Ten principles of national health care legislation

The key principles of legislation include, among other things:

Keeping what works today, and increasing choice and competition. First, the bill will protect and improve consumers’ choices.

• If an individual likes their current plan, they will be able to keep it.

• For individuals who either aren’t currently covered, or want to enroll in a new health care plan, the proposal will establish a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance option or a plan offered by private insurers.

• This new marketplace will reduce costs, create competition that leads to better care for every American and keep private insurers honest. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind about their health coverage. Second, the legislation will ensure that Americans have portable, secure health care plans — so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the exchange will have a plan that includes standardized, comprehensive and quality health care benefits.

• It will end increases in premiums or denials of care based on preexisting conditions, race or gender, and limited age rating (2:1).

• The proposal will also eliminate copayments for preventive care, cap out-of-pocket expenses and guarantee catastrophic coverage that protects every American from bankruptcy.

Improving quality of care for every American. Third, the legislation will ensure that Americans of all ages, from young children to retirees, have access to greater quality of care by focusing on prevention, wellness and strengthening programs that work.

• The proposal guarantees that every child in America will have health care coverage that includes dental and vision benefits.

• It will provide better preventive and wellness care. Every health care plan offered through the exchange will cover preventive care.

• By growing the health care workforce, the proposal will ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.

• The proposal strengthens Medicare and Medicaid so that seniors, people with disabilities and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. Fourth, the bill will ensure that individuals, employers and the federal government all share responsibility for a quality and affordable health care system.

• Employers who currently offer coverage will be able to continue offering coverage to workers. Employers who don’t currently offer coverage could choose to cover their workers or pay a penalty.

• All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.

• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families, to make premiums affordable and reduce cost sharing.

Protecting consumers and reducing waste, fraud and abuse. Fifth, the legislation will put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud and abuse.

• The proposal provides complete transparency in plans in the health exchange so that consumers have the clear, complete information needed to select the plan that best meets their needs.

• Additionally, it establishes Consumer Advocacy Offices as part of the exchange in order to protect consumers, answer questions and assist with any problems related to their plans.

• The proposal will identify and eliminate waste, fraud and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers and employers will all encounter a streamlined, less confusing, more consumer-friendly system.