Jeff Bingaman United States Senator from New Mexico

The Patient Protection and Affordable Care Act includes health insurance market reforms that will benefit New Mexicans immediately, including those who currently have health insurance. The following benefits will be available within the first year after enactment:

• Children with pre-existing conditions will no longer be denied health insurance coverage, and adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary subsidized high-risk pool. Once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.
• Health care plans will allow young people to remain on their parents' insurance policy up until their 26th birthday.
• Insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage. Under health insurance reform, New Mexicans will be ensured access to the care they need.
• Insurers will be prohibited from discriminating based on gender, salary, occupation, or family history.
• Small businesses will receive tax credits of up to 35 percent of premiums to firms that choose to offer health coverage to employees; later, when exchanges are operational, tax credits will be up to 50 percent of premiums. The full credit will be available to firms with 10 or fewer employees with average annual wages of $25,000, while firms with up to 25 or fewer employees and average annual wages of up to $50,000 will also be eligible for the credit.
• The Patient Protection and Affordable Care Act closes the coverage gap in the Medicare (Part D) drug benefit. The new law reduces the size of the “donut hole,” raising the ceiling on the initial coverage period by $500 in 2010. The new law will also guarantee 50 percent price discounts on brand-name drugs and biologics purchased by low and middle-income beneficiaries in the coverage gap, beginning July 1, 2010.
• From now on, patient choice will be protected. Plan members may pick their own participating primary care provider, insurers will be prohibited from requiring prior authorization before a woman sees an ob-gyn, and patients will be ensured access to emergency care.