Health Care Reform Update: The New Deal, Drug Re-importation and Annual Limits

The deal to expand Medicare in exchange for eliminating the public option from the Patient Protection and Affordable Care Act has been the source of major controversy.  This week, the new Senate “gang of 10” (liberal and moderate Democrats) discussed an alternative solution in place of the public option.  The proposal expands Medicare for uninsured adults age 55-64.  The details are sketchy, however, the proposal has sparked responses from the AARP, doctors, and the drug, insurance and hospital industries.   More details will follow once the Congressional Budget Office has had the opportunity to score (determine the cost) the Medicare buy-in proposal.  To read recent articles about the proposal visit:
Washington Post Article-Medicare Buy-In
USA Today Article-Medicare Buy-In
Politico Article-Medicare Buy-In
Drug re-importation has been another hot button item addressed on the Senate floor this week.  Senator Byron Dorgan plans to offer his legislation, the Pharmaceutical Market Access and Drug Safety Act, as an amendment to the health reform bill. According to a press release from his office, the bill “would allow American consumers to safely import lower-priced, Food and Drug Administration-approved drugs from other countries”.  HFA has received several inquiries concerning the inclusion of biologics in the drug re-importation amendment.  The bill DOES NOT include biological products (plasma-derived and recombinant DNA-derived products).  To read the press release and the amendment, please visit:
Dorgan Press Release
Dorgan Drug Re-importation Amendment (begins half-way through page)
Lastly, HFA is concerned with the impact annual limits in health insurance plans will have on the bleeding disorders community.  Last month the HFA voiced our concern for annual limits in H.R. 3962 through a letter drafted by NORD and the NPAF.  Several groups asked Speaker Pelosi and other leaders in the House of Representatives to amend H.R. 3962 to implement the elimination of annual limits in 2010, similar to the elimination of lifetime limits.
It is time to ask the Senate do the same.  Elimination of ALL annual limits is crucial to the bleeding disorders community.   CBS News recently reported on the impact of annual limits in “Senate Loophole May Let Insurers Cap Care“.  The legislative language included in the Patient Protection and Affordable Care Act (Senate bill) says: 
 SEC. 2711. NO LIFETIME OR ANNUAL LIMITS.
 ”(a) IN GENERAL.-A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish-
”(1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
”(2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue Code of 1986) on the dollar value of benefits for any participant or beneficiary.
SEC. 1251. PRESERVATION OF RIGHT TO MAINTAIN EXISTING COVERAGE.
(a) NO CHANGES TO EXISTING COVERAGE.-
(1) IN GENERAL.-Nothing in this Act (or an amendment made by this Act) shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on the date of enactment of this Act.
(2) CONTINUATION OF COVERAGE.-With respect to a group health plan or health insurance coverage in which an individual was enrolled on the date of enactment of this Act, this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply to such plan or coverage, regardless of whether the individual renews such coverage after such date of enactment.
TAKE ACTION NOW! Call your Senator’s office and discuss the impact annual limits has on a person with a bleeding disorder.  Ask for immediate elimination of ALL annual and lifetime limits!  Please visit HFA’s Legislative Action Center for Senate contact information.