Menendez To Vote In Favor Of Health Insurance Reform Bill In Finance Committee

Menendez To Vote In Favor Of Health Insurance Reform Bill In Finance Committee

NJ Senator says moving the process forward is important, but also important to continue pursuing improvements on affordability, inclusion of public option. Menendez successfully includes slew of amendments to help expand access, lower costs, protect consumers.

Washington - U.S. Senator Robert Menendez (D-NJ) today will vote in favor of the Finance Committee's health insurance reform bill. Menendez says that he still has concerns about the Finance bill on the affordability of insurance for those in the new insurance exchange and on the lack of a public insurance plan option, and he believes those need to be addressed when the bill is before the full Senate. However, he also said that enough improvements were made during the committee markup to warrant moving the process forward in order to ultimately craft and enact effective landmark health insurance reform.

During the committee markup, Menendez was able to successfully include a number of his amendments to the legislation, including stronger consumer protections, guaranteeing coverage for behavioral health treatments and a tax credit for start-up biotechnology firms on the cusp of medical innovation. He will work to protect those provisions throughout the remainder of the legislative process.

"Getting this legislation through the rigors of the Finance Committee is a watershed moment in the effort to reform the health insurance system, which has long been too expensive and too inaccessible for too many families," said Menendez. "This committee is a high hurdle to clear, but it is also vital to clear this hurdle so that, in the end, we can deliver the type of real reform that is badly needed.

"My vote comes with the understanding that I fully expect improvements to be made to the bill as currently constituted before it becomes a final product in the full Senate. Certainly, some upgrades were made in the Finance Committee, which is a testament to Chairman Baucus, but they are not yet enough. There are remaining questions as to whether health coverage in the new insurance exchange will be affordable for all and there is a gaping hole that should be filled by a public option, among other issues. Through the remainder of the legislative process, we have to continue to improve the bill so that quality health insurance is affordable and accessible for everyone.

"I am proud to have included a number of my amendments in the legislation, which will help lower health insurance costs, protect consumers and expand access to health coverage. My amendment to guarantee the coverage of behavioral health treatments will help bring economic security and peace of mind to many families dealing with autism or other behavioral health conditions. My amendment to provide a tax credit to small biotechnology firms can help spark medical innovation that improves the health of our families, lowers the costs of health care and creates jobs. And my amendments to protect consumers will help make things even between families and their insurance companies."

"At this stage, to vote against the bill before us is to do nothing. It would be a vote to stay the course and let insurance companies continue to treat the health of the American people as an investment, minimizing risk and maximizing profitability. To vote yes is to do what's right. That being said, more work will need to be done to pass what I consider to be comprehensive health care reform that is consumer-friendly, affordable, and provides a real choice for every American."

Video of Menendez's closing remarks in Finance Committee:


• Require insurance plans to provide behavioral health treatments. Plans in the exchange must cover behavioral health treatments as part of the minimum benefits standard. For example, applied behavior analysis is a behavioral health treatment for people with autism. Unless behavioral health treatment is explicitly spelled out as a covered benefit, people with autism are not likely to receive comprehensive healthcare.

• Tax credit for biotechnology. Creates a credit that would encourage investments in new therapies to prevent, diagnose, and treat acute and chronic disease, lower health care costs.

• Excluding middle-class families, seniors from excise tax on high-value insurance plans (joined Sen. Kerry on amendment). Successfully fought to raise tax thresholds for retirees and high-risk workers so that their additional health needs could be recognized. Successfully fought to raise the indexing of the high premium excise tax threshold to save millions of family policies from being hit.

• Require private insurers to fully reimburse Federally-Qualified Health Centers in the exchange (offered amendment with Sen. Lincoln). This amendment would ensure that FQHCs, which are a primary health care option for millions, would not lose revenue when treating newly insured patients gaining coverage through the new health insurance exchanges.

• Out-of-pocket cost limit for families between 300-400 percent of the federal poverty level. For those between 300-400 percent of FPL, within the same actuarial value, the benefit will include an out-of-pocket limit equal to two-thirds of the Health Savings Account (HSA) current law limit.

• Women's Medical Home (included in bill prior to markup). Legislation creates an Innovation Center within CMS to test and evaluate different structures to increase patient care and lower cost. The center is required to test a number of different models, including a "medical home that addresses women's unique health care needs."

• Child-only insurance option and subsidies in the exchange. Ensures that minor children qualify as exchange eligible individuals and would also provide for the availability of child-only health insurance coverage in the exchanges.

• Consumer protection for emergency services. Requires that each health care plan and insurance issuer offering coverage in the exchange must provide enrolled individuals coverage for emergency services without regard to prior authorization.

• Internal and external claims appeal process for insurance plans. Requires that each health care plan and health care insurance issuer offering coverage in the exchange must provide an internal claims appeal process and each state must provide an external review process for plans in the individual and small group markets.

• Ombudsman assistance with internal appeals. Allows policyholders to access the ombudsman created in the legislation for help with internal appeals.

• Ombudsman assistance with tax credit appeals. Allow policyholders to access the ombudsman for assistance in resolving problems with their premium and cost-sharing credits, and with assistance in filing appeals as needed.

• Support, education, and research for postpartum depression. Provides support services to women suffering from postpartum depression and psychosis and helps educate mothers and their families about these conditions. In addition, supports research into the causes, diagnoses and treatments for postpartum depression and psychosis.

• Rural Floor. The provision in current law acknowledges the costs of hospitals operating in urban states by ensuring that the wage index used in determining Medicare reimbursement in those states not fall below an "imputed rural floor". The provision included in the Finance bill will ensure that the cost of those payments be distributed in a budget-neutral fashion across all hospitals nationwide and not on hospitals within a given state.

• Urban Medicare Hospitals. Some urban hospitals are highly dependent on Medicare payments because they serve high proportions of Medicare patients, but, unlike many otherwise similar hospitals, they do not receive any special add-on payments. This would provide for a study for a special add-on payment to be afforded this select group of hospitals that could be designated as urban Medicare-dependent hospitals.

• Value-Based Purchasing for Hospital Acquired Infections. This measure includes healthcare-associated infections, as measured by the prevention metrics and targets established in the Department of Health and Human Services' HHS Action Plan to Prevent Healthcare-Associated Infections or any successor plan.