Jeff Bingaman United States Senator from New Mexico

WASHINGTON – U.S. Senator Jeff Bingaman today voted to bring up key health insurance reform legislation in the Senate for debate and amendment.  Today's vote (60-39) is the first procedural vote in the process to allow the Senate to consider The Patient Protection and Affordable Care Act.

The bill takes several key steps that would both contain skyrocketing health care costs and extend health insurance to the 46 million Americans who currently do not have it.

"New Mexico families are paying increasingly higher insurance premiums, and under the status quo premiums will continue to rise at an unsustainable rate.  At the same time, our state has one of the highest uninsured rates in the country," said Bingaman, who for months has been helping write the health insurance reform proposal.  "It's clear that our health care system is broken, and I am very glad that we are finally focused on fixing it."

Bingaman has said New Mexicans with insurance stand to benefit tremendously from this legislation because it seeks to contain costs.  In 2000, the average New Mexico family spent $6,000 on insurance premiums.  By 2006, that number rose to $11,000, and it is expected to rise to $28,000 by 2016.

The bill also extends coverage to uninsured New Mexicans by creating "exchanges" where insurance can be purchased and by helping defray the cost of premiums.

If the bill, as written, were to be signed into law, within the first year it would do the following:

Provide access to Affordable Coverage for the Uninsured with Pre-existing Conditions

• Will provide $5 billion in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions
• Coverage under this program will continue until new health insurance exchanges are operational
• Will provide $5 billion in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions
• Coverage under this program will continue until new health insurance exchanges are operational

Re-insurance for Retiree Health Benefits Plans

• Will create immediate access to re-insurance for employer health plans providing coverage for early retirees.
• This re-insurance will help protect coverage while reducing premiums for employers and retirees

Closing the Coverage Gap in the Medicare (Part D) Drug Benefit

• Will reduce the size of the Medicare prescription drug coverage gap or "donut hole" by raising the ceiling on the initial coverage period by $500 in 2010.
• Will also guarantee 50 percent price discounts on brand-name drugs and biologics purchased by low and middle-income beneficiaries in the coverage gap.

Small Business Tax Credits

• Will offer tax credits to small businesses of 25 or fewer full time workers to make employee coverage more affordable.
• Tax credits of up to 50 percent of premiums will be available to firms that choose to offer coverage.

Extension of Dependent Coverage for Young Adults

• Will require insurers to allow parents to opt to maintain family coverage for young adults up to 26 years of age.

Free Prevention Benefits

• Will require coverage of prevention and wellness benefits and exempt these benefits from deductibles and other cost-sharing requirements in public and private insurance options.

No Arbitrary Limits on Coverage

• Will prohibit insurers from imposing lifetime limits on benefits and will restrict the use of annual limits.

Protection from Rescissions of Existing Coverage

• Will stop insurers from rescinding insurance when claims are filed, except in cases of fraud or intentional misrepresentation of material fact.

Prohibits Discrimination Based on Salary

• Will Prohibit group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees.

Ensuring Value for Premium Payments

• Establishes standards for insurance overhead to ensure that premiums are spent on health benefits.
• Also, requires public disclosure of overhead and benefit spending and require premium rebates for insurers that exceed established standards for overhead expenses.

Public Access to Comparable Information on Insurance Options

• Enables the creation of a new website to provide information on and facilitate informed consumer choice of insurance options

Health Insurance Consumer Information

• Provides assistance to States in establishing offices of health insurance consumer assistance or health insurance ombudsman programs to assist individuals with the filing of complaints and appeals and enrolling in a health plan.

Clear Summaries, Without the Fine Print

• Requires insurance companies to outline coverage options using a simple and standard format that enables consumers to make an apples-to-apples comparison when they are choosing their health insurance plans.

Appeals Process

• All plans will implement an effective appeals process for appeals of coverage determinations and claims.

Administrative Simplifications

• All health plans will adopt uniform descriptions of plan benefits and appeals procedures and will use uniform forms and claims processes to reduce costs.