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New Senate Health Reform Language Benefits Alaska

As historic vote approaches, Begich proposals added to bill

With an agreement in place and the major vote pending on landmark health insurance reform, U.S. Sen. Mark Begich on Dec. 19 said Alaskans and all Americans will benefit greatly from the amended bill unveiled early this morning.

"Alaskans didn't send me to Washington to delay critical reforms or to defend the status quo," Begich said. "Amidst a real snowstorm and a snowstorm of misinformation from insurance and drug companies, the Senate is poised to pass historic health reform that will finally give Alaskans more choices and competition in the insurance marketplace, cut health care costs, reduce the deficit and strengthen Medicare."

The pending Senate bill got a boost today when the non-partisan Congressional Budget Office (CBO) said the measure will extend health coverage to 31 million currently uninsured Americans and reduce the deficit significantly. Because of required savings and cost containment measures that reduce outlays by the federal government, CBO projects the bill will cut the deficit by $132 billion during the first decade after enactment and by $1.3 trillion in the second.

The Senate is in session for the third weekend in a row, and senators are planning to work around the clock in the midst of a major East Coast snowstorm to pass the sweeping reforms. Although Republicans are using every possible procedural tool to delay passage of the bill, the key vote to assure Senate passage is expected Monday at approximately 1 a.m. EST. 

Begich met with other Senate Democrats this morning to review final language to be inserted into the legislation. The so-called "manager's amendment" is posted on Senator Begich's website at: http://begich.senate.gov/public/?a=Files.Serve&File_id=4dfcd384-5ca9-4436-bf6d-4d6c71d6f20f. It will be merged with the overall Senate reform bill, H.R. 3590, which has been available on his website since November.

Key provisions drafted or co-sponsored by Begich focus on increasing the health care workforce; addressing Alaska's Medicare problem; supporting hospitals and expanding health clinics; enhancing coverage options and affordability for small businesses; improving access to care for military veterans and Alaska Natives; and containing costs within the health delivery system. Specifics include:

  • More providers - A Begich amendment will increase loan repayments from $35,000 to $50,000 annually for National Health Service Corps provider across the country. The program serves Health Professional Shortage Areas, including 77 in Alaska. In part because of this and due to other major expansions, the Senate Health, Education, Labor and Pensions Committee is estimating the bill will attract more than 24,000 new primary care providers to the workforce. Another significant change makes medical student loan forgiveness non-taxable.
  • Hospitals - Another Begich amendment reauthorizes a Medicare project supporting hospitals in smaller communities and rural states. This allows facilities in Soldotna, Juneau and Sitka to offer needed services and treat more patients in their own communities. The program will now be available in 20 states and expand nationally from 15 to 30 participating hospitals.
  • Alaska health care task force - A Begich amendment requires federal health care agencies to assess and recommend improvements to health care in Alaska. Lack of primary care and specialists is a problem, especially for members of the military, their dependents and veterans.  A task force will review critical Alaska issues, including problems associated with reimbursement for TRICARE and Medicare providers.
  • More physician assistants - Begich inserted language into the bill to allow loan repayments for physician assistant teaching faculty. The provision is expected to open up the bottleneck at medical schools and expand the workforce. Physician assistants are critical in Alaska - last year 375 PAs handled 1.2 million office visits by Alaskans.    
  • Indian Health Service - The bill reauthorizes the Indian Health Care Improvement Act for the first time in 21 years - a major accomplishment pushed for by Begich and eight other senators. It also protects Alaska Natives from penalties for not acquiring insurance and expands coverage to other public programs.
  • Cost containment - Begich joined other freshmen Democrats in developing a widely praised cost containment package. It will cut costs to consumers, increase value and innovation in the health care system and, according to CBO, save hundreds of millions of dollars.

Other major provisions in the final Senate bill supported by Begich:

  • Community health centers - The bill includes significant new funding for federally qualified health centers (FQHCs), which provide primary care in underserved areas. An estimated 80,000 Alaskans already get care at FQHCs. That will increase under the bill.
  • Small business protections - The manager's amendment will expand the existing small business tax credits in the underlying bill and make health insurance more affordable for small businesses and their employees. In Alaska, more than 8,600 small businesses will be eligible for the tax credits. The tax credits will begin a year earlier, in 2010, and available to small businesses with fewer than 25 employees. Small businesses with 50 or fewer workers would be exempt from employer responsibility provisions.
  • Support for seniors - The bill saves more than 10,000 Alaska seniors $500 on prescription drug costs and provides free preventative care. Senate leaders are working with the House and health care providers to fix the problem of low Medicare reimbursements in the coming year.
  • Major insurance reforms - These include:
    • Stronger medical loss ratios. Health insurers will be required to spend more of their premium revenues on clinical services and quality activities, with less going to administrative costs and profits.
    • Accountability for excessive rate increases. A health insurer's participation in the exchanges will depend on its performance.  Insurers that jack up their premiums before the exchanges begin will be excluded - a powerful incentive to keep premiums affordable.
    • Ban on pre-existing condition exclusions. Health insurers will be prohibited from excluding coverage of pre-existing conditions - including immediately for children.

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