benefit will receive a $250 rebate from Medicare.

Patient benefits that take effect during the next four years

In the private health insurance market:

U.S. citizens and legal residents cannot be denied private health insurance coverage for any reason, beginning in 2014. All U.S. citizens and legal residents must obtain health insurance coverage or pay a minor tax penalty (although there are some exemptions). This is to ensure that everyone is in the insurance pool so no one can get a “free ride” by not having affordable coverage and then going to an emergency room for care.
State-based health insurance exchanges will begin operating in 2014, where people who do not have access to employer-based insurance can shop and compare the benefits and costs of private health insurance plans. These exchanges will create insurance pools that will allow people to choose among affordable coverage options. All insurance companies in the exchange must provide at least a minimum benefit package, as well as additional coverage options beyond a basic plan.
Federal subsidies through tax credits or vouchers will be provided in 2014 to people who cannot afford the full cost to help them purchase coverage through the exchanges.
Beginning in 2011, states can require insurance companies to submit justification for premium increases and can impose penalties for excessive increases.

For patients enrolled in Medicare or Medicaid:

You no longer will pay any cost-sharing for a number of preventive services, effective Jan. 1, 2011.
If you are subject to the “doughnut hole” for your Medicare drug coverage, you will receive a 50 percent discount on those prescription drugs beginning Jan. 1, 2011.
A series of pilot programs will be implemented during the next four years to help find new ways to improve quality and lower the cost of the care you receive from your doctors, hospitals and nursing homes in the Medicare and Medicaid programs.
Medicaid coverage will be expanded in 2014 to all eligible children, pregnant women, parents and childless adults under age 65 who have incomes at or below 133 percent of the federal poverty level.

What could health system reform mean for you?

User — Thu, 25 Mar 2010 18:39:00 +0000

Curious as to what the recent health system reform legislation means for you? Check out the following resources:

Frequently asked questions about health system reform legislation - AMA
Consumers’ Big Question: What’s in It for Me? - New York Times
What does the health-care law mean to me? - Washington Post
Health care: What you could see - USA Today
How the health care overhaul could affect you - New York Times
Q+A: How does healthcare overhaul affect Medicare? - Reuters
The immediate effects of the health reform bill - Kaiser Health News
5 key things to remember about health care reform - CNN
True or False: Seven Concerns About The New Health Law - Kaiser Health News
Top 10 facts to know about health care reform - Politifact.com
Health Care Reform Explained - AARP Bulletin
What will health reform mean for you? - White House

Let us know if you come across any good sources of information and we will add it to this list.

House passes health system reform legislation

User — Tue, 23 Mar 2010 02:21:19 +0000

Late Sunday evening (3/21/2010) the U.S. House of Representatives passed H.R. 3590, the Patient Protection and Affordable Care Act, as well as the reconciliation bill, H.R. 4872, the Health Care and Education Affordability Reconciliation Act, which contains additional refinements. Together, the two bills are viewed as the most important health care legislation since the creation of the Medicare program.

H.R. 3590 and the related reconciliation bill provides a historic opportunity to help millions of patients by extending coverage to 32 million Americans, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens and protecting the fundamental principles of the patient-physician relationship. After carefully weighing the benefits and the shortcomings, the AMA announced its qualified support for passage of H.R. 3590 because we believe it will improve the ability of patients and their physicians to achieve better health outcomes.

The health system reform legislation remains an imperfect product. Action to permanently repeal the Medicare sustainable growth rate (SGR) formula was separated from health system reform legislation months ago. The AMA is engaged in active discussions with the Obama Administration as well as House and Senate leaders on bringing SGR legislation for a vote this spring in a separate piece of legislation.

There still is much work to be done and the AMA will be relentless in pursuit of the unfinished business of health system reform and empowering patients and physicians to improve the health of our nation.

Please stay tuned for further developments.

AMA supports passage of health system reform legislation

User — Fri, 19 Mar 2010 18:09:11 +0000

After careful review and consideration, the AMA announced its qualified support (PDF) today of passage of health system reform legislation under consideration in the U.S. House of Representatives. Passage would be another step forward in the journey to provide health care coverage for all Americans.

When H.R. 3590 was being considered in the U.S. Senate, the AMA supported its passage while expressing opposition to certain provisions that we believed could be resolved in the conference committee process. We worked hard and made significant progress toward resolving those issues before the conference negotiations ended. There are still issues in H.R. 3590 that cannot be addressed through the current reconciliation process and will need to be addressed by Congress and the administration.

By extending coverage to the vast majority of the uninsured, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research, the AMA believes that H.R. 3590 does, in fact, improve the ability of patients and their physicians to achieve better health outcomes.

The pending bill is an imperfect product but passage of H.R. 3590 marks an important step toward improving the health of the American people. Our work is far from done and additional congressional action is needed to address outstanding issues. The AMA will be relentless in its pursuit of these important policy adjustments and will work with the administration on the next steps to strengthen our health care system.

The House is expected to vote on the health system reform bill on Sunday, March 21. Stay tuned for further updates on H.R. 3590.

Health System Reform Coming Soon?

User — Mon, 15 Mar 2010 17:39:14 +0000

This afternoon (March 15), the House Budget Committee will begin consideration of a reconciliation bill that will carry refinements to H.R. 3590, the Senate-passed health system reform legislation. The Budget Committee is scheduled to begin meeting at 3:00 pm and plans to stay in session until midnight.

A 2,300 page bill has been posted on the Budget Committee web site. Importantly, this bill is NOT the vehicle that House leaders intend to bring to the floor. The language contained in this “shell” vehicle will ultimately be stripped out and replaced with new legislative language that is not yet available for review. We do not expect the true reconciliation bill language to be released before Tuesday.

Following the Budget Committee’s action, the House Rules Committee will meet later this week and insert the final language into the bill before it is brought to the House floor for a vote. The floor vote is not expected to take place until the end of the week, perhaps on Friday or Saturday.

We will keep you informed as the process unfolds.

Now is the time for health system reform

User — Mon, 16 Nov 2009 10:25:19 +0000

Sometimes the task seems daunting, especially when you know there are 46 million uninsured people in our country, and their ranks are growing every day; that patients and their doctors have to fight with insurers to approve treatment, and then fight again for payment; and that dedicated doctors are driven from the profession by the burdens of bureaucracy, astronomical medical liability premiums and payments that fail to cover practice costs.

But with great challenges come great opportunities. We need reforms that will:

Maintain the relationship between patients and their doctors;
Expand coverage to all Americans through a choice of plans;
Repeal the flawed Medicare physician payment system that harms seniors’ access to care;
Curb insurance industry practices that frustrate patients—and their doctors!

Use our Patients’ Action Hotline at (888) 434-6200 to call Congress. Or Take Action here.

Talk to your doctor about health reform

User — Sun, 15 Nov 2009 22:36:55 +0000

Health system reform is all over the media—from newspapers to TV to YouTube.

What must not get lost in the current debate is that almost everyone agrees reforms are needed. We need to work toward consensus around the considerable common ground that exists and re-commit to resolving the differences.

Join us on Facebook and Twitter

User — Sun, 15 Nov 2009 21:54:18 +0000

This year, comprehensive health system reform is a top priority for Congress and the Obama administration. Help shape health system reform and stay informed on the latest legislation by joining the Patients’ Action Network on Facebook and Twitter. We’re also on some of your other favorite social networking sites; check us out on those by clicking on the buttons below.
By sharing your thoughts, stories, questions and ideas, you can help lead the conversation on health system reform. And by spreading the word to your friends and family, we can convince Congress to pay attention and promote access to quality health care for all Americans.

We want to connect with you. Share what is on your mind. Find out how to get involved. Ask questions and become a part of shaping the health system reform debate.

Stay connected with the Patients’ Action Network:

Spread the Word

User — Sat, 14 Nov 2009 14:49:49 +0000

Encourage your friends and family to join your efforts and join the Patients’ Action Network.