Kirsten Gillibrand United States Senator for New York

"Ensuring that every American has access to quality, affordable health care coverage is a national priority."  - Kirsten Gillibrand, U.S. Senator

Senator Kirsten Gillibrand believes that the high cost of health care is a serious problem for families and for employers, who struggle with the high cost of providing health insurance for their employees. The problem is getting worse - more than 47 million Americans, including more than 2.5 million New Yorkers, are uninsured and millions of families and businesses are struggling with skyrocketing health care costs. In Congress, she has always fought hard to expand health care access and protect the coverage for those at risk of losing it. In the Senate, she is working with President Obama to reform our health care system and provide affordable, quality care to every single American.

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT

The ­­­Patient Protection and Affordable Care Act will ensure that all Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs.  The Congressional Budget Office (CBO) has determined that the Patient Protection and Affordable Care Act is fully paid for, will provide coverage to more than 94 percent of Americans while staying under the $900 billion limit that President Obama established, bending the health care cost curve, and reducing the deficit over the next ten years and beyond.

Quality, Affordable Health Care for All Americans
The ­­­Patient Protection and Affordable Care Act includes immediate changes to the way health insurance companies do business to protect consumers from discriminatory practices and provide Americans with better preventive coverage and the information they need to make informed decisions about their health insurance.

Uninsured Americans with a pre-existing condition will have access to an immediate insurance program to help them avoid medical bankruptcy and retirees will have greater certainty due to reinsurance provisions to help maintain coverage.

New health insurance Exchanges will make coverage affordable and accessible for individuals and small businesses.  Premium tax credits and cost-sharing assistance will help those who need assistance.

Insurance companies will be barred from discriminating based on pre-existing conditions, health status, and gender.

Cuts the Deficit and Provides Access to Affordable Care
The Patient Protection and Affordable Care Act delivers reform to the American people in a balanced, fiscally responsible way.

• Cuts the deficit by $130 billion over the first 10 years and by as much as $650 billion in the next decade
• Extends guaranteed coverage to more than 94% of Americans - including a 31 million person reduction in the uninsured
• Achieves almost a trillion dollars in cost savings

Cracks Down On Insurance Industry Abuses
The bill finally puts an end to insurance industry abuses that have denied coverage to hard working Americans when they get sick and need it the most.

• Ends discrimination for pre-existing conditions
• Ends discrimination based on gender and limits variation based on age
• Provides protection from exorbitant out-of-pocket costs
• Restricts arbitrary limits on the amount of coverage you can receive
• Makes it illegal for insurance companies to drop your coverage if you get sick

Creates Choice and Competition and Gives Americans More Control
The bill levels the playing field for consumers through Health Insurance Exchanges and a strong public option.  We are giving Americans more control over their health care choices, keeping insurers honest and driving down rising costs from private insurers. 

• Allows Americans to shop for the best health care plans to meet their needs in a market place (Exchange) and health insurance companies will have to compete for your business
• States would be able to determine whether the public option should compete in their Exchange and will have the ability to opt-out

Protects Seniors
The Patient Protection and Affordable Care Act protects seniors' benefits and will make Medicare a stronger, more sustainable program.     

• Helps seniors better afford their medicine by reducing the size of the donut hole
• Ends insurance industry discrimination based on age
• Cuts waste, fraud and abuse in Medicare
• Ensures Medicare funds go to improving seniors care, not to insurance companies
• Extends the solvency of Medicare

Invests in Small Business
By improving the affordability of health care for employers, this legislation addresses the skyrocketing health care costs which negatively impacts small businesses and our economy

• Provides tax credits to small businesses to make employee coverage more affordable - up to 50 percent of premiums will be available to firms that choose to offer coverage

Protects Current Law on Reproductive Rights
The Senate bill continues existing law, banning the use of federal funding for abortion.  However, unlike the Stupak amendment passed in the House, it does not restrict reproductive coverage in the Exchange. In fact, it ensures that at least one plan in each state exchange contains reproductive coverage.

The Role of Public Programs
The ­­­Patient Protection and Affordable Care Act expands eligibility for Medicaid to include all non-elderly Americans with income below 133 percent of the Federal Poverty Level (FPL), with substantial assistance to States for the cost of covering these individuals.

Improving the Quality and Efficiency of Health Care
Congress is committed to protecting and strengthening the Medicare program for America's seniors. Medicare is a sacred trust with seniors and people with disabilities, and the ­­­Patient Protection and Affordable Care Act will ensure that trust is preserved.  The cost of inaction is unacceptable for seniors and the Medicare program that serves them; without action, the Medicare hospital insurance trust fund is expected to go broke in just over seven years.  The Patient Protection and Affordable Care Act will make Medicare a stronger, more sustainable program.Medicare currently reimburses health care providers on the basis of the volume of care they provide rather than the value of care. For each test, scan or procedure conducted, Medicare provides a separate payment, rewarding those who do more, regardless of whether the test or treatment contributes to helping a patient recover. The ­­­Patient Protection and Affordable Care Act includes a number of proposals to move away from the "a la carte" Medicare fee?for?service system toward paying for quality and value and reducing costs to America's seniors.

Prevention of Chronic Disease and Improving Public Health
The ­­­Patient Protection and Affordable Care Act promotes preventive health care and improves the public health to help Americans live healthy lives and help restrain the growth of health care costs over time.  The ­­­Patient Protection and Affordable Care Act will eliminate co-pays and deductibles for recommended preventive care, provide individuals with the information they need to make healthy decisions, improve education on disease prevention and public health, and invest in a national prevention and public health strategy.

Health Care Workforce
Currently, 65 million Americans live in communities where they cannot easily access a primary care provider, and an additional 16,500 practitioners are required to meet their needs. The ­­­Patient Protection and Affordable Care Act will address shortages in primary care and other areas of practice by making necessary investments in our nation's health care workforce.  Specifically, the ­­­Patient Protection and Affordable Care Act will invest in the National Health Service Corps, scholarship and loan repayment programs to expand the health care workforce.  The bill also includes incentives for primary care practitioners

Transparency and Program Integrity
The ­­­Patient Protection and Affordable Care Act will provide consumers with information about physician ownership of hospitals and medical equipment as well as nursing home ownership and other characteristics.  The bill also includes provisions that will crack down on waste, fraud, and abuse in Medicare, Medicaid, CHIP and private insurance.  Finally, the Patient Protection and Affordable Care Act will establish a private, non-profit entity to identify priorities for and provide for the conduct of comparative outcomes research.

Improving Access to Innovative Medical Therapies
The ­­­Patient Protection and Affordable Care Act will establish a regulatory pathway for FDA approval of biosimilar versions of previously licensed biological products.  The ­­­Patient Protection and Affordable Care Act will also expand the scope of the existing 340B drug discount program, so that patients at children's hospitals, cancer hospitals, rural hospitals and in other underserved communities have access to medicines at lower cost.

Community Living Assistance Services and Supports (CLASS)
The ­­­Patient Protection and Affordable Care Act will make long-term supports and services more affordable for millions of Americans by providing a lifetime cash benefit that will help people with severe disabilities remain in their homes and communities.  CLASS is a voluntary, self-funded, insurance program provided through the workplace. For those whose employers participate, affordable premiums will be paid through payroll deductions. Participation by workers is entirely voluntary.  The Congressional Budget Office confirms that the program, which has been revised from earlier versions, is actuarially sound.

Revenue Provisions
The ­­­Patient Protection and Affordable Care Act is fully paid for and reduces the deficit in the next ten years and beyond.  The revenue provisions in the bill focus on paying for reform within the health care system.  This is accomplished by tightening current health tax incentives, collecting industry fees, and slightly increasing the Medicare Hospital Insurance tax for high income earners.  The bill also includes a fee on insurance companies when they sell high cost health insurance plans.  This fee is designed to generate smarter, more cost-effective health coverage choices.  Additional changes to health care tax incentives include capping FSA contributions, conforming definitions of deductible medical expenses and changing penalties for HSA spending that is not devoted to health care.  The industry fees reflect responsible contributions from industries who have long profited from health care and who will benefit from the expanded coverage of millions of additional Americans under health care reform.  The bill also contains a 0.5% increase in the Medicare Hospital Insurance tax for individuals who earn more than $200,000 and couples who earn over $250,000.  This tax will not only help fund health care reform, but will also extend the solvency of the Medicare Trust Fund.  Together, these revenue provisions represent a balanced, responsible package of proposals that bend the health care cost curve by putting downward pressure on health spending.