Congressman Gregory W. Meeks Announces Benefits of the Affordable Care Act for New York One Year Later

(WASHINGTON, DC)– The 111th Congress passed one of the most critical pieces of Health Care Legislation in the history of this country to ensure that all Americans have access to quality and affordable health care. Below are the benefits of the Affordable Care Act for people across the state of New York one year later.

• Provides New Benefits and Lowering Costs for Medicare Beneficiaries. Nearly all 44 million beneficiaries who have Medicare, including 2.8 million in New York, can now receive free preventive services such as mammograms and colonoscopies – as well as a free annual wellness visit with their doctor. Also, more than 252,288 New York residents who hit the Medicare prescription drug coverage gap known as the “donut hole” received $250 tax-free rebates, and will receive a 50% discount on brand name prescription drugs when they hit the donut hole this year. By 2020, the law will close the donut hole completely. Taken together, the changes in the law will save seniors enrolled in traditional Medicare more than $3,500 over the next 10 years.

• Lowers Taxes for Small Businesses. The law provides $40 billion of tax credits to up to 4 million small businesses, including up to 340,358 in New York to help offset the costs of purchasing coverage for their employees and makes premiums more affordable.

• Provides Greater Resources for New York. The law gives Governors millions of dollars in Federal support for their work to hold down insurance premiums, build competitive insurance marketplaces, provide insurance to early retirees, and strengthen their public health and prevention efforts. So far, New York has received $156 million from the Affordable Care Act. Grants to New York include:

• $1.8 million to support a consumer assistance program
• $1 million to plan for a Health Insurance Exchange
• $27 million to develop an “Early Innovator” Exchange IT model
• $1 million to crack down on unreasonable insurance premium increases
• $30.1 million to support capital development in community health centers
• $34.6 million from the Prevention and Public Health Fund
• $48 million in Therapeutic Discovery Project Program Tax Credits and Grants
• $1.7 million for Medicare improvements for patients and providers
• $6.1 million for demonstration projects to address health professions workforce needs
• $250,000 for Nursing and Home Health Aides Training Programs
• $4.1 million for Maternal, Infant and Childhood Home Visiting

• Providing New Coverage Options for Young Adults. Insurance companies are now required to allow parents to keep their children up to age 26 without job-based coverage on their insurance plans. An estimated 74,600 young adults in New York could gain insurance coverage as a result of the law.

• Covering Children with Pre-Existing Conditions. Most insurance companies are now banned from denying coverage to children because of a pre-existing condition. An estimated 1.1 million kids with a pre-existing condition in New York will be protected because of this provision. In 2014, insurers are banned from discriminating against anyone with a pre-existing condition.

• Removing Lifetime Limits on Health Benefits. The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. The law also restricts the use of annual limits and bans them completely in 2014. This will protect 10.6 million New York residents with private insurance coverage from these limits.

• Making it Illegal for an Insurance Company to Drop Coverage When You Get Sick. The law bans insurance companies from dropping coverage when an individual gets sick because of simple mistake on an application. This will protect 814,000 New York residents who buy coverage on the individual market from losing their coverage when they need it the most.

• Increasing the Value of Health Insurance. Under the law, insurance companies must provide consumers greater value by spending at least 80% of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 10.6 million New York residents with private insurance coverage will receive greater value for their premium dollars.

• Scrutinizing Unreasonable Premium Increases. New rules in the law require insurers to publicly justify unreasonable premium increases, and strengthen States’ abilities to crack down on premium hikes.

• Strengthening Economic Growth in New York. Since the President signed the Affordable Care Act into law last March, the economy has created nearly 1.4 million private sector jobs, and has grown at an average annual rate of 2.7%. Experts predict that the Affordable Care Act will create anywhere from 250,000 – 400,000 jobs each year.

• Lowering Early Retiree Coverage Costs. An estimated 283,000 people from New York retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time. But thanks to the creation of the Early Retiree Reinsurance Program in the Affordable Care Act, 521 employers in New York have been approved to receive support to firms that continue to provide health coverage to their early retirees—lowering their total health care costs. In 2010, employers in New York received $4.8 million in payments.

• Creating New Coverage Options for Individuals with Pre-Existing Conditions. Residents of New York who have been locked out of the coverage system because of a pre-existing condition are now eligible for coverage through a new Pre-Existing Condition Insurance Plan that was created under the law. To learn more about the plan available in New York go here: https://www.pcip.gov/StatePlans.html.

• Increasing Support for Community Health Centers. The Affordable Care Act increases the funding available to the more than 1,100 community health centers in all 50 States, including the 565 existing Community Health Centers in New York in rural communities and inner cities, enabling them to double the number of patients they serve from 19 million to nearly 40 million by 2015. This builds on a $2 billion investment in Community Health Centers in the American Recovery and Reinvestment Act, which has provided an unprecedented opportunity to serve more patients, create new jobs, and meet the significant increase in demand for primary health care services.

• Reducing the Health Care Workforce Shortage. Nearly 11% of New York residents live in an underserved area. The law includes new resources to boost the number of doctors, nurses and health care providers in communities where they are needed most. These resources include grants, scholarships, loan repayment programs, as well as increased support for educational institutions that provide training for a range of health care careers.}