United States Senator Patty Murray

How Has Health Care Reform Helped You?

Since its passage on March 23, 2010, health care reform has allowed Washington state families and small business owners the ability to benefit from better access, more choices, and a health care system that no longer works only for those who can afford it.  

Some of these benefits include: 

Expanding coverage options for young adults

Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family’s coverage.

• See Washington state-specific information on coverage for young adults HERE 

Making prescription drugs affordable for seniors

In 2010, Medicare beneficiaries who hit the coverage gap or “donut hole” in the
Medicare prescription drug benefit received a one-time $250 rebate.  In 2011, Medicare beneficiaries began receiving a 50 percent discount on covered brand name drugs and coverage for 7 percent of the cost of generic drugs in the coverage gap.  In 2012, Part D covers 14 percent of the cost of generic drugs in the coverage gap. Coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will be closed. 

• See Washington state-specific information on prescription drug coverage HERE

Covering preventive services with no deductible or co-pay

Insurance companies are now required to provide certain preventive services without requiring a copayment, co-insurance, or deductible to receive recommended preventive health services.

• See Washington state-specific information on preventive services HERE

 Removing lifetime limits on health benefits

The law bans insurance companies from imposing lifetime dollar limits on health
benefits. It also restricts the use of annual limits and bans them completely
in 2014. 

• See Washington state-specific information on insurance coverage limits HERE 

Creating new coverage options for individuals with pre-existing conditions

The law created the Pre-Existing Condition Insurance Plan (PCIP) which provides health coverage for individuals who have been without health coverage for at least six months, have a pre-existing condition or have been denied health coverage because of a health condition.  Moreover, beginning immediately, families seeking insurance for their children gained the right to
have the child’s pre-existing condition covered without any exclusion. In 2014,
this will expand to ensure all individuals will no longer be discriminated against based on a pre-existing condition. 

• See Washington state-specific information on coverage for pre-existing conditions HERE 

Providing better value for yourpremium dollar

Insurance companies must spend generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they do not, they must provide consumers a rebate or reduce premiums. 

• See Washington state-specific information on getting better value for your premiums HERE 

Scrutinizing unreasonable premium increases

Insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. 

• See Washington state-specific information HERE 

Assistance for small business employers

The law provides employers who have small businesses with fewer than 25 employees and provide health insurance to their employees the ability to qualify for a tax credit of up to 35 percent (up to 25 percent for non-profits) to offset the cost of insurance. This credit will increase in 2014 to 50 percent (35 percent for non-profits). 

• See Washington state-specific information on help for small businesses HERE  

Creating Affordable Insurance Exchanges

Beginning in 2014, Health insurance exchanges will be set up in each state to allow individuals and small businesses to compare health plans, get answers to questions, find out if they are eligible for tax credits for private insurance or health programs like the Children’s Health Insurance Program (CHIP), and enroll in a health plan that meets their needs.  

• See Washington state-specific information on the exchanges HERE 

Preventing illness and promoting health

The Prevention and Public Health Fund was created to support effective policies in Washington, its communities, and nationwide so that all Americans can lead longer, more productive lives.

• See Washington state-specific information on prevention and wellness HERE 

Increasing support for community health centers

The law increases funding for community health centers in all 50 states, including the 223 existing community health centers in Washington. 

• See Washington state-specific information on community health centers HERE 

Additional Critical Funding Thanks to Health Care Reform

So far, Washington has received more than $133.7 million from the Affordable Care Act.

• See Washington state-specific information HERE

Get Access to Health Insurance Coverage with No Waiting Period

Are you uninsured?  Do you have a pre-existing condition?        

If your answer is yes to both questions, you may be eligible for the Pre-existing Condition Insurance Plan – a new federal program for children and adults with pre-existing conditions who have been uninsured for at least six months – with no waiting period.

For more information and how to apply, go to the Pre-existing Condition Insurance Plan – Washington website or call toll-free 1-877-505-0514.

Helping Seniors Afford the Prescription Drugs they Need

With this law, seniors have seen substantial relief on the cost of their prescription medications.  Here is some information that Washington state Medicare beneficiaries need to know about how the law will help them.

As stated above, those seniors who fell into the gap in coverage in 2010 received a $250 check this year to help offset the cost.  These checks were mailed out on June 10, 2010.  They were sent by a Medicare contractor in envelopes with the Department of Health and Human Service logo clearly displayed and with the contractor’s Wisconsin address as the return address.  Additionally,in 2011, Medicare beneficiaries began receiving a 50 percent discount on covered brand name drugs and coverage for 7 percent of the cost of generic drugs in the coverage gap.  In 2012, Part D covers 14 percent of the cost of generic drugs in the coverage gap. This coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will be closed.

If you have any questions regarding potential discounts and rebates, you should call Medicare's toll-free number  1-800 MEDICARE (1-800-633-4227).

HealthCare.gov was launched to help individuals have more control over their health care as informed and empowered consumers. It makes comparison shopping easier with a new insurance finder that allows users to answer a few basic questions and receive information about insurance options that could work for them. The site makes a system that thrived on complication and confusion easier to understand.

Links to Full Health Care Reform Law