Congressman José E. Serrano

Representing the 15th District of New York

Health Care Reform

For years residents of the Bronx have struggled to get quality, affordable health care. In 2009, Congressman Serrano proudly voted in favor of the Affordable Care Act, which will bring coverage within reach of millions of American families. As the law's reforms have gone into effect, the law's popularity has increased, and yet Congressman Serrano is still helping to defend it against political attacks that would undermine it. 

For years residents of the Bronx have struggled to get quality, affordable health care. In 2009, Congressman Serrano proudly voted in favor of the Affordable Care Act, which will bring coverage within reach of millions of American families. As the law's reforms have gone into effect, the law's popularity has increased, and yet Congressman Serrano is still helping to defend it against political attacks that would undermine it. 

Below you will find some key provisions of the health care reform bill. To learn more, please visit http://www.healthcare.gov/

The Affordable Care Act Key Provisions

IF YOU ARE A SMALL BUSINESSES OWNER:

SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available. Effective beginning for calendar year 2010. (Beginning in 2014, small business tax credits will cover 50 percent of premiums.)

IF YOU ARE A SENIOR:

BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. Beginning in 2011, institutes a 50% discount on brand-name drugs in the donut hole; also completely closes the donut hole by 2020.

FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

HELP FOR EARLY RETIREES—Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment.

IF YOU HAVE PRIVATE HEALTH INSURANCE:

NO DISCRIMINATION AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to adults as well.)

NO RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.

NO LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.

NO RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)

FREE PREVENTIVE CARE UNDER NEW PLANS—Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. Effective 6 months after enactment.

NEW, INDEPENDENT APPEALS PROCESS FOR NEW PLANS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions. Effective 6 months after enactment.

MORE FOR YOUR PREMIUM DOLLAR—Requires plans to put more of your premiums into your care, and less into profits, CEO pay, etc. This medical loss ratio requires plans in the individual and small group market to spend 80 percent of premiums on medical services, and plans in the large group market to spend 85 percent. Insurers that don’t meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

NO DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

IF YOU DON’T HAVE HEALTH INSURANCE:

IMMEDIATE HELP FOR THE UNINSURED WITH PRE-EXISTING CONDITIONS(INTERIM HIGH-RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool – until the Exchanges up and running in 2014. Effective 90 days after enactment. (Beginning in 2014, health plans are banned from discriminating against all people with pre-existing conditions, so high-risk pools would phase out).

EXTENDING COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.

GENERAL REFORMS:

COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly doubling the number of patients served over the next 5 years. Effective beginning in fiscal year 2010.

MORE PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

HEALTH INSURANCE CONSUMER ASSISTANCE—Provides aid to states to establish offices of health insurance consumer assistance to help consumers file complaints and appeals. Effective beginning in FY 2010.

A NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

And in 2014, once the exchanges have formed, more insurance reforms go into effect, including:

NO DISCRIMINATION AGAINST ADULTS WITH PRE-EXISTING CONDITIONS

BAN ON HIGHER PREMIUMS FOR WOMEN

PREMIUMS BASED ON AGE CAN ONLY VARY BY A MAXIMUM OF 3-TO-1 RATIO

CAP ON OUT-OF-POCKET EXPENSES for private health plans

Learn more by visiting http://www.healthcare.gov/

More on Health Care Reform

Sep 11, 2017 The Serrano Report

In Washington, DC


Congressman Serrano Reaffirms His Commitment to Protecting DREAMers 

May 4, 2017 Press Release

Washington, D.C. – Congressman José E. Serrano (D-The Bronx) issued the following statement regarding today’s vote on Congressional Republican’s dangerous American Health Care Act (AHCA) proposal in the U.S. House of Representatives.

“In my 27 years as a member of the House of Representatives, I have never seen such a blatantly shameless attempt to rip away health care coverage for more than 24 million Americans- including hundreds of thousands of my constituents- and inflict devastating harm to our economy. Today’s vote on the AHCA was just that.

Mar 7, 2017 Press Release

Washington, D.C. – Congressman José E. Serrano (D-The Bronx) issued the following statement regarding the release of Congressional Republicans’ plan to repeal and replace the Affordable Care Act (ACA). The “American Health Care Act” will essentially rip coverage from away from over 20 million Americans, including nearly 400,000 individuals in the Bronx.

Apr 8, 2016 Press Release

Lawmakers Have Been Fighting to Address Puerto Rico’s Health Care Crisis, Including the Unfair Medicare Advantage Rates That Include Inadequate Payments to Individuals With Dual Eligibility

After Lawmakers’ Push, CMS is Implementing New Formula That Will Increase Medicare Advantage Payment Rates for Low-Income Beneficiaries & Lead to An Expected Revenue Change of 1.25 Percent

Mar 4, 2016 The Serrano Report

In Washington, DC

Nov 6, 2015 The Serrano Report

In Washington, DC


Congressman Serrano Receives the ‘Champion of Healthcare Innovation’ Award

On Tuesday, Congressman Serrano was presented with the ‘Champion of Healthcare Innovation’ award by the Healthcare Leadership Council (HLC). HLC honored the Congressman at their annual Healthcare Innovation Expo for his work and support of medical advancements that are patient-centered. The expo showcased the latest innovations in medical technology from leading healthcare companies.

Oct 29, 2015 Press Release

Washington, DC – Members of the congressional delegation representing the Bronx, Reps. Charles B. Rangel (NY-13), Joe Crowley (NY-14), Eliot Engel (NY-16), and Jose Serrano (NY-15) congratulated the Bronx for being one of the eight winners of the Robert Wood Johnson Foundation's 2015 RWJF Culture of Health Prize, which is awarded annually to honor outstanding community efforts and partnerships that are helping people live healthier lives.

Oct 22, 2015 Press Release

Washington, DC – U.S. Congressman José E. Serrano today released the following statement on the legislative proposal unveiled last night by the U.S. Treasury Department and the Department of Health and Human Services to help Puerto Rico pay its debt and get on the path of economic recovery:

Sep 30, 2015 Press Release

Washington, DC — Today, Congressman José E. Serrano released the following statement on the passage of the Women’s Public Health and Safety Act (H.R. 3495). Republicans introduced H.R 3495 as a way to keep public health care providers, including Planned Parenthood, from receiving Medicaid funding for reproductive health services. Congressman Serrano voted against the bill, which would prevent millions of women who use Medicaid from accessing critical preventative and primary health care.

Jul 30, 2015 Press Release

WASHINGTON, DC – U.S. Congressman José E. Serrano today celebrated the 50th Anniversary of Medicare & Medicaid, signed into law by Democratic President Johnson on this date in 1965 as part of the Social Security Act.