Health insurance marketplace

“ Over the past year, more than ten million Americans have gained the financial security and peace of mind that comes with health insurance.
More than seven million people enrolled in affordable coverage by visiting HealthCare.gov, or going to the marketplace in their state. On average, they’re paying just $82 a month for coverage. For a lot of people, that’s less than a cell phone bill or a cable bill. Insurance companies can no longer deny you coverage just because you have a preexisting condition, and they now have to cover free preventive care like checkups and mammograms. ”

“ I want a competitive marketplace where health care is accessible, it is affordable, where it is purchased across States lines, where it is personal, where it is portable, and where people have jobs so they can get health insurance. ObamaCare is what is denying health insurance to millions of Americans. ”

“ What that means is, with a few clicks on HealthCare.gov, you’ll find private insurance companies competing for your business. You can compare plans and choose the one that’s right for your family. In fact, most Americans will find an option that costs less than $75 a month. Even if you already have insurance through the Marketplace, check it out. Shopping around can save you a lot of money -- last year, consumers who shopped saved almost $400. ”

“ Lower or eliminate health insurance premiums for millions of lower- and middle-income families enrolled in health insurance marketplaces. A family of four making $90,000 could see their monthly premium come down by $200 per month. ”

“ Congress also determined that the cost of
uncompensated care is passed on from providers “to private insurers, which pass on the
cost to families.” Id. This cost-shifting inflates the premiums that families must pay for
their health insurance “by on average over $1,000 a year.” Id. Rising premiums push
even more individuals out of the health insurance market, further increasing the cost of
health insurance and perpetuating the cycle. See 47 Million and Counting: Why the
Health Care Marketplace Is Broken: Hearing Before the S. Comm. ”

“ So there's plenty of room for bipartisanship on this issue if the Congress would look to find it. Q Ari, are you saying that the insurance companies are now raising prices in anticipation of -- MR. FLEISCHER: No, even without this legislation, there has been an increase in health care premiums. It's been a trend that slowed down, has accelerated in the last several years and is continuing again this year. It's just a reality of the marketplace that health care costs are going up. ”

“ It's perfectly understandable for a corporation to try and make a profit, but when those profits are soaring higher and higher each year while millions lose their coverage and premiums skyrocket, we have a responsibility to ask why.
At a time when businesses are facing increased competition and workers rarely stay with one company throughout their lives, we also have to ask if the employer-based system of health care itself is still the best for providing insurance to all Americans. ”

“ To manage the risks associated with medical care—its high cost, its unpredictability, and its inevitability—most people in the United States obtain health insurance. Many (approximately 170 million in 2009) are insured by private insurance companies. Others, including those over 65 and certain poor and disabled persons, rely on government-funded insurance programs, notably Medicare and Medicaid. Combined, private health insurers and State and Federal Governments finance almost 85% of the medical care administered to U.S. residents. ”

“ Every year, the problem gets worse. Every year, insurance companies deny more people coverage because they’ve got preexisting conditions. Every year, they drop more people’s coverage when they get sick right when they need it most. Every year, they raise premiums higher and higher and higher. ”

“ In other words, because any uninsured person may need medical care at any moment and because health-care companies must account for that risk, every uninsured person impacts the market price of medical care and medical insurance.
The failure of individuals to acquire insurance has other deleterious effects on the health-care market. Because those without insurance generally lack access to preventative care, they do not receive treatment for conditions—like hypertension and diabetes—that can be successfully and affordably treated if diagnosed early on. ”

“ These rising costs are driving up the price of health insurance and making it harder for working families to afford coverage. These rising costs also make it harder for small businesses to offer health coverage to their employees. We must address these rising costs so that more Americans can afford basic private health insurance. ”

“ Within the first year of signing health care reform, thousands of uninsured Americans with preexisting conditions would suddenly be able to purchase health insurance for the very first time in their lives, or the first time in a long time. ”

“ And it's not just the drug industry that's manipulating the market. In the last ten years, there have been over four hundred health insurance mergers. Right here in Iowa, just three companies control more than three-quarters of the health insurance market. These changes were supposed to increase efficiency in the industry. ”

“ Congress has imposed an extensive set of regulations on the health insurance industry, and compliance with those regulations will likely cost the industry a great deal. If the industry does not respond by increasing premiums, it is not likely to survive. And if the industry does increase premiums, then there is a serious risk that its products—insurance plans—will become economically undesirable for many and prohibitively expensive for the rest. ”

“ But the problem that plagues the health care system is not just a problem of the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. ”

“ In the past decade, premiums have doubled. Over the past few years, total out of pocket costs for people with insurance rose by a third. And we know that if we do not reform the system, this will only be a preview of coming attractions. A new report for the Business Roundtable – a non-partisan group that represents the CEOs of major companies – found that without significant reform, health care costs for these employers and their employees will well more than double again over the next decade. The cost per person for health insurance will rise by almost $18,000. ”

“ Many of them may decide that purchasing health insurance is not an economically sound decision—especially since the guaranteed-issue provision will enable them to purchase it at the same cost in later years and even if they have developed a pre-existing condition. But without the contribution of above-risk premiums from the young and healthy, the community-rating provision will not enable insurers to take on high-risk individuals without a massive increase in premiums. ”

“ They are getting billions of dollars a year from the government, from taxpayers, when they’re making a big profit. I'd rather see that money going to people who need it. (Applause.)
We’ll set a new fee on insurance companies that stand to gain as millions of Americans are able to buy insurance. They’re going to have 30 million new customers; there’s nothing wrong with them paying a little bit of the freight. And we’ll make sure that the wealthiest Americans pay their fair share of Medicare, just like everybody else does. ”

“ The Act considered as a whole makes clear that Congress was
concerned that individuals maintain minimum coverage not as an end in itself, but
because of the economic implications on the broader health care market. Virtually
everyone participates in the market for health care delivery, and they finance these
services by either purchasing an insurance policy or by self-insuring. ”

“ Right now, two out of every ten patients account for more than eighty percent of all health care costs. These are patients with serious illnesses like cancer or heart disease who require the most expensive surgeries and treatments. Insurance companies end up spending a lion's share of their expenses on these patients, and not surprisingly, they pass those expenses on to the rest of us in the form of higher premiums. ”

“ The Patient Protection and Affordable Care Act adopts a series of interlocking reforms designed to expand coverage in the individual health insurance market. First, the Act bars insurers from taking a person’s health into account when deciding whether to sell health insurance or how much to charge. Second, the Act generally requires each person to maintain insurance coverage or make a payment to the Internal Revenue Service. And third, the Act gives tax credits to certain people to make insurance more affordable. ”

“ In the absence of the requirement, some individuals would make an economic and financial decision to forego health insurance coverage and attempt to self-insure, which increases financial risks to households and medical providers. (B) Health insurance and health care services are a significant part of the national economy. National health spending is projected to increase from $2,500,000,000,000, or 17.6 percent of the economy, in 2009 to $4,700,000,000,000 in 2019. ”

“ By significantly increasing health insurance coverage, the requirement, together with the other provisions of this Act, will minimize this adverse selection and broaden the health insurance risk pool to include healthy individuals, which will lower health insurance premiums. The requirement is essential to creating effective health insurance markets in which improved health insurance products that are guaranteed issue and do not exclude coverage of pre-existing conditions can be sold. ”

“ Then there's the problem of rising costs. We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. ”

“ If you could purchase insurance across State lines, there would be a 50–State market and you could get low-cost, inexpensive catastrophic health insurance. If you think about health insurance right now, it doesn’t work like insurance. ”

“ For the first time in their lives -- or oftentimes, in a very long time -- uninsured individuals and small business owners will have the same kind of choice of private health insurance that members of Congress get for themselves. ”

“ And by reforming the health insurance market, my plan assures that Americans will have access to basic health insurance even if they change jobs or develop serious health problem We must bring costs under control, preserve quality, preserve choice and reduce people's nagging daily worry about health insurance. ”