Healthcare

• Removed Bush-era restrictions on embryonic stem cell research (2009)

• Federal support for stem cell and new biomedical research (2009)

• Expanded the SCHIP program to cover health care for 4 million more children and signed Children’s Health Insurance Reauthorization Act (Feb 4, 2009)

• Established an independent commission to make recommendations on slowing the costs of Medicare (2009)

• The First Family initiated several personal projects to promote healthy lifestyles, including planting a garden for the White House’s vegetables and flowers, installing a swing set/playground for the Obama daughters and children of White House employees, and promoting exercise and fitness for children (2009)

• Reversed some of the Bush-era restrictions that prevented Medicare from negotiating with pharmaceutical firms for cheaper drugs, allowing government to again competitively bid (2009) * Note: Obama had promised to lift all restrictions but, while he did negotiate with drug companies for them to lower their costs, the deal only lifted some restrictions

• Expanding government vaccination programs (2009-2011)

• Issued new disease prevention guidelines and priorities for the CDC (2009)

• Authorized the FDA to finally begin regulating tobacco (2009)

• Tasked federal labs to prioritize research on and deployment of H1N1 vaccines (2009)

• Signed Family Smoking Prevention and Tobacco Control Act (June 22, 2009)

• Established a new council on National Prevention, Health Promotion, and Public Health to be chaired by Surgeon General and charged with promoting healthy lifestyles and integrative healthcare (2010)

• Assisted Social Security recipients with claims; signed Social Security Disability Applicants’ Access to Professional Representation Act (Feb 27, 2010)

• Signed Medicare Physician Payment Reform Act (Feb 27, 2010)

• When accusations to the contrary arose, an Executive Order was signed to reaffirm that federal funds are not to be used for abortion services (2010)

• Signed the Prevent All Cigarette Trafficking Act (March 31, 2010)

• Signed the Stem Cell Therapeutic and Research Act (Oct 8, 2010)

• Signed the Healthy, Hunger-Free Kids Act (Dec 13, 2010)

• Signed the Early Hearing Detection and Intervention Act (Dec 22, 2010)

• Extended healthcare and compensation for 9/11 responders (Jan 2, 2011)

• Established National Alzheimer’s Project (Jan 4, 2011)

• Signed a reauthorization of the Combatting Autism Act (Sept 20, 2011)

• Asked multiple congressional committees to bring forward a healthcare reform bill; held dozens of public hearings and town halls on the issue (2009-2010); signed Patient Protection and Affordable Care Act (March 23, 2010); healthcare reform bill is $940 billion over 10 years (2010) * Note: 32 million additional Americans will receive healthcare coverage and costs will be lowered for most Americans, but many of the goals are phased in over four years

Components of the bill:

-          Prevents insurance companies from denying coverage to individuals/family members with pre-existing health conditions; a temporary plan is being developed to cover high-risk individuals with pre-existing conditions until the full reforms go into effect in 2014

-          Prevents insurance companies from placing lifetime limits on benefits

-          Bans “rescission” so insurance companies can’t cancel coverage if individuals keep their policies current or if they become ill

-          An individual’s out-of-pocket healthcare expenses are capped

-          Closes the “donut hole” (Part D) for Medicare prescription drug coverage (under Bush, Medicare helped pay for drugs up to $2,600 and above $4,550, but individuals had to pay 100% of the costs in between these amounts); now Medicare helps cover costs irrespective of the amount – seniors will now pay only 25% of drug costs up to $4,550 and only 5% of drug costs above that amount

-          In 2010, an emergency provision will offer seniors a $250 rebate on the costs incurred within the “donut hole”

-          Individuals living at or below the poverty line were eligible for healthcare under Medicaid, but by 2014 individuals/families living slightly above (making up to $14,404/$29,327) the poverty line will also be eligible for benefits

-          Individuals/families making less than $43,320/$88,200 per year will qualify for government subsidies to help purchase health insurance

-          All individuals must have health insurance or face a government fine; all large (over 50 employees) employers must offer health insurance to employees or pay a fine

-          Small businesses can get a tax credit if they offer health care

-          There are hardship exemptions if individuals can’t afford health insurance

-          Families can keep their children in college on their plans through age 26

-          Promotes health insurance “exchanges” so consumers can buy “wholesale”

-          Creates consumer assistance offices to help consumers file complaints or appeal decisions from insurance companies; beginning in 2011, insurance companies can no longer make excessive rate hikes without justification and approval, and those doing so may be barred from participating in new health insurance exchanges

Funding sources:

-          Large employers (over 50 workers) that don’t offer health benefits will be charged a $2,000/worker fee; if the employer offers coverage but employees instead purchase federally subsidized insurance the fee is $3,000/worker receiving federal subsidies or $750/worker (whichever is lower)

-          Annual fees on pharmaceutical companies ($27 billion), health insurance companies ($60 billion), and medical device-makers ($20 billion)

-          Annual penalties on individuals who do not have health insurance (up to a maximum of $695/person)

-          Increase in the Medicare payroll tax from 1.45% to 2.35% for individuals making $200,000+ and families making $250,000+

-          3.8% tax on unearned income for millionaires

-          Insurance companies will be subject to a tax on each high-end insurance plan (so-called “Cadillac” plans) they offer

Miscellaneous:

-          Illegal immigrants are not eligible for insurance or subsidies

-          By Executive Order, such federal funding can’t be used for abortion

-          The federal government will assist states by covering all of the increased expenses of expanding Medicaid coverage (90% of costs after 2020)