Health Care Issues
The Affordable Care Act
Congressman Blumenauer was proud to vote for historic health care reform legislation, the Patient Protection and Affordable Care Act. This new law will improve access, quality, and affordability of health care for all Americans, while protecting your right to choose your own doctor and health plan. New data demonstrates the benefits that the law has already provided to seniors, young adults, small businesses, and many others in the Oregon.
As a result of the law:
- Only 7 percent of people in Oregon went uninsured in 2015, new Census data show, down from 17.1 percent in 2010. That dramatic drop means 403,000 more Oregonians had coverage in 2015.
- In 2014, nearly 480,000 people with Medicare in Oregon received free preventive services
- Since the law was enacted in 2010, Oregon residents with Medicare have saved nearly $147,491,460 on prescription drugs.
- Over 54,000 people with Medicare in Oregon received a $935 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2015.
New rights, benefits, and protections under the Affordable Care Act:
Insurers Will No Longer Be Able To:
- Deny coverage to children with pre-existing conditions. Health plans cannot limit or deny benefits or deny coverage for a child younger than age 19 simply because the child has a pre-existing condition like asthma.
- Put lifetime limits on benefits. Health plans can no longer put a lifetime dollar limit on the benefits of people with costly conditions like cancer.
- Cancel your policy without proving fraud. Health plans can’t retroactively cancel insurance coverage – often at the time you need it most - solely because you or your employer made an honest mistake on your insurance application.
- Deny claims without a chance for appeal. In new health plans, you now have the right to demand that your health plan reconsider a decision to deny payment for a test or treatment. This also includes an external appeal to an independent reviewer.
Consumers in New Health Plans Will Also Be Able to:
- Receive cost-free preventive services. New health plans must give you access to many recommended preventive services such as screenings, vaccinations and counseling without any out-of-pocket costs to you.
- Keep young adults on a parent’s plan until age 26. If your health plan covers children, you can add or keep your children, including step children or foster children, on your health insurance policy until they turn 26 years old if they don’t have coverage on the job, even if they are married.
There are several reforms and benefits to Medicare as well to fix reimbursements, reduce fraud, improve preventative services, and close the "donut-hole" in prescription drug coverage for seniors.
Learn more at Healthcare.gov.
End-of-Life Care and Advanced Illness Management:
Congressman Blumenauer has been a tireless champion of empowering patients and providers to better recognize goals, values, and wishes throughout the care continuum. During the Affordable Care Act (ACA) debate, his provision to provide Medicare reimbursement for doctors who discuss end-of-life care treatment preferences with their patients was included in the House version of the bill. Since the ACA, he continued to push for these important conversations to become a Medicare benefit, which was finally recognized in the 2016 Medicare Physician Fee Schedule.
Congressman Blumenauer is also the author of legislation that would strengthen end-of-life care by establishing new models of care that will better manage advanced illness, improve quality of care, and enhance training, resources, and tools for providers, patients, and their families. This legislation is supported by patient advocates, physicians, nurses, and the faith community, who understand how advance care planning fundamentally improves quality of care and quality of life.