Washington State Healthcare Reform Petition  


President Obama's Commitment: The Tri-Committee bill fulfills the President's commitment to health care reform via legislation that:

  • Reduces costs;
  • Protects current coverage and preserves choice of doctors, hospitals and health plans; and
  • Ensures affordable, quality health care for all.


Plan Overview:

  • Maintains the ability for people to keep what they have and minimizes disruption;
  • Invests in health care workforce to improve access to primary care;
  • Invests in prevention and public health programs;
  • Creates a new national health Exchange that permits States the option of developing a State or regional
  • exchange in lieu of the national Exchange;
  • Establishes shared responsibility among individuals, employers, and government;
  • Offers sliding scale credits to ensure affordability for low and middle-income individuals and families;
  • Jump starts health care delivery system reforms to reduce costs, maintain fiscal sustainability, and
  • improve quality; and
  • Expands authority to prevent waste, fraud and abuse.


Workforce Investments:

  • Expands the National Health Service Corps;
  • Boosts training of primary care doctors and expands pipeline of individuals going into health
  • professions, including primary care, nursing and public health;
  • Supports workforce diversity efforts; and
  • Expands scholarships and loans for individuals in needed professions and shortage areas.

Prevention and Wellness:

  • Expands Community Health Centers;
  • Waives cost-sharing for preventive services in benefit packages;
  • Creates community-based programs to deliver prevention and wellness services;
  • Targets community-based programs and new data collection efforts to better identify and address racial, ethnic and other health disparities; and
  • Strengthens state, local, tribal and territorial public health departments and programs.

Insurance Market Reforms:

  • Ensures availability of coverage by prohibiting insurers from excluding pre-existing conditions or engaging in other discriminatory practices;
  • Prohibits rating based on gender, health status, or occupation and strictly limits premium variation based on age;
  • Establishes a new Health Insurance Exchange to create a transparent marketplace for individuals and small employers to comparison shop among private insurers and a new public health insurance option; and
  • Introduces administrative simplification and standardization to reduce administrative costs across all plans and providers.

Ensuring Affordability and Access:

  • Includes sliding scale affordability credits in the Exchange to support individuals and families with incomes between Medicaid eligibility levels and 400% of the federal poverty level (FPL); (NOTE: The average cost of family coverage today is 14% of a family's income at 400% of poverty.)
  • Expands Medicaid for the most vulnerable, low-income populations and improves payment rates to enhance access to primary care under Medicaid; and
  • Caps total out-of-pocket spending in all new policies to prevent bankruptcies from medical expenses.

Public Health Insurance Option:

  • Enhances transparency and accountability by creating a new public health insurance option within the Exchange to offer choice and ensure competition;
  • The public health insurance option is self-sustaining and competes on "level field" with private insurers in the Exchange; and
  • When individuals "enter" the Exchange, whether on their own or as employees of a business that is purchasing in the Exchange, they are free to choose among available public and private options.

Benefits:

  • Independent public/private advisory committee recommends benefit packages based on standards set in statute;
  • Guarantees choice and fair, transparent competition by creating various levels of standardized benefits and cost-sharing arrangements, with additional benefits available in higher-cost plans; and
  • Phases-in requirements relating to benefit and quality standards for employer plans.

Shared Responsibility:

  • Once market reforms and affordability credits are in effect to ensure access and affordability, individuals are responsible for having health insurance with an exception in cases of hardship;
  • Employers choose between providing coverage for their workers or contributing funds on behalf of their uncovered workers;
  • Government is responsible for ensuring affordability of insurance through new affordability credits, insurance market and delivery system reforms and oversight of insurance companies; and
    Protects small businesses by exempting small low-wage firms and providing a new small business tax credit for firms providing health coverage.

Reforming the Health Care Delivery System and Ensuring Sustainability:

  • Uses federal health programs (Medicare, Medicaid and the new public health insurance option) to reward high quality, efficient care, and reduce disparities;
  • Adopts innovative payment approaches and promotes better coordinated care in Medicare and the new public option through programs such as accountable care organizations; and
  • Attacks the high rate of cost growth to generate savings for reform and fiscal sustainability, including a program in Medicare to reduce preventable hospital readmissions.

Modernizing, Improving and Preserving Medicare:

  • Replaces the currently flawed Sustainable Growth Rate (SGR) formula that determines physician pay rates in Medicare;
  • Increases reimbursement for primary care providers, improves the Part D program, and implements many other MedPAC recommendations;
  • Extends solvency by eliminating overpayments to Medicare Advantage plans, and refining payment rates for certain services;
  • Creates new consumer protections for Medicare Advantage beneficiaries;
  • Improves low-income subsidy programs to ensure Medicare is truly affordable and accessible for those with lower incomes; and
  • Eliminates cost-sharing for all preventive services.