The Patient Protection and Affordable Care Act (H.R. 3590) Passes

This is the major health care reform bill, passed by the House on March 21, 2010 by a party-line vote of 219-212 (North Carolina had the highest number of Democrats voting no - Reps. Larry Kissell, Mike McIntyre and Heath Schuler). This bill will expand health care coverage to 31 million currently uninsured Americans through a combination of cost controls, subsidies and mandates. The Democratic Policy Committee has posted a summary and more information about the bill. The Republicans have posted their own summary.

Much of this will be rolled out over time but here are some highlights most relevant to people with disabilities:
• Provide assistance for those who are uninsured because of a pre-existing condition.
• Prohibit pre-existing condition exclusions for children.
• Expand Medicaid: Beginning in 2014, all children, parents and childless adults who are not entitled to Medicare and who have family incomes up to 133% Federal poverty Level will become eligible. The federal government will pay 100% of the cost to cover the newly eligible population initially.
• The Community First Choice option was also included, although the effective date of the option was delayed until October 1, 2011. This establishes an optional Medicaid benefit through which States could offer community-based attendant services and supports to Medicaid beneficiaries with disabilities who would otherwise require the level of care offered in a hospital, nursing facility, or intermediate care facility for the mentally retarded.
• Removes barriers to providing home and community-based services (HCBS) by giving States the option to provide more types of HCBS through a State plan amendment to individuals with higher levels of need, rather than through a waiver, and to extend full Medicaid benefits to individuals receiving HCBS under a State plan amendment.
• Extends the Money Follows the Person Rebalancing Demonstration through September 30, 2016 and changes the eligibility rules for individuals to participate in the demonstration project by requiring that individuals reside in an inpatient facility for not less than 90 consecutive days.
• Establishes a national voluntary insurance program for purchasing community living assistance services and support (CLASS program) by individuals with functional limitations.
• Expresses the Sense of the Senate that during the 111th Congress, Congress should address long-term services and supports in a comprehensive way that guarantees elderly and disabled individuals the care they need, in the community as well as in institutions.