Health Reform Blog

National Prevention, Health Promotion and Public Health Council

The new National Prevention, Health Promotion and Public Health Council, created by the Affordable Care Act, submitted its first status report to Congress today.

Chaired by Surgeon General Regina Benjamin and composed of senior government officials across federal departments and agencies, the Council is charged with elevating and coordinating prevention activities and designing a focused strategy across federal departments to prevent disease and promote the nation’s health. The report submitted today is the Council’s first, and an early step in the Administration’s development of a first-ever National Prevention and Health Promotion strategy. The Strategy’s impact will be significant because it will take a community health approach to prevention and well-being—identifying and prioritizing actions across government and between the public and private sectors. Both the forthcoming Strategy and the ongoing work of the new Council present a historic opportunity to bring prevention and wellness to the forefront of the nation’s efforts to improve the health status of all Americans.

Read the Council's report

Read the Fact Sheet

Important Update For Early Retiree Reinsurance Program Applicants

Updated Materials Posted On-Line To Help Facilitate the Application Process
6/29/10 as of 6:00 PM

There has been a tremendous amount of interest today in submitting an application for the Early Retiree Reinsurance Program, an important new program created by the Affordable Care Act. There have also been some questions.

We wanted to bring your attention to some important new materials that have been posted on-line today to help you submit your applications for the Early Retiree Reinsurance Program.  Based on important feedback from applicants, the U.S. Department of Health and Human Services' Office of Consumer Information and Insurance Oversight this afternoon posted an updated version of Frequently Asked Questions, Application Submission Do’s and Don'ts, and instructions for filling out the application. Applicants are strongly encouraged to review these materials before completing and submitting their Early Retiree Reinsurance Program applications as they provide guidance for how to respond to some of the questions in the application.

In addition - it was brought to our attention that certain applicants were having difficulty with the on-line application that was posted early this morning, June 29, 2010. A revised copy of the application has been posted that accommodates the entering of numeric sequences that start with zeros in fields requiring numbers (e.g., EIN, phone numbers, etc.). If you had problems with the early version of the application, please resubmit using the new updated form. Applicants who had completed and submitted the early version of the application but who did not experience a problem entering zeros, do not need to re-complete their application form.

Last but not least, there has been some confusion about how applications should be submitted. Applications should be submitted through the U.S. Postal Service.

Thank you for patience and interest in this program. Please keep checking http://www.hhs.gov/ociio/regulations for all the latest information on the Early Retiree Reinsurance Program.

Equal Visitation Rights for All Hospital Patients

You never know when you or a loved one might need to be admitted to a hospital for care. In those times of crisis, you should be able to decide who you want to have by your side. Taking another step forward in protecting patients’ rights, a new proposed rule would ensure that patients can choose their visitors during a hospital stay, including a visitor who is a same-sex domestic partner.

On April 15, 2010, the President tasked HHS with developing new standards for hospitals in the Medicare and Medicaid programs that would require them to honor the rights of all patients to choose who may visit them when they’re in the hospital. This week, the Centers for Medicare & Medicaid Services acted on the President’s directive and issued a proposed rule that would require Medicare- and Medicaid-participating hospitals to honor such choices, without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, or disability.

The new proposed rule would require that all patient visitors enjoy equal visitation privileges – moving us further in the direction of equal rights and inclusiveness in our health care system, regardless of personal and family situations.

Congress Takes Action On Short-term Physician Fee Fix; Long-term solution still needed

President Obama released the following statement tonight after Congress took action on a short-term fix to the physician fee payment cut.

“I’m pleased that Congress has acted to ensure the security of our seniors’ health care. A 21-percent pay cut to physicians’ payments would have forced some doctors to step seeing Medicare patients – an outcome we can all agree is unacceptable.

We should also agree, as I’ve said in the past, that kicking these cuts down the road just isn’t an adequate solution to the problem. The current system of recurring cuts and temporary fixes was passed into law more than 10 years ago. It’s untenable.

I believe we need to permanently reform the Medicare formula in a way that attacks our fiscal problems without punishing our hard-working doctors or endangering the benefits on which so many of our seniors rely. I look forward to working with Congress to achieve that goal, and I’m gratified that in the meantime they’ve taken the provisional step of blocking this pay cut.”

Read the President's statement here.

Protecting Patients with Private Insurance

During the health reform debate, we heard story after story of Americans let down by the private health insurance system.  Parents in Texas unable to buy coverage for their infant born with a heart defect.  A Los Angeles woman forced to stop chemotherapy for months while fighting her insurer’s claim that her cancer was a pre-existing condition.  Patients whose life-saving treatments and therapies are cut short due to annual or lifetime coverage limits.

A major goal of the Affordable Care Act is to put American consumers back in charge of their coverage and care.  Today, President Obama announced new regulations that will crack down on some of the most egregious practices of the insurance industry to help people with pre-existing conditions gain coverage and keep it when they need it, and protect Americans’ choice of doctors.   

The new regulations include a set of protections that apply to health coverage starting on or after September 23, 2010, six months after the enactment of the Affordable Care Act. 

• No Pre-Existing Condition Exclusions for Children Under Age 19.  Each year, thousands of children who were either born with or develop a costly medical condition are denied coverage by insurers.  The new regulations will prohibit insurance plans from limiting benefits for children and from refusing to sell children coverage at all based on the fact that a child has a pre-existing condition.  This policy applies to all types of insurance except for individual market plans that are “grandfathered.”  This critical policy will be broadened to Americans of all ages in 2014.
• No Unjustified Rescissions of Insurance Coverage.  Right now, insurance companies are able to retroactively cancel someone’s policy when they become sick, or if they or their employers made an unintentional mistake on their paperwork.  Under the regulations, insurers will be prohibited from rescinding coverage – for individuals or groups of people – except in cases involving fraud or an intentional misrepresentation of material facts.  There are no exceptions to this policy.
• No Lifetime Limits on Coverage.  Millions of Americans living with costly medical conditions are at risk of having their health insurance coverage disappear when their costs reach a lifetime limit set by their insurance company.  No plan issued or renewed after September 23, 2010 can use such a limit.
• Restricted Annual Limits on Coverage.  Even more binding than lifetime limits are annual dollar limits on what an insurance company will pay for health care.  The rules will phase out the use of annual limits over the next three years for most health plans before banning such limits entirely in 2014. 
• Protecting Your Choice of Doctors.  Being able to choose your own doctor is a central principle in the Affordable Care Act that is highly valued by Americans.  The new rules make clear that health plan members are free to designate any available participating primary care provider as their primary care provider. 
• Removing Insurance Company Barriers to Emergency Department Services.  Some insurers will pay only for health care provided by a limited number or network of providers – including emergency health care.  Others require prior approval before receiving emergency care at hospitals outside of their networks.  The new rules make emergency services more accessible for consumers.  Health insurers will not be able to charge higher cost-sharing (copayments or coinsurance) for emergency services obtained outside the plan’s network. 

Together, these new protections create an important foundation of patients’ rights in the private health insurance market that puts Americans in charge of their own health.  And Americans will have peace of mind, knowing that their health insurance will be there when they need it.

For more information about this rule, read the fact sheet.

Learn What’s Been Accomplished in 90 Days: Secretary Sebelius Answers Your Health Care Questions Live

Today marks the 90 day anniversary of the signing of the Affordable Care Act, the landmark new law that puts consumers, not health insurance companies, in charge of their own health care and HHS Secretary Sebelius will be on hand tomorrow to answer questions from the American people about the new law in a live web chat.

Join in the discussion by:

• Submitting your questions through About.com 
• Watching the event live tomorrow at 3:15 pm on WhiteHouse.com/live

In just three months, significant progress has been made to implement the new law -- insurance companies have stopped rescinding care from patients when they need it most, employers are gaining new resources to help maintain retirees’ health coverage, seniors hitting the “donut hole” are receiving a one-time, tax free $250 check to help subsidize prescription drug costs, small businesses are taking advantage of tax credits that make it more affordable to provide insurance to their employees, and more parents have been able to keep their kids under 26 years of age on their health plans.

To recognize the 90 day anniversary, President Obama will give a speech tomorrow about the important work being done to deliver the benefits and cost savings of the new law to the American people and begin leveling the playing field by making the insurance market more competitive as we move toward 2014 when individuals and small businesses will have access to more affordable choices through state Exchanges – the same choices as members of Congress. He will also meet with insurance company CEO’s -- and some of the nation’s leading State insurance commissioners who are conducting important oversight into premium increases -- to discuss the need to work together to implement the new law and to fairly deliver its immediate benefits to consumers by avoiding unjustified premium increases.

Watch the event live tomorrow at WhiteHouse.com/live.

This blog also appeared at Whitehouse.gov.

Investing in Prevention

Our current health care system leaves many Americans without the preventive care that stops disease and illness before they start. What we need is an approach to health care that keeps people from getting sick in the first place, and that addresses the underlying drivers of chronic disease. 

Under the Affordable Care Act, we are taking the steps to redesigning our health care system to do just that. 

The Affordable Care Act created a new Prevention and Public Health Fund designed to help create the necessary infrastructure to prevent disease, detect it early, and manage conditions before they become severe.  This new initiative will increase the national investment in prevention and public health, improve health, and enhance health care quality.

Secretary Sebelius today announced the allocation of $250 million in Federal fiscal year 2010 for prevention from the new Fund dedicated to four critical priorities:

• Community and Clinical Prevention:  $126 million will support federal, state and community prevention initiatives; the integration of primary care services into publicly-funded community-based behavioral health settings; obesity prevention and fitness; and tobacco cessation.
• Public Health Infrastructure: $70 million will support state, local, and tribal public health infrastructure and build state and local capacity to prevent, detect, and respond to infectious disease outbreaks. 
• Research and Tracking: $31 million for data collection and analysis; to strengthen CDC’s Community Guide by supporting the Task Force on Community Preventive Services; and to improve transparency and public involvement in the Clinical Preventive Services Task Force.
• Public Health Training: $23 million to expand CDC’s public health workforce programs and public health training centers.

Earlier this week, Secretary Sebelius announced the allocation of the first half of the Prevention and Public Health fund to increase the number of clinicians and strengthen the primary care workforce.  Building on the earlier investments made by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act, particularly for the National Health Service Corps, the investments will support the training and development of more than 16,000 new primary care providers over the next five years.

With these investments and others, the Affordable Care Act is continuing the Obama Administration’s historic work to promote wellness and reduce chronic disease.  The new law also calls for a national strategy to improve the nation’s health, eliminates co-pays for key preventive services like cancer screenings, and provides new support for employer wellness programs.

To read more about these exciting investments, check out this fact sheet.

Building a Stronger Health Care Workforce

Primary care providers are the backbone of our health care system – which means that the stronger our health care workforce, the more likely patients can get the care they need when they need it. For too long, communities across the country have suffered from a shortage of primary care providers.  Without action, experts project a continued shortfall due to an aging population and fewer medical students choosing to go into primary care. But that is all about to change.

Thanks to new investments in our healthcare workforce in the Affordable Care Act, cities and towns across the country will see an increase in the number of health care providers.  A greater number of physicians and nurses creates an opportunity for increased access to care that can help Americans prevent disease and illness, making for healthier families and communities. The new investments will go towards training new doctors, nurse practitioners, and physician assistants. Between the Recovery Act and the Affordable Care Act, in the next five years, we’ll begin to see the training and development of more than 16,000 new primary care providers.

We have a unique opportunity to further strengthen our primary care workforce for the future. Among other things, the investments announced will:

Strengthen new nurse-managed clinics to assist in the training of nurse practitioners. This will help provide comprehensive primary care to populations living in underserved communities.

Make health care education more accessible so more physicians, nurse practitioners, and physician assistants will be encouraged to practice primary care.

Support the development of more than 600 new physician assistants, who practice medicine as members of a team with their supervising physician, and can be trained in a shorter period of time compared to physicians

Train an additional 600 nurse practitioners, including providing incentives for part-time students to become full-time and complete their education sooner.

To learn more about expanding our health care workforce, you can watch our latest webchat where HHS Secretary Kathleen Sebelius and I took your questions. Watch the webchat here.

And to read more about this, check out the fact sheet

Bipartisan Advice on Implementing the Affordable Care Act

As a former Governor and Insurance Commissioner, I believe that as part of our efforts to implement the Affordable Care Act, it is critical to reach out and take advantage of expertise outside government to ensure the new law is implemented as quickly and effectively as possible. We know that people had a variety of opinions during the debates on the legislation.  But now the Affordable Care Act is the law of the land and we all have a stake in implementing it.

I’ve been holding a series of outreach meetings, to get input and advice.  Today, I hosted a bipartisan group of leaders, who all have experience implementing or writing major pieces of health care legislation.  This impressive group, which included former HHS Secretaries, a former CMS official, and a former Senate leader, shared the lessons they have learned and gave me some good suggestions.  I plan to check in with them and other leaders throughout the coming months.

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Attending today’s meeting were:

Former HHS Secretary Louis Sullivan, who served under President George H.W. Bush, served as former President of Morehouse, and is a recognized leader on women's health who launched the Healthy People 2000 Initiative at the Department;

• Former HHS Secretary Donna Shalala, the Department's longest-serving HHS Secretary, who currently serves as President of the University of Miami and who helped create and implement the Children's Health Insurance Program;
• Former Senate Majority Leader Bill Frist, who crafted and passed the Medicare Modernization Act;
• Chris Jennings, who served from 1993 to 2001 as President Clinton's Senior Health Care Advisor at the Domestic Policy and National Economic Councils, where he was charged with developing and implementing the Administration’s health care policy;
• Nancy-Ann DeParle, current Director of the White House Office on Health Reform and one of the President' s point people on health reform implementation, who also headed CMS and shepherded the agency through the Balanced Budget Act of 1997.

Today’s meeting builds on our Department’s efforts to gather the best ideas and suggestions on how to implement the Affordable Care Act.  Over the past month, Administration and HHS officials held four briefings with Congressional staff on both sides of the aisle to answer questions and hear about how to better meet the needs of their constituents.  We also hold weekly calls with the staff of Governors, Insurance Commissioners, and other state officials to provide updates on implementation and answer questions. 

In May, I met with insurance executives to ask for their help in ensuring that the new consumer rights and benefits, as well as affordable coverage choices, are delivered as quickly as possible, and called on them to help keep premiums down.

In a few weeks, I will speak to the National Governors Association and will reach out to a bi-partisan group of Governors to hear their thoughts and ideas on the new law and build on our efforts to work together to help more Americans get affordable, quality health insurance.  And in the months ahead, I will continue to reach out across the country as we turn this new law into a reality for American families. 

I also appreciate the chance to answer questions directly from the American people in our webchats.  Today, we talked about how the Affordable Care Act strengthens the doctor-patient relationship, and invests in the training and development of a new generation of health care professionals. We will continue holding these discussions on a regular basis to remain engaged with the American people as implementation moves forward.  These webchats are one of many resources to help Americans understand how to take advantage of the new law to gain greater control over their health care and get access to quality, affordable care.  We encourage you to regularly check www.HealthReform.gov for the latest information.