Under the Health Security Act, people who get Medicare will
receive all the benefits they do today and see little difference
in how, where or from whom they receive their care. In addition,
there will be an expansion of Medicare benefits to include the
cost of prescription drugs. A new program will also be
established to provide home and community-based long-term care.
The savings from reduced growth in Medicare spending will be
rechanneled into those new benefits.
Americans eligible for Medicare will automatically
qualify for prescription drug coverage when they enroll in the
Part B benefit, which covers physician visits and other
outpatient services. Monthly part B premiums will increase by
about $11 to cover the cost of this new benefit. However,
Medigap policies, the extra coverage many seniors buy to pick up
where Medicare leaves off, should decline by a proportionate
amount since those policies will no longer cover as much, if any,
of the cost of drugs.
With the new prescription drug coverage there is a $250
annual deductible for each person. Individuals on Medicare also
pay 20 percent of the cost of each prescription. The maximum
amount a person can pay however, is $1,000 over the course of a
year. The prescription drug benefit covers drugs and biological
products, including insulin, approved by the Food and Drug
Administration.
Today, all people covered by Medicare pay 25% of the actual
cost of coverage. Under the Health Security Act, higher-income
beneficiaries -- those individuals who earn more than $100,000
per year -- will be asked to pay 75% of the actual cost of
coverage.
As health care reform moves forward, Medicare recipients
will have more options -- with the opportunity to join
fee-for-service or other types of health plans, including health
maintenance organizations and preferred provider networks. As
Americans enrolled in health plans turn sixty-five, they can
choose between remaining in their health plan or getting coverage
through Medicare.
MEDICAID
The Health Security Act will integrate Medicaid
beneficiaries into the new system, relieving pressures on state
budgets and on those who need care but simply cannot afford it.
Under reform, state and federal governments will continue to
pay for people receiving cash assistance. Just as private sector
employers will make payments for their health coverage, state and
federal governments will pay to cover the costs of providing
benefits to cash assistance recipients.
Once the state where a person lives enters the new system,
people who get Medicaid will enroll in health plans like other
Americans, and be able to choose among plans. They will carry
the same Health Security card that other Americans carry,
providing guaranteeing the comprehensive package of benefits.
Medicaid will also offer the services it has now --� such as
transportation, translation and interpretation, and child care
during clinic visits.
People now on Medicaid who do not receive cash assistance
will no longer rely on Medicaid. They will be covered like
everyone else. Families with incomes less than 150 percent of
poverty -- less than $22,200 for a two-parent family -- will be
eligible for discounts on the cost of insurance.
The Health Security Act will enable those people who now
stay on welfare to keep their Medicaid benefits to seek
employment.
THE DEPARTMENT OF DEFENSE
Under the Health Security Act, the Department of Defense
maintains its commitment to military readiness as its first
priority while fulfilling its obligation to provide health care
to military personnel, their dependents and retirees.
The Secretary of Defense will develop a plan for
implementing health reform and may establish military health
plans centered around military hospitals and clinics in the
United States. People who are now eligible for CHAMPUS will have
the added choice of selected civilian health plans.
Military health plans will meet the same requirements and
standards that all health plans meet. They will provide the
comprehensive benefits package, and in addition, any other
services they currently provide.
In areas in which a military health plan is established,
active-duty personnel will automatically enroll. Family members
of active duty personnel and retirees who are under the age of 65
will have the opportunity to choose a military health plan or a
civilian plan.
Employers of individuals enrolled in military health
plans will pay the employer share of the premium, as they do in
civilian health plans.
VETERANS HEALTH CARE
Health care reform will honor the nation's commitment to
continue providing comprehensive health care to its veterans.
Reform will give veterans more choices about how and where they
receive care. It will also preserve veterans' benefits and
increase the flexibility of the VA health care system.
Under the Health Security Act, the Department of Veterans
Affairs will either organize its health centers and hospitals
into health plans or allow them to act as health providers and
contract with health plans to deliver services.
Health plans organized within the VA system must meet the
standards for all health plans.
All veterans may choose to join a VA health plan if one
exists in their area. If the health plan can serve only a
limited number of people, veterans with service-connected
disabilities have first priority for enrollment, followed by
low-income veterans.
The Department of Veterans Affairs will continue to provide
services that have become its specialty -- for example, treatment
of spinal cord injuries and post-traumatic stress syndrome, as
well as long-term care for elderly and disabled veterans.
THE FEDERAL EMPLOYEES HEALTH
BENEFITS PROGRAM
The Health Security Act is based on a principle embodied in
today's FEHB program: broad consumer choice of plans. Under the
Health Security Act, federal employees and retirees will join
with other members of the communities where they live and choose
from among the health plans offered by the regional health
alliance.
Federal employees and retirees, like other Americans, will
be guaranteed the security of knowing that if they change jobs,
lose their job or move, they will still be covered. The benefits
package provided in the Health Security Act is based on today's
best plans, including several of the type now offered through
FEHBP.
Under reform, government contributions will increase for
federal workers to 80 percent of the average premium, up from the
maximum of 75 percent today.
For current federal retirees, including those eligible for
Medicare, the Office of Personnel Management (OPM) will
administer a Medigap option to continue the additional protection
they currently receive.
INDIAN HEALTH SERVICE
Under the Health Security Act, the Indian Health Service
will operate outside the regional alliance system; tribal
governments will exercise their full autonomy to devise health
care delivery that works for them.
When health reform is implemented, American Indians and
Alaskan Natives will have the option to choose whether they want
to receive care through the Indian Health Service or through a
health plan in a regional alliance.
The Indian Health Service will expand public health and
prevention activities, and for the first time may provide some
service to non-Indian residents living near reservations. During
a five--year period, the Indian Health Service will renovate and
expand its clinics to provide all of the services guaranteed in
the comprehensive benefits package.
