Congress Considers Health Care

In July the Senate Health, Education, Labor and Pensions (HELP) Committee marked up The Affordable Health Choices Act, which would give states the ability to create a health exchange system, called a “Gateway,” for the purchase of individual health insurance.

Of great importance to the thalassemia community is the prohibition of insurance companies from denying coverage based on pre-existing conditions, and further, companies would be required to provide guaranteed renewal of coverage. The elimination of lifetime insurance caps was included in the bill as well. If this provision became law, insurance companies would no longer be able to impose a coverage limit over a personís lifetime. Currently, over half of employer-sponsored health plans and seventy percent of private individual insurance plans set aggregate lifetimes caps on covered benefits. The elimination of these caps could be helpful to those with expensive diseases, such as thalassemia, in that the concern about ìrunning outî of insurance would no longer exist.

The Senate Finance Committee continues its work throughout August to write legislation. Reports indicate that about 80% of the bill will be similar to the HELP Committeeís legislation.

The House’s three committees of jurisdiction, Energy & Commerce, Ways & Means, and Education & Labor have each marked up the Houseís version of legislation, HR 3200, Americaís Affordable Health Choices Act. HR 3200 is similar to the HELP bill in that it would prohibit the denial of coverage based on pre-existing conditions, provide guaranteed issue and renewal, and also eliminate lifetime caps. It is different from the HELP bill in that it sets up a national insurance exchange system rather than multiple state-based exchanges. The House will return after Labor Day to continue work on HR 3200, with a full House vote expected at the end of September.

Both of these proposals are great steps forward for the coverage and treatment of those who have thalassemia and their families. Guaranteed availability of insurance and the elimination of lifetime caps will certainly allow for better and more flexible treatment, and the overall goal of bringing down the cost of health care is also imperative to the community.

Along with health reform, Congress will return in September to work on funding the National Institutes of Health. It is equally important that the NIH continue to focus on finding cures and better treatments for thalassemia. The work that Congress takes up in the latter half of this year will have a direct impact on thalassemia patients, whether they are able to pass comprehensive health reform, a scaled back version that may include some of the provisions outlined above, or funding for the NIH.