The Patient Protection and Affordable Care Act was passed into law despite a chorus of misinformation. Today, though, that disinformation is giving way to Americans' real-world experiences of health care reform's effects on their lives. As reform becomes a reality, it will become clear that its effects are more protection and lower costs for consumers, more control for families and small-business owners — not insurance companies — over health care decisions, and less debt for our nation. There is still a great deal of work standing between today and reform's full implementation in 2014, but possibly the biggest challenge is standing strong against political pressure to go back on the bill's deficit-reducing promises.
Americans are already seeing the positive effects of health care reform, with some of its most valuable benefits having taken effect. Insurance companies answered the administration's request and allowed young adults up to age 26 to stay on their parents' plans. They've already stopped dropping coverage or raising rates when policyholders get sick. And 4 million small businesses have already become eligible for tax credits to help them keep their employees covered.
More benefits are kicking in throughout this year. This month, seniors whose prescription drug costs fall into the "doughnut hole" will receive a $250 rebate to help them pay for the prescriptions that they need. States will receive federal assistance to strengthen their oversight over insurance companies' decisions to raise premiums. And next month, those unable to get insurance because of pre-existing conditions will be able to take advantage of temporary high-risk insurance pools that will help them get the care that they need until they're able to buy insurance through the exchange — a competitive marketplace that will be up and running in 2014.
Other benefits are coming in the months to follow. By September of this year, no child in America will be denied coverage because of a pre-existing condition and no insurance company will be able to impose lifetime limits on care. And starting on New Year's Day 2011, Medicare and new private insurance plans will provide free preventive care, including help to stop smoking, mammograms, flu shots and checkups.
All of these steps mean more secure health care for millions of Americans. Those who are uninsured will soon be able to turn to the exchange, where they can compare a wide range of competitive, private-sector plans on costs and benefits, as easily as shopping online. With 94 percent of Americans soon to be covered, taxpayers will no longer have to pay $60 billion to help cover uncompensated care, and the average family will no longer have to pay an annual premium $1,100 higher to subsidize care for the uninsured.
Health care reform will also benefit our country's budget by reining in the exploding health care costs — the highest in the world — that are the biggest cause of our long-term deficit. Reform means different tax treatment for some pricey health care plans, incentives for doctors to cooperate on more efficient care, support for hospitals to more efficiently store health information electronically, streamlined doctors' forms and less waste, fraud and abuse in Medicare. For all of those reasons, according to the nonpartisan Congressional Budget Office, the Affordable Care Act will significantly reduce our deficit over this decade and the next one. And according to leading health care economist David Cutler, the bill's incentives for more efficient, coordinated care will save us an additional $600 billion over the first 10 years and more in the next decade.
Nevertheless, sticking to the bill's deficit-reducing provisions will take Congressional courage. Pressure to water down the bill's deficit-reducing provisions began even before it was passed, when the bill's critics demagogically portrayed its Medicare savings as the end of that vital program. Congress was able to face the pressure when passing health care reform — but serious deficit reduction is always easy to exploit for cheap political gain. And Congress will find it much easier to stick by its deficit-reducing commitment if advocates of fiscal sustainability make a concerted effort to change the political incentives that we face, turning a willingness to make hard choices about our country's fiscal future into a political plus.
When President Barack Obama signed the Affordable Care Act into law, he said, "It's been easy at times to doubt our ability to do such a big thing, such a complicated thing. ... But today, we are affirming that essential truth ... we are a nation that faces its challenges and accepts its responsibilities."
It was true in the struggle to pass health care reform — and it must be true in the struggle to live up to its promise.
Rep. Steny Hoyer (D-Md.) is the House Majority Leader.