Email from Sen. Bob Casey Jr

Dear Mr. Masters:

Thank you for taking the time to contact me about health care reform. I appreciate hearing from you about this issue.

On March 23, 2010, President Obama signed the landmark Patient Protection and Affordable Care Act into law. This legislation is the result of over a year of work in Congress, and reflects our Nation’s commitment to ensuring health care for all Americans. With the improvements included in the Health Care and Education Reconciliation Act, the Patient Protection and Affordable Care Act will extend health insurance coverage to an additional 32 million Americans, ensuring that 95% of our Nation has access to quality, affordable care.

As I worked with my colleagues to pass health care reform, I saw with increasing clarity that doing nothing was not an option. The path we were on was unsustainable: one study concluded that without changes, 52% of the median income of a family in Pennsylvania would be spent on health insurance by 2016. Families all across Pennsylvania are one illness away from bankruptcy, one layoff away from not being able to get the health care they need.

Health insurance is a shared responsibility, and the Patient Protection and Affordable Care Act will ensure that all Americans have access to affordable health insurance in several ways. Individuals will be responsible for purchasing health insurance, employers will be responsible for providing health insurance, and the federal government will ensure that all Americans can afford health insurance. The Patient Protection and Affordable Care Act includes provisions to help low- and moderate-income individuals and families buy insurance, and it makes it easier for small businesses to provide coverage for their employees.
New, refundable tax credits will be available to help Americans with incomes between 133% and 400% of the federal poverty level (FPL) (about $88,000 for a family of four) to purchase health insurance; illegal immigrants will not be eligible for federal subsidies. All children, parents and childless adults who are not eligible for Medicare and who have family incomes of up to 133% of the federal poverty level will become eligible for Medicaid. Pennsylvania is one of several states currently covering individuals beyond federally mandated levels, and will benefit from increased federal funding. Small businesses (under 25 employees with average annual wages of less than $50,000) that purchase health insurance for their employees will be eligible for a new tax credit which will begin this year.

Individuals purchasing their own health insurance and small businesses with up to 100 employees will have access to the state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges to be established in each state by 2014. These exchanges will include web portals to make it easier for individuals and small businesses to compare and purchase health insurance. These exchanges will pool small businesses and their employees, which will spark competition and give small businesses the kind of purchasing power that big businesses enjoy today. Members of Congress will also enroll in plans offered through the Exchanges.

In addition to increasing access to health insurance, the Patient Protection and Affordable Care Act creates strong consumer protections that will protect Americans from losing their health insurance when they get sick or change jobs, and will prohibit insurance companies from discriminating against individuals based on their medical history or health status, gender, or salary. Dependent children will be able to stay on their parents’ health insurance plans until they reach age 26, providing security to young adults as they finish school and enter the workforce.

The Patient Protection and Affordable Care Act provides new and enhanced benefits to the 2.2 million Pennsylvanians on Medicare. Beneficiaries will now get a free annual wellness visit every year, and will have no out-of-pocket copayments for preventive benefits such as cancer and diabetes screenings. Beneficiaries enrolled in a Medicare Part D prescription drug plan who hit the “donut hole” this year will be given a $250 rebate to help purchase drugs. The bill gradually closes the donut hole over the next decade, ending it completely in 2020. Furthermore, the bill makes important payment and delivery system reforms that prioritize the quality of care a beneficiary receives. It makes investments that will enable beneficiaries to continue to access highquality, affordable care, while encouraging prevention and care coordination for those with chronic conditions. These efforts will help modernize the program and strengthen Medicare’s financial health increasing program solvency by at least nine years, protecting both beneficiaries and taxpayers.
The nonpartisan Congressional Budget Office estimates that the Patient Protection and Affordable Care Act (including the modifications included in the reconciliation bill) will cost $938 billion, and will produce a reduction in the federal deficit of $143 billion over the next ten years. In the second ten years, the deficit reduction is supposed to be even greater, about $1.2 trillion. This legislation is fully paid for with revenue provisions that focus on paying for reform within the health care system, through tightened health tax incentives, industry fees, modest excise taxes and a slight increase in the Medicare Hospital Insurance (HI) tax for high-income individuals. In total, the revenue provisions in the bill represent a balanced, responsible package of proposals that bend the health care cost curve by putting downward pressure on health spending, closing unintended tax loopholes and promoting tax compliance.

To learn more about what the Patient Protection and Affordable Care Act means for Pennsylvania and for you, I encourage you to visit my website, where I have posted additional information about the specific provisions in the bill and how the legislation will be implemented. As with all legislation, there were some important policies that were not included in this bill. I will continue to work on these issues and others in the coming months and years. If you have further questions about how you and your family will be affected by this legislation, please do not hesitate to contact my office; my staff will be happy to assist you.

Again, thank you for sharing your thoughts with me. Please do not hesitate to contact me in the future about this or any other matter of importance to you.

If you have access to the Internet, I encourage you to visit my web site, http://casey.senate.gov. I invite you to use this online office as a comprehensive resource to stay up-to-date on my work in Washington, request assistance from my office or share with me your thoughts on the issues that matter most to you and to Pennsylvania.

Sincerely,
Bob Casey
United States Senator