Title I. Quality, Affordable Health Care for All Americans

This Act puts individuals, families and small business owners in control of their health care. It reduces premium costs for millions of working families and small businesses by providing hundreds of billions of dollars in tax relief – the largest middle class tax cut for health care in history. It also reduces what families will have to pay for health care by capping out-of-pocket expenses and requiring preventive care to be fully covered without any out-of-pocket expense. For Americans with insurance coverage who like what they have, they can keep it. Nothing in this act or anywhere in the bill forces anyone to change the insurance they have, period.

Americans without insurance coverage will be able to choose the insurance coverage that works best for them in a new open, competitive insurance market – the same insurance market that every member of Congress will be required to use for their insurance. The insurance Exchange will pool buying power and give Americans new affordable choices of private insurance plans that have to compete for their business based on cost and quality. Small business owners will not only be able to choose insurance coverage through this exchange, but will receive a new tax credit to help offset the cost of covering their employees.

It keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses. And it bans insurance companies from denying insurance coverage because of a person’s pre-existing medical conditions while giving consumers new power to appeal insurance company decisions that deny doctor ordered treatments covered by insurance.

This year, American families and small business owners will begin to experience the benefits of this common-sense reform:

• New Affordable Choices:
  • Uninsured Americans with pre-existing conditions will finally have the choice of quality, affordable insurance through a new insurance pool;
  • Small business owners will be eligible for billions in tax credits to help offer insurance coverage to employees;
  • New plans will have to offer preventive care and immunizations at no cost;
  • New plans and certain existing plans that offer dependent coverage will have to cover an enrollee’s dependent children until age 26;
  • A re-insurance program for employers that offer health insurance to their early retirees will save as much as $1,200 for every family enrolled.
  • A new website to help consumers compare different insurance coverage options along with state-by-state health care consumer assistance and ombudsman for any of their health insurance questions;
  • A new independent appeals process for new plans so consumers and patients can appeal insurance company decisions.
  • Prohibits new plans and existing group health plans from denying coverage for children because of a pre-existing medical condition;
  • Review of requested insurance premium increases; health insurers with a pattern of excessive rate increases can be blocked from selling through new insurance exchanges;
  • Remove arbitrary lifetime limits on coverage in all plans, and remove restrictive annual limits on benefits in all new plans and existing group health plans so people know that all of the care they need will be paid for;
  • Prevent insurance companies from dropping insurance coverage when a person gets sick and needs it most.

  These common-sense reforms will be implemented step by step so that families and small business owners have the information they need to make the choices that work best for them.