An Historic Moment

The US House of Representatives made history Sunday evening when it passed historic health reform legislation by a vote of 219-212. That bill, combined with reconciliation legislation that included adjustments recommended by President Obama, would expand health coverage to 32 million uninsured – bringing the total share of legal US residents with health coverage to 94 percent by 2019. President Obama is expected to sign the legislation on Tuesday. Not since Medicare and Medicaid were signed into law by President Lyndon Johnson in 1965 has Congress made such broad and sweeping progress toward the well-being of all Americans.

Enactment of the bill will also have immediate repercussions for state budget discussions. Health reform would generally prevent states from reducing eligibility in publicly supported health coverage programs. That means reductions to Medi-Cal and the Healthy Families Program proposed by Governor Schwarzenegger in January cannot be enacted. The Governor had proposed rolling back eligibility for Medi-Cal and Healthy Families in order to reduce state spending. The proposals would have resulted in an estimated 1.6 million Californians – mostly children – losing access to health care.

In the near-term, passage of the Patient Protection and Affordable Care Act, and the accompanying Health Care and Education Affordability Reconciliation Act of 2010, will end many health insurance industry practices that leave individuals unable to find or afford coverage. Additionally, passage of the two bills means that:

  • Seniors on Medicare will no longer have to make copayments for preventive services effective 2011, and individuals on Medicare who spend more than $2,830 on their prescription drugs in 2010 will receive a $250 rebate;
  • Children may no longer be denied health insurance coverage due to pre-existing conditions, a change that will apply to all individuals in 2014;
  • Adult children may remain on their parents’ coverage until age 26; and
  • Small businesses offering health coverage will receive tax credits equal to 35 percent of premium payments, with credits increasing to 50 percent of premium costs in 2014.

In the longer term, the package will extend health coverage to low-income adults without children. The reform bills will also help working families whose employers do not offer health coverage find affordable, subsidized, and more comprehensive health plans as part of a larger group that is able to negotiate lower rates for better coverage.

The legislation is welcome news – particularly in California – where the number of uninsured has grown by more than 25 percent to 8 million since the national recession began, according to a recent UCLA Center for Health Policy Research report.

— Hanh Kim Quach

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