Optimus Template

I. New Insurance Company Reforms

• Bars insurance companies from discriminating against individuals based on preexisting conditions

• Immediately bars insurance companies from discriminating against children based on pre-existing conditions

• Prohibits gender rating, and limits age rating.

• Establishes state consumer offices to help with the filing of insurer complaints and appeals.

• Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan.

• Eliminates annual and lifetime limits.

• Allows children to stay on parents coverage until age 26

• Eliminates cost-sharing for recommended preventive care for all plans

II. Expanding Coverage Before 2014

• Creates a new high-risk pool for uninsured Americans with pre-existing conditions that end in 2014.

• Creates a temporary reinsurance program for early retirees (age 55-64) that will help them retain their former employer health coverage by giving incentives to businesses. This program terminates in 2014.

• Creates a voluntary long-term care insurance program that provides a lifetime cash benefit for long-term support services. "CLASS" is a self-funded insurance program provided through the workplace. For those whose employers participate, affordable premiums will be paid through payroll deductions. Participation by workers is entirely voluntary. The Congressional Budget Office confirms that the program, which has been revised from earlier versions, is actuarially sound.

• Invests in Community Health Centers to expand access to health care in low income and low-access communities.

• Allows states to increase Medicaid to 133 percent of the Federal Poverty level at their discretion.

• Maintains current funding levels for the Children's Health Insurance Program (CHIP) through fiscal year 2015.

• Increases payments to primary care doctors in Medicaid, to help ensure they can continue to afford to see Medicaid patients.

III. Expanding Coverage After 20 14-The Insurance Exchange

• An exchange is a competitive marketplace where individuals and small business can buy affordable health care coverage in a manner similar to that of big businesses today. Exchanges provide consumers a one-stop shopping experience that promotes choice and competition.