Thank you for contacting me regarding the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. I appreciate hearing your thoughts on this important issue. I apologize for my delayed response.

Since the start of the health reform debate over two years ago, I have carefully examined how this legislation will impact our state. I have listened to the personal stories and concerns of constituents and have been extremely focused on working to ensure that our health care system works for every North Carolina family. In these last two years, I have received hundreds of thousands of letters, emails, and telephone calls from North Carolinians, and I truly appreciated hearing your views on many of the issues discussed.

In March 2010, the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act became law. Currently, there is a lot of discussion about repealing this legislation. Throughout the health reform debate, I consistently heard stories from North Carolinians who were denied health insurance because they had a “preexisting condition,” or had been dropped from their insurance plans once they became sick. Repealing this legislation would only create countless more stories from people denied coverage.  Through its various provisions, health reform will help an estimated 32 million people that previously were without health insurance to secure medical coverage. A 2009 study in the American Journal of Public Health found 45,000 people a year died because they lacked health insurance. Quite simply, I believe North Carolina’s families deserve better than this.

In addition, our current health care spending is simply unsustainable. Each year, costs associated with our current health care system increase. Ten years ago, North Carolinians paid $6,000 in annual family premiums. Today those premiums cost more than $12,000. With these reforms, we will reduce health care costs for families, seniors, and small businesses, not just in the next few years, but also for the long term.

Another important consideration in the discussion of repealing health reform is the cost to our federal deficit. In January 2011, the nonpartisan Congressional Budget Office (CBO) estimated that repealing the health care overhaul would increase the deficit by a total of $230 billion over 10 years. Our country cannot sustain continued deficit spending far into the future and I am working to enact a number of policies that will help address our nation’s deficit and debt.

Although the various provisions in this historic legislation will be implemented over time, many critical protections have already gone into effect in the last year. These provisions have expanded access to high quality, accessible, and affordable health insurance for thousands of North Carolinians. I would like to bring your attention to several of these provisions.

Starting on September 23, 2010, the new law ended some of the worst insurance company abuses and provided important new benefits for you and your family. First, the new law prohibits insurance companies from refusing coverage to or limiting the benefits of children (up to age 19) because of a preexisting medical condition. This prohibition applies to all health plans offered by employers and when an individual purchases a new policy. In 2014, discriminating against all individuals who have a preexisting condition will be prohibited. Second, the law prohibits all insurance plans from putting lifetime caps on the dollar amount that they will spend on benefits. In the past, patients with cancer or other chronic diseases ran the risk of hitting a lifetime cap and losing access to care. The law also restricts most insurance companies’ use of low annual dollar limits on benefits. In 2014, annual limits will be eliminated. Third, the law prohibits all insurance plans from canceling your coverage because of an unintentional mistake on an application.

Also beginning on September 23, 2010, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old. Prior to health reform, insurance plans could remove enrolled children — usually at age 19, sometimes older for full-time students. By allowing children to stay on their parents’ plan, health reform makes it easier and more affordable for young adults to get health insurance coverage. If health reform legislation were repealed, an estimated 37,300 young adults in North Carolina would lose their insurance coverage through their parents’ health plans.

On July 1, 2010, a new Preexisting Condition Insurance Plan program went into effect. This program offers uninsured individuals with preexisting conditions coverage in special state-based “pools” at an affordable rate. Prior to health reform, many people with illnesses or disabilities were unable to obtain private health insurance or the coverage offered to them was so costly that they could not afford it. For more information on this program, visit www.inclusivehealth.org

Over 120,235 North Carolina small businesses are also now eligible for a small business tax credit to make premiums more affordable. This small business tax credit gives small employers the ability to offer insurance to their workers. Tax credits will be provided up to 35% of the employer’s eligible premium expenses for tax years 2010-2013. Beginning in tax year 2014, employers can receive a tax credit for up to 50% of the cost of the premiums.

Effective January 1, 2014, most individuals who can afford it will be required to obtain basic health insurance coverage or pay a penalty. If affordable coverage is not available to an individual, he or she will be eligible for an exemption or will be able to utilize new tax credits to help them afford health insurance. Medicaid will also be extended to Americans with low incomes of up to $14,000 for an individual or $29,000 for a family of four in 2010 dollars. If your employer doesn’t offer insurance, you will be able to buy insurance directly in an Exchange — a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable insurance coverage.

Health reform also made needed improvements that will keep Medicare strong and solvent. Guaranteed Medicare benefits won’t change-whether beneficiaries get them through Original Medicare or a Medicare Advantage plan. Instead, beneficiaries will see new benefits and cost savings, and an increased focus on quality. Most importantly, seniors in North Carolina can more easily afford their medications. Last year, over 97,000 North Carolina seniors who hit the prescription drug “donut hole” received a $250 rebate check. The donut hole will be incrementally closed over the next several years until it is completely closed by 2020. Beginning this year, beneficiaries who reach the coverage gap will receive a 50% discount when buying Part D-covered brand-name prescription drugs. In addition, the 1.5 million Medicare beneficiaries in North Carolina are now eligible for an annual wellness visit with their doctor without cost-sharing or out-of-pocket payments.  This wellness visit includes free preventive care services like colorectal cancer screening and mammograms.

Like you, I am concerned about rising health insurance premiums, which is one of the many reasons I supported health care reform. Health care reform includes new resources and authorities to crack down on unjustified rate hikes. Today, 46 states, including North Carolina, are using resources under the new reform law to pass or strengthen rate review laws, which will help to keep rates low. This year, the law requires insurance companies to publicly justify, on their websites, any unreasonable premium increases.

If health reform is repealed, all of these protections would be taken away from North Carolinians and insurance companies would be put back in control over your health care – discriminating against individuals with preexisting conditions and canceling coverage when people get sick. It would also allow insurance premiums to continue to skyrocket – forcing many families to choose between purchasing food and paying for a place to live or being able to purchase necessary health care. This would be bad for North Carolinians, bad for business, and bad for our economy.

So much information is circulating about health care reform, and sorting through it can be overwhelming and frustrating. I encourage you to visit my website, www.hagan.senate.gov, where I have factual information about what the law does and what it means to you and your family. Other useful information about health care reform can be found at http://www.healthcare.gov. Finally, do not hesitate to call my office if you have a specific question about the health care reform law.