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Health Insurance Reform:
The Facts, Questions and Answers
For Workers Who Deliver Public Services

March 30, 2010
From the SEIU Public Services Division

    SEIU public service members were a national force driving the passage of the historic health care legislation President Obama signed into law on Tuesday March 23, 2010.
     For more than a decade we marched, we voted, we raised our voices in support of quality, affordable health care for all, and against big insurance companies and special interests.
     Now, thanks to the power of our voices on behalf of working women and men everywhere, it has become a reality. Our nation has taken a major step forward in improving the quality and affordability of health care for all Americans, of all ages, and all incomes—but especially America’s middle class.
     The Patient Protection and Affordable Care Act is an enormous victory for every working family who ever worried about how they were going to pay for their children’s health care, struggled in the face of medical bankruptcy or saw their dreams taken away by skyrocketing health care costs.
     SEIU members should be very proud to share this good news with their family, friends, and neighbors.
The Facts: What Health Insurance Reform Means to America’s Working Families

     
  •      It helps more than 32 million Americans afford health care who cannot afford it today, including 15 million children. 
  •      It provides the largest middle class tax cut for health care in history, reducing premium costs for millions of working families who can’t afford it. 
  •      It holds insurance companies accountable. Gets skyrocketing premium costs under control. Prevents insurance industry abuses and denial of care. 
  •      It will end discrimination against Americans with pre-existing conditions. 
  •      For working women and men who don’t have health insurance through their employer, it will provide a choice of affordable healthcare plans, giving tens of millions of Americans the exact same choices that members of Congress have.
  •      Tax credits are available immediately for small businesses who offer coverage, and small businesses will have more affordable, stable insurance choices.
  •      It strengthens our national economy by reducing the deficit and generating more jobs throughout the healthcare industry, jobs that can’t be shipped overseas. 
  •      It closes the Medicare prescription drug ‘donut hole’ and protects and strengthens Medicare for our seniors and for future generations.

National health insurance reform will bring real protections and key benefits that take effect this year.  *

1.    No lifetime limits and restricted annual limits on coverage
2.    If we get sick, insurance companies can’t drop us
3.    Our children can stay covered under our policy until the  age of 26
4.    Our children can’t be denied care because of a preexisting condition
5.    Our parents will be paying less for their prescriptions
6.    All new plans must cover preventive screenings and immunizations
7.    Tax credits will be available for small businesses who offer coverage

*Collectively bargained plans can wait to comply with these new federal requirements.  They have until the expiration of the collective bargaining agreement or six months from the signing of the law, whichever is later.

The Patient Protection and Affordable Care Act:  Questions and Answers
Q1:    I have great health care coverage that we bargained for and won.  
What does the new law mean for me?
A.    Over the past decade, health care premium hikes have crowded out wage increases for working families. The new law is intended to bring skyrocketing costs under control and stop them from being such a problem.

The new law requires any entity administering health plans to provide certain new benefits and strengthen your rights.  Employers will need to re-negotiate their contract with the insurance provider to ensure your new benefits and rights are reflected. 

Q2:    Will national health reform happen right away?

A.    Improvements to our health care system will happen in stages: there are immediate benefits that take effect this year, including ensuring that children can’t be denied care due to an existing illness, allowing parents to keep their children on their coverage up to age 26 and a $250 rebate for seniors who fall in the Medicare ‘donut hole’.   More improvements will continue to take effect each year, with major expansions of health care to low-income and working families happening in 2014. 

Q3:     I heard this plan will tax my health care benefits.  Is that true?
   
A.    One of the underlying problems the new law tries to address is that health care plans can be high cost simply because of where we live, or our age or our health status.
        Although SEIU opposed an excise tax on high cost health plans ,our strong advocacy postponed its effective date until 2018 and reduced its potential impact.   No worker will pay the tax directly; if owed, the tax will be paid by health insurance companies or health plan sponsors.  The threshold for when the tax is imposed has been raised to$10,200 for individual premiums and $27,500 for family premiums, with even higher thresholds for: retirees, for plans that cover a high percentage of older workers or more women, and for workers in certain high-risk professions.  In addition, dental and vision coverage will not be taxed.  The excise tax was included to put pressure on insurance companies to lower the cost of premiums as well as press employers to negotiate the best possible price.  SEIU will be working with your local to share strategies you can take to your employer.   

Q4:     My son doesn’t have health insurance because he’s young and healthy now, but I worry about him.   Will he need to buy a healthcare plan?

A.     The new law includes many improvements so that every American has access to regular check-ups and preventive care; care that is very important to preventing disease and improving our health at any age. This means that people who can’t afford health care coverage --, including some publicly funded workers such as family child care providers --  will be eligible for tax credits or Medicaid to help pay for their coverage.     If your son is younger than 26, the law gives you the option of insuring him under your health care plan.  By 2014, all Americans who have access to affordable health insurance need to be covered by a plan, or they will pay a small fee when filing their income taxes.

Q5:    How does the new health care law help my state’s economy in 2010?

A.    The new health care law takes on powerful insurance interests on behalf of the health care consumer and drives down costs over time.  Budget challenges in state and local governments are linked to unemployment, the decline of revenue, and increased demand to help communities deliver effective public services.

Our union believes additional fiscal relief to state and local governments is essential to get our economy back on track.  Over the past year, $53.4 billion has been provided to states and an additional $34.3 billion will be distributed in 2010.  Another bill is on its way to President Obama and it will extend Medicaid relief through June 2011, providing states $23 billion additional revenue.

Q6:    My Governor says this law is bad for our state Medicaid program.  Is this true?
A.      We all know Medicaid costs are unsustainable, and more people are seeking Medicaid as they’ve lost jobs.  The extra Medicaid money is helping states through the fiscal crisis.  The new health insurance reform law will cover 100% of states’ costs to cover newly eligible Medicaid beneficiaries starting in the year 2014.

Q7:     If someone in my family loses his or her job, will this help?

A.    Health care reform is critical to turning around our economy, reducing our deficit, and generating more family-sustaining jobs.  While this won’t happen overnight, should someone in your family lose his/her job tomorrow, he/she may be eligible to continue their health care coverage under COBRA.  In addition, under the American Recovery and Reinvestment Act of 2009 (ARRA) that our members supported, he/she may be able to pay a greatly reduced health care premium. 

By 2014, every American will have the security of knowing they can get affordable coverage if they lose their jobs, if their hours are cut, or if they return to school full time.  Going forward, national health reform will mean more affordable, secure health care options for all Americans, whether they work for a large company, a small business, or as an independent contractor.

Q8:    I help my parents with their prescription drug costs each month.  What will this legislation do for us?

A.    It will strengthen and protect Medicare by eliminating fraud and abuse and gradually close the Medicare Part D ‘donut hole’ by lowering the cost of prescription drugs.  Seniors who hit the gap in drug coverage this year will receive a $250 rebate for their prescription costs.  In 2011, the bill provides a 50% discount on brand name prescription drugs.  The ‘donut hole’ is completely closed by 2020.

Q9:     I work part-time and can’t afford health care coverage.  How will this help?

A.    The new law begins to build a system of coverage for people who have part-time positions. By 2014, part-time workers who are not eligible for health insurance at work will be able to get affordable coverage in the new state insurance exchanges or they may be eligible for Medicaid. 

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     With 2.2 million members in Canada, the United States and Puerto Rico, SEIU is the fastest-growing union in the Americas. Focused on uniting workers in health care, public services and property services, SEIU members are winning better wages, health care and more secure jobs for our communities, while uniting their strength with their counterparts around the world to help ensure that workers  —  not just corporations and CEOs  —  benefit from today's global economy.