December 16, 2009
Legislation on health care reform is taking place at a rapid pace and there are discussions about many parts of the bills including those on lifetime caps and annual limits. The Senate is currently in discussion about these two issues and action is needed to inform our Representatives about the importance of eliminating lifetime caps and annual limits to those in the hemophilia community. This is the time to make our voices heard and help to shape the reform.
In the current Senate Health Reform Bill lifetime caps are eliminated in all new plans in the individual, small group and large group markets. But all existing plans and their renewals are grandfathered in and can continue to have lifetime caps indefinitely. Senator Dorgan (D-ND) has just filed an amendment to the Senate health reform bill which would address the problem of grandfathered plans. His amendment (#3218) would phase-out lifetime caps for grandfathered plans, setting a minimum lifetime cap on these plans at $5 million for two years, then $10 million for two years. Lifetime limits would be eliminated altogether in 2014. Please call and write your Senators TODAY. Ask them to contact Senator Dorgan and Majority Leader Reid to offer their support for Senator Dorgan's amendment.
In addition to lifetime caps, there is language in both the House and Senate bills relating to annual limits. In the House bill, annual limits would be eliminated in 2014. As currently drafted, the Senate bill states “(a) IN GENERAL. – A group health plan and a health-insurance issuer offering group or individual health insurance coverage may not establish – (1) lifetime limits on the dollar value of benefits for any participant or beneficiary; or (2) unreasonable annual limits (within the meaning of section 223 of the Internal Revenue Code of 1986) on the dollar value of benefits for any participant or beneficiary.” Please contact your Senators in support of the immediate elimination of annual limits.
Below is a script and contact phone number that can be used. Tell the operator where you live and he or she will connect you with your Senators' offices.
Hi, my name is _________ and I am one of your constituents and I am affected by hemophilia. As someone who is affected by hemophilia we have very high medical costs and limits on insurance coverage force people to make difficult treatment decisions to maximize their coverage. I strongly support the health insurance reforms included in the Senate health reform bill, especially the immediate elimination of lifetime limits for new health insurance plans. However, I am concerned that existing plans are exempt from the requirement to eliminate lifetime limits. I urge you to support Senator Dorgan's amendment #3218 which would address this critical loophole. In addition, I would like to address the provision concerning annual limits. I believe that annual limits should be treated the same way and should also be eliminated immediately. Thank you for your consideration.
Senate phone number: 202-224-3121 (tell them your state and ask to be connected with your Senators).
In addition, there is a letter template that can be emailed. This information is available at the National Hemophilia Foundation web site at: http://gomembers-ecommunicator.com/campaign/EliminateLifetimeCaps
Feel free to modify the phone script or email message to personalize the information.
The text of the current Senate bill can be downloaded (pdf 4.9mb) from the Senate web site. It is quite lengthy but informative. The information specific to lifetime caps and annual limits is addressed on page 16.
We will continue to keep you informed about the health care reform process and if you have any questions, please contact HNC at 800.990.5557 or by email at info@hemophilia-nc.org.
Thank you.
— Susan Cowell
Executive Director
Hemophilia of North Carolina