"Our country spends more on health care than any other industrialized nation, yet on average produces worse outcomes in important quality measurements. In addition, far too many Americans go without affordable health coverage. The Patient Protection and Affordable Care Act (ACA) or Obamacare, while not perfect, was passed into law in 2010 and has brought about needed reforms to broken aspects of our health care system by slowing the increase in health care costs, increasing access to care and using private sector innovation and competition to improve quality and value for patients. Some of the reforms that have already taken effect include important consumer protections such as prohibitions on cancelling, or denying, coverage for those with preexisting conditions, an end to lifetime caps on coverage benefits, an end to charging women more for coverage simply because they are women, and other generally increased coverage options. Many of the reforms went into effect at the beginning of 2014. To date, over 7 million Americans have signed up for coverage in the marketplaces.
Since the law was enacted, Medicare beneficiaries in Virginia who hit the "donut hole" have saved over $197 million on covered prescription drugs. Furthermore, 66,000 young adults in Virginia have gained insurance coverage as a result of a provision that allows parents to keep their children under age 26 without job-based coverage on their family coverage. More than 1.5 million Virginians with private health insurance have gained preventive service coverage without cost sharing.
While I do think the law was a good step in the right direction to fixing our health care system, I have always recognized that we would need to revisit this legislation to fix problems as they arose during implementation. I am against repealing the law in its entirety because that would add an estimated $109 billion to the deficit over the next ten years, as well as reinstate unfair insurance practices, while reversing delivery system reforms that are critical to increasing quality and lowering costs. It is critical that we put in place innovative and financially responsible policies to fix what is wrong, improve the things that could be better, and incorporate incentives to make the system more patient-centered.
However, I do believe that it is important to start fixing the law now. In March, I laid out some common-sense legislative fixes that I believe will strengthen the law by improving and modifying a variety of provisions, ensuring that it works better for Virginia families, employers and employees. I joined five of my colleagues in outlining some of these ideas in an op-ed, a copy which is attached for your convenience.
During the 113 th Congress , I cosponsor ed the Consumer Choice Act, which would create a new choice of health plan option for consumers. One that is a lower-cost, higher-deductible option for consumers, while also covering the essential health benefits and consumer protections required of all health plans offered through the ACA. Outside analysis done by Avalere has shown that the addition of such a new metal tier could decrease the premiums in the market by as much as 17%.
I also introduced the Commonsense Competition and Access to Health Insurance Act , which borrows a good concept I hear a lot of my Republican colleagues talk about – working to help create pathways for the selling of insurance across state lines. This legislation would help identify and eliminate any regulatory and administrative barriers and direct state insurance commissioners to work together to design an open, transparent and effective system that allows insurers to offer coverage across state boundaries while maintaining current consumer protections. Lastly, the bill would build on the idea of interstate compacts – or efforts to let states join together to have bigger pooling mechanisms – to allow small businesses to participate in those compacts.
We can also work to provide assistance to the many businesses that are and want to continue doing the right thing – but are overwhelmed by the amount of information they have to share. For months now, I have been urging the Administration to ease the reporting burden on employers and to streamline any reporting with other already-in place systems. Over the last 6 months I sent two letters urging them to streamline the requirements. However, the Administration's final regulations did not provide the necessary streamlining, and instead places an additional burden on employers. That is why I have introduced the Commonsense Re porting Act , which directs the Department of Health & Human Services and the Treasury Department to design a more workable and less burdensome system for employers to report the hours worked by their employees.
I have heard from a number of Virginians who are unhappy that some insurers have decided to alter or discontinue individual policies. In general, health insurance plans are 12-month contracts, and insurers are free to decide whether or not to renew particular plans every year. Under the ACA, there are new requirements for what coverage must be provided and other new rules that insurers must follow. Many insurers have decided to not renew a variety of these previous plans because they did not meet these requirements.
In December 2013, I asked the U.S. Health and Human Services Secretary to further clarify efforts to help those individuals whose previous plans were cancelled, and who were unable to find an affordable option on the exchange. The Administration agreed these individuals should have access to additional options: now, if your plan has been cancelled and you are unable to afford a Marketplace plan to replace it, you will be automatically approved for a hardship exemption which allows you to purchase a lower-cost, "bare bones" catastrophic plan. Additionally, the Department of Health and Human Services has given state insurance commissioners the option to allow consumers to keep their existing plans for two additional years. However, Virginia law had prohibited the Commonwealth's insurance commissioner from allowing this change. That is why I pushed for the General Assembly to pass bipartisan legislation this summer which would have allowed Virginia to join many other states, including North Carolina, in adopting this policy. However, the General Assembly chose not to act on that bill in a timely manner, and only passed the legislation once insurance companies had already offered their plan options for 2015.
Virginia chose to let the federal government run the health care exchange in the Commonwealth, rather than establishing a Virginia-specific exchange. As of today, nine different insurers are offering hundreds of plans to individuals across Virginia. While not all insurers offer products in every region, all Virginia consumers now have a choice of plan options. For the first time, individuals will be able to compare plans and understand what is and is not covered. Furthermore, many Virginians are finding they are eligible for tax credits to reduce the cost of monthly premiums.
In addition to coverage through the exchange, more than 400,000 uninsured Virginians could become eligible for Medicaid under the ACA. Virginians from across the political spectrum support providing expanded coverage because they understand that getting more people into the system will help us lower costs for everyone in the long run. Otherwise, many individuals will continue to access health care through the emergency room, which is the most expensive and inefficient way to access health care and drives up the cost for everyone.
I recognize that health care coverage is an issue that is very personal. Please know that I am committed to fixing the parts of the ACA that need fixing and making sure that we have a health care system that is affordable and fair. Please continue to be in touch with your opinions and concerns. For further information or to sign up for my newsletter please visit my website at ."