The American Heart Association / American Stroke Association supports and advocates for public policies that will help improve the cardiovascular health of all Americans by 20 percent while reducing deaths by coronary heart disease and stroke by 20 percent by 2020.



 The following are the public policy priorities for Delaware in 2011-2012:

• Support Physical Activity and Healthy Eating in the School Environment – The American Heart Association will work with the Secretaries of the Department of Education and of the Department of Health and Social Services, the Director of the Division of Public Health, the Administration, Nemours Health and Prevention Services, and the legislature to advance legislation that will expand opportunities for kids to engage in physical activity throughout the school day and ask schools to report on the physical activity students engage in throughout the school day.
• Support Physical Activity and Healthy Eating in the Community Environment – The American Heart Association will provide continued leadership to the Delaware Healthy Eating and Active Living Coalition (DE HEAL) to incorporate policy, systems, and environmental changes that weave better eating and increased activity into the lives of all Delawareans. This coalition and its numerous participants are working together to change the health care setting, communities, schools, everywhere that people live, play, learn, and work. Specifically, we will seek to advance built environment and transportation priorities that emphasize physical activity and access to healthy foods in communities; including advocacy for bike and walking trails related to a significant Bond Bill appropriation during the last legislative session. The coalition supports healthy communities’ concepts, including the development and use of community assessment tools that encourage walk-ability, multi-modal transportation, linkages and multiuse zoning, and recreational facilities and amenities integration.
• Support Implementation of Health Care Reform - The American Heart Association long recognized the need to reform our health care system and applauded passage of the Patient Protection and Affordable Care Act by the 111th Congress. The AHA will work with state, local, and community partners public and private to ensure that reforms are implemented with fidelity to the Act’s patient-centered protections, vision for improving the quality of health care delivery, and focus on prevention. AHA recognizes that reducing fragmentation within the health care system is integral to the success of reform’s goals of improving patient care and reducing costs.

We will continue to keep you updated as we advance these policy priorities through 2012.

Neil Meltzer, the AHA’s immediate past chairman, has been selected to serve as a member of the National Healthcare Workforce Commission. The commission, created under this year’s healthcare reform legislation, will play an important role in ensuring an adequate and well-qualified healthcare workforce to meet the current and future healthcare needs of all Americans.


Meltzer is COO and president of Mount Sinai Hospital and senior vice president of LifeBridge Health, both in Baltimore.

“Neil Meltzer is uniquely qualified to address the workforce challenges faced by a range of healthcare professionals, communities and health systems,” said AHA CEO Nancy Brown in a Sept. 30 statement. “Through his leadership in Baltimore and the state of Maryland, he has helped create innovative partnerships with local community colleges and universities to train entry-level healthcare workers, brought together local funding agencies to place job coaches at hospitals to support worker success and satisfaction, aided in establishing a high school for students interested in pursuing health careers, and helped develop a strategic plan for the growth of biosciences in the Baltimore region.”

The six-month anniversary of the Affordable Care Act marks an important milestone for millions of Americans who have long-awaited access to affordable, quality health care. Countless heart disease and stroke patients and their families will immediately benefit from the important insurance reforms that take effect on September 23. Among them, the ban on lifetime and unreasonable annual limits on care; the ban on denying coverage for children with pre-existing conditions; protections against termination of coverage when individuals get sick; enhanced availability of preventive services with no cost-sharing; and coverage for young adults up to age 26. In addition, the launch of the new Pre-Existing Condition Insurance Plans is providing an indelible safety net to the thousands of Americans with pre-existing conditions who were previously denied coverage.

The American Heart Association welcomes this important milestone and has recently launched a series of online videos to help educate Americans about the new law and these health consumer and patient protections that will help them access essential health services without the risk of financial hardship or personal bankruptcy. The video vignettes feature heart disease and stroke patients asking questions of health care experts some of the most common questions about the law. These videos can be found on our health care reform website, http://www.heartsforhealthcare.org/.

The recently released sobering data from the U.S. Census that an additional 4.4 million Americans lost their insurance coverage last year reminded us all that our health system was unsustainable and that enactment of reform was necessary. These early consumer protections and insurance reforms provide important relief for families nationwide. The association remains committed to working with Congress, the Administration and others to implement the Affordable Care Act and ensure that it fulfills the promise of accessible, affordable care to heart disease and stroke patients.

1. Information about the patients protections taking effect this week, such as:
• Eliminating lifetime caps on coverage and restricting annual limits
• Prohibiting coverage denials to children based on pre-existing conditions
• Allowing young adults (under age 26) to remain covered under their parent's plan
• Providing preventative services for free under new health plans (and in Medicare starting January 1) 
• Prohibiting insurance companies from rescinding coverage if you get sick
2. A series of short videos featuring AHA experts who answer your fellow volunteers' questions about the health care law and the new protections mentioned above.
3. Links to other resources to provide you with additional information and tools to learn about the protections and options available to you.

The American Heart Association has long recognized that ensuring patients have access to the care they need is critical to our mission of building healthier lives free of cardiovascular disease and stroke. We hope you will seek out the information you need to learn about how the new law will affect you, so you can take full advantage of these new consumer provisions and patient protections.

Report on Medicaid and Healthcare Reform
A new report from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) examines how state Medicaid agencies are preparing for a lead role in implementing the new health reform law while continuing to deal with the impact of the recession. The report is based on interviews with state Medicaid directors, which helped outline how states are addressing increased caseloads and weakened tax revenues. It also summarizes state strategies for preparing to implement healthcare reform.
For more information, read the report titled, State Medicaid Agencies Prepare for Health Care Reform While Continuing to Face Challenges from the Recession.

State Coverage Initiative Report Released
The new State Coverage Initiative (SCI) program report that was released last week outlines state policy options in reference to the national reform of the Patient Protection and Affordable Care Act. Ohio was one of 14 states chosen to participate in this program, and recommendations come from a team of 45 leaders, who believe these are the best options to extend coverage to Ohio's uninsured.
For more information view the report,"State Implementation of National Health Reform: Harnessing Federal Resources to Meet State Policy Goals" (pdf, 47 pages), written by Stan Dorn of the Urban Institute.

The American Heart Association/American Stroke Association believe the new health care reform law, the Patient Protection and Affordable Care Act, makes significant progress toward the Association’s core principles for meaningful health reform. The Association has worked hard to make sure that the final package of reforms will make coverage more available, affordable, adequate and understandable for patients with heart disease and stroke. We will continue to work on these reforms in the months to come to ensure that implementation of health reform is successful and to build on these reforms in the years ahead.

The law contains the following provisions that will benefit patients and their families and those at-risk for heart disease or stroke:

HEALTH CARE WILL BE MORE WIDELY AVAILABLE

• Heart disease and stroke patients and others with pre-existing medical conditions will no longer be denied insurance coverage due to their health needs, beginning this year for children and in 2014 for adults.
• Those who currently have health insurance coverage and like their plan will be able to keep it.
• Those who are uninsured or who currently must rely on the expensive individual and small group markets will be able to buy the private health plan of their choice through a marketplace called an insurance exchange. The health insurance exchanges will provide consumers with the benefit of competitive, group insurance rates, beginning in 2014.
• Doctors and their patients will decide what care is the right treatment – not insurance companies or the government.
• In exchange for guaranteed, affordable coverage regardless of health status, individuals will be responsible for obtaining health insurance coverage – just like they are required to buy car insurance for their automobiles – beginning in 2014.

• People, including heart disease and stroke patients, will no longer be charged higher premiums because of their medical condition, gender, or occupation, beginning in 2014.
• Lifetime and annual caps on essential medical benefits will be prohibited (beginning this year, lifetime caps will be prohibited; for annual caps, tight restrictions will begin this year, followed by a complete ban on their use in 2014).
• There will be limits on out-of-pocket costs so that families are protected from bankruptcy, beginning in 2014.
• Charging older people significantly higher premiums because of their age will be limited, beginning in 2014.
• Tax credits based on financial need will be available to individuals and families with low and moderate-incomes who purchase coverage through an insurance exchange to help make coverage affordable, beginning in 2014.
• The smallest employers will receive tax breaks to help them provide affordable coverage to their employees beginning this year.

HEALTH CARE COVERAGE WILL BE ADEQUATE

• Consumers buying coverage through an exchange will be assured that essential health care services will be covered, including hospital care, ambulatory care, prescription drugs, preventive services, emergency care, and rehabilitative and habilitative services.
• Preventive care will be fully covered by Medicare and new private health insurance plans with no cost sharing (beginning this year for new private plans and next year for Medicare).
• The Medicare prescription drug “doughnut hole” will be narrowed immediately and completely closed by 2020.
• Patients will have access to an adequate number and type of providers so they can receive the specialized care they need without incurring out-of-network costs.
• Consumers will be given easily understandable information about their health insurance benefits and costs.
• The law includes incentives to improve the quality of care delivered to patients, including a greater emphasis on primary, preventive and coordinated care.

Do you have more questions? Check out our FAQ on Healthcare Reform!

The U.S. House of Representatives took a historic and bold step forward to expand health care to millions of Americans to guarantee accessible, affordable, and high quality care. We all acknowledge that such a complex piece of legislation like the final health reform package isn’t perfect -- no package of similar magnitude has ever been perfect at the outset -- but this is the first step of a legacy building process that will transform American health care. This measure takes important steps forward by enacting needed insurance reforms, increasing affordability and reducing costs, emphasizing value over volume and placing a greater emphasis on prevention and wellness. For the American Heart Association (AHA), health care reform has always been about the needs of heart disease and stroke patients and we’re gratified that lawmakers didn’t lose sight of the concerns of those facing pre-existing medical conditions, lifetime and annual limits and other challenges with the health care system.

We now have health care reform that makes significant progress towards embracing the excellence of available health care in America while improving a health care delivery system that was untenable for too many Americans and unsustainable for all Americans.

We realize the current system cannot fully accommodate the current and growing burden of disease. Risk factors for cardiovascular disease and other chronic illnesses are on the rise and will only worsen if attaining better health does not become a high priority. The AHA will continue to do its part and now with this legislation all Americans will have preventive benefits that help lower rates of obesity, hypertension, tobacco use and diabetes. First dollar coverage for evidence-based preventive services and appropriate treatments and medications that allow patients to lead productive lives after a heart attack or stroke will be key components in our efforts to reduce the burden of disease and extending prevention into communities, especially those of the underserved, will be invaluable.

[The recent] vote for health care reform represents a major milestone but not the end of the journey. We believe the work on health care reform is just beginning. The AHA remains committed to working with Congress, the Administration and our partners in the public and private sectors to further improve the health care system, to monitor and implement this legislation and to transform the current system into one that fulfills our American generational promise to make life better for future generations.

After decades of delays, heart disease and stroke patients can look forward to meaningful reforms in our health care system with today's historic vote in the Senate for the Patient Protection and Affordable Care Act.  We are gratified the Senate has given Americans a holiday to remember with approval of a bill which, while still imperfect, will benefit patients and their families as they struggle to cover the cost of medical care. Although much more work lies ahead to fix our broken health care system and ensure quality, affordable care for all Americans, this bill lays the groundwork to expand coverage to the uninsured, place an increased emphasis on preventing disease and improve the delivery of care – all measures that will enable us to reduce soaring health care costs and relieve the stress and anxiety of patients who have run out of options in securing quality and affordable health care. 

Senate passage of a health care reform bill is an important and necessary milestone; however, we recognize there are more hurdles to overcome in the weeks ahead. Differences between the House and Senate bills must be ironed out in order to complete this monumental effort and produce the strongest bill possible for meeting the needs of heart disease and stroke patients.  The American Heart Association looks forward to working with House and Senate leaders to improve the final bill and see health care reform over the finish line early in the new year.

The mission of the American Heart Association is: Building healthier lives, free of cardiovascular diseases and stroke.
The American Heart Association / American Stroke Association supports and advocates for public policies that will help reduce coronary heart disease, stroke and risk by 25 percent by 2010. The following are the public policy priorities for West Virginia in 2009-2010.

♥ Tobacco Control

• Strengthen and Protect Smoke-Free Workplace Laws
  All 55 West Virginia counties are protected by smoke-free board of health regulations at some level. In recent years, many counties have strengthened their regulations, including Kanawha County (Charleston) effective 7/1/08. AHA will continue to work with coalition partners to strengthen local regulations, while also working at the state level to guard against statewide preemption and to look for opportunities to pass a strong statewide smoke-free law.
• Increase Tobacco Excise Taxes
  West Virginia’s cigarette tax is currently 55 cents per pack. AHA has lead coalition efforts in recent years to significantly increase the cigarette tax and will continue that campaign, particularly in light of state budget deficits.
  
• Support Tobacco Control Prevention and Treatment Programs
  Attempts have been made in recent years to reduce the funds spent on tobacco prevention and cessation programs. AHA will continue to work with coalition partners to protect that funding and seek to earmark a portion of any cigarette tax increase for additional prevention efforts.
  

♥ Acute Cardiovascular Care
Designation of Primary Stroke Centers: We will embark on a campaign this year to recognize primary stroke centers designated so by The Joint Commission as a first step to building stronger stroke systems of care throughout the state. These efforts will be in conjunction with the state stroke task force.

♥ Quality and Availability of Care
Promote Broader Access to Health Coverage: Through coalition efforts, support policies that extend health coverage to all citizens of West Virginia and monitor all proposed health care reform initiatives and advocate, when appropriate, for measures which:

1. Adhere to AHA clinical guidelines and treatment protocols.
2. Establish or expand quality improvement initiatives.
3. Make preventative health benefits available and affordable.
4. Remove barriers to health care coverage for people with pre-existing conditions.

This is the beginning of a new series on our legislative work. First, we will share the legislative agendas of each state. In a few months, we will share a legislative update to inform advocates of where we stand on our set agenda. Finally, we will have a wrap-up post at the end of legislative session to share our final results.

The mission of the American Heart Association is: Building healthier lives, free of cardiovascular diseases and stroke.
The American Heart Association / American Stroke Association supports and advocates for public policies that will help reduce coronary heart disease, stroke and risk by 25 percent by 2010. The following are the public policy priorities for Pennsylvania in 2009-2010.

♥ Heart Disease and Stroke Funding
While Pennsylvania does have a Heart Disease and Stroke Program through the PA Department of Health, the federal funding that solely supports its operations is not guaranteed each year. There is no state funding to support efforts to address the #1 and #3 leading causes of death. House Bill 816 would expand current functions of the Department of Health that promote best practices in the prevention and treatment of heart disease and stroke. We will work to pass House Bill 816 first to establish a strong statewide policy to address heart disease and stroke. We will then work to secure state funding to support implementation of House Bill 816.

♥ Quality of Care
Pennsylvania hospitals do not have a consistent set of measures or benchmarks to ensure quality care for stroke patients. We will work to ensure that all Pennsylvania hospitals are equipped with Get With the Guidelines as the state stroke registry data platform by passing House Bill 816, which would establish a framework for reaching this measure.

♥ Obesity Prevention
Pennsylvania, along with the rest of the nation, is in the grips of an obesity epidemic. Too many people are taking in too many calories and are not getting enough physical activity and this is especially true for our children.

• School Nutrition
  Schools are an especially effective and efficient environment for modeling healthy food choices and helping to instill in children lifelong behaviors of health and physical activity. Science tells us that eating and drinking a diet full of fruits, vegetables, whole grains, low-fat and non-dairy products, coupled with foods low in saturated and trans fats, cholesterol and added sugar and salt can significantly reduce one’s risk for becoming overweight or obese. But, yet so many of our schools have beverage, snack and a la carte items that have little nutritional value and are high in fats, sugars and sodium. We will work to ensure that more fruits, vegetables and other nutritious foods and beverages are substituted and offered all throughout the school day.
  
• Physical Education
  Schools should promote a learning environment that integrates physical activity and education. Pennsylvania does not require PE as a condition for graduation, nor does it establish minute requirements for PE. We will work to promote quality PE by establishing mandatory minute standards, requiring physical education as a condition for graduation, and promoting physical activity and healthy food choices in our schools and throughout the community.
  
• Menu Labeling
  The AHA believes that educated consumers, armed with the right nutrition information, can make healthier choices when they eat out. We will work to strongly advocate for calorie labeling on all menus and menu boards at the point-of-purchase in restaurants with standardized menus and recipes.

♥ Chain of Survival
Pennsylvania’s Good Samaritan law provides civil immunity for lay rescuers, but the law is currently written in a way that provides program facilitators with civil immunity only if the AED program requirements are met. There is also currently no requirement that all schools implement an AED program. We will identify a legislative champion to support expanding Good Samaritan civil immunity to include program facilitators regardless of if the AED program requirements are met. We will also work to ensure all school buildings are equipped with an AED, in addition to implementation of Medical Emergency Response Plans that follow AHA guidelines.

♥ Tobacco Control
Pennsylvania passed a smoke-free law for public workplaces, but it provides for several exemptions to public places where people will be allowed to smoke. While Pennsylvania remains above the national average in its cigarette excise tax, the national average is quickly catching up to Pennsylvania. Pennsylvania also remains the only state in the nation that does not tax other tobacco products (OTP). We will work to: Strengthen and protect smoke-free workplace laws and remove Pennsylvania’s preemption provision; support significant increases in tobacco excise taxes at all levels of government; and support tobacco control Prevention and treatment programs.

♥ Quality and Availability of Care
Our nation is in the midst of a health care crisis and state and federal governments are grappling over how to best reform our health care delivery system. We will continue to monitor legislative proposals that promote access to health care, expanded coverage for pre-existing conditions, scientifically-based pay-for performance and health information technology.


This is the beginning of a new series on our legislative work. First, we will share the legislative agendas of each state. In a few months, we will share a legislative update to inform advocates of where we stand on our set agenda. Finally, we will have a wrap-up post at the end of legislative session to share our final results.

Health Care Reform is certainly a hot topic this summer and into the fall. However, the American Heart Association has been talking about patient centered health care reform since 1992!

While the discussion will certainly continue, learn more about the American Heart Association's position on this important issue.

The American Heart Association has a longstanding commitment to approaching health care reform from the patient’s perspective. This focus – including the important roles that health care providers, biomedical research and the health care delivery system play – is reflected in AHA’s past and current positions on meaningful health care reform.

In 1992, AHA’s Board of Directors approved five key principles for access to health care. They concentrated on patient access to preventive services and quality health care and continued biomedical research to improve the prevention and treatment of heart disease and stroke.

More than 15 years later, some progress has been made in achieving this vision – particularly with regard to developing guidelines for appropriate patient care and methods to measure quality, evaluate outcomes and determine cost-effectiveness.

However, more Americans than ever lack health insurance, presenting a major barrier to receiving quality health care. These include children with congenital heart disease, who formerly would have died, but now survive to confront these challenges. And after an initial doubling, the National Institutes of Health’s budget has fallen flat with an actual reduction in purchasing power because funding has failed to keep pace with biomedical research inflation.

In this summary document, AHA updates what it believes to be the six critical principles that must be addressed if health care in the United States is to be effective, equitable and excellent.

Use this link to read about the critical principles or visit www.heartforhealthcare.org

The American Heart Association supports Congress’ efforts to reform our nation’s healthcare system. As a leading patient advocate, our association supports reforms that make healthcare more affordable, adequate, and accessible to all Americans. On the last day of September I joined volunteers from across the country on Capitol Hill to send a clear message, Americans need reform this year of our broken system. Too many of our friends, neighbors, and family members forgo preventative health services, skip doses of needed medications, or struggle with mounting bills from a “pre-existing” condition

I spent much of the day with a young woman from Delaware who was born with a congenital heart defect and at the time was the youngest recipient of a pacemaker at one day old. In our current system, she is practically shut out of starting her own business and pursuing entrepreneurial ventures because in the small and individual health insurance markets she’s uninsurable for her “pre-existing” condition, if insurance could be obtained at all. Her career choices are thereby limited primarily to large companies or the public sector. The health reforms that the American Heart Association is supporting would change this and make health care more accessible to all Americans. Get involved @ www.heartsforhealthcare.org.

Jonathan Kirch, DE Advocacy Director
American Heart Association

On September 30th, I had the opportunity, as a volunteer, to participate in the American Heart Association’s FLY-IN day on Capitol Hill in Washington, D.C. There were several reasons that I volunteered to participate for the Fly-In, and of course to be active with Grass Roots Advocacy. First of all, I have been involved with Healthcare in some form or another for approximately 13 years and I have been in constant contact with physicians, nurses, and patients. Daily, I hear testimonials of struggle and pain with the healthcare system and of course I have many personal stories of family toil with disease and strangulating medical bills.

My “Lobby Day” on Capitol Hill was a truly enlightening and rewarding experience. Some of you have had this experience before ( I would love to hear your stories) and in fact it was my second such visit over the last three years. I was the lone representative from the State of Kentucky for the Grassroots Advocacy of the American Heart Association, and I had the opportunity to converse, one on one, with my local Congressman, Ben Chandler, and with our Senator's Chief of Staff's on HealthCare. In these meetings I had discussions about Cardiovascular disease, financial impact, research and development, patient access, healthcare affordability and reform. Also, I had the opportunity to hear the position and stance from Health Care Committee Chairman Senator Tom Harkin (D-Iowa) and I was involved in a Q&A with the White House's internal advisor on Health Care. From these meetings, I was able to gain their insight and perspective to bring back to the AHA and to my Territory.

Furthermore, I had the opportunity to connect with and hear some amazing testimonials from patients and families affected by Cardiovascular Disease. I know that these Representatives hear from hundreds of constituents everyday, but I was, as a normal citizen, able to raise a few unknown points and peak some interest from a different perspective, the AHA perspective.

In conclusion, We, as constituents, as citizens, can affect change and our voices can be heard. Write the letters, make the calls, vote: Get involved; this is your country and your life.

Sincerely,

Matt Rudacille
AHA Volunteer

WASHINGTON, September 30, 2009 –American Heart Association advocates today urged their representatives in Congress to pass meaningful health reform legislation that will help prevent disease and expand access to affordable, quality care for the insured and uninsured.

The association supports measures that will make health care affordable, accessible and adequate for all Americans, particularly heart disease and stroke patients. Nearly 80 million Americans suffer from cardiovascular diseases and many cite cost as the reason they are uninsured. During the association’s health care reform Fly-In Lobby Day on Capitol Hill today, heart disease and stroke survivors told their personal stories to Congress to help influence the debate and call attention to the needs of patients and their loved ones.


“We can save more lives and improve quality of life with health care reform legislation that puts the needs of patients first,” said Clyde W. Yancy, M.D., American Heart Association President. “By promoting prevention, expanding access and using the best evidence-based treatments, we can help Americans reduce their risk factors for cardiovascular disease and other chronic illnesses.”

One-third of uninsured patients with cardiovascular disease report not getting essential medical care due to the cost and as a result, many experience a higher rate of death following a heart attack or stroke compared to those with insurance, Yancy added.

The association supports health care reform proposals that eliminate pre-existing conditions and annual or lifetime limits on covered benefits, apply out-of-pocket limits to out-of-network care and place a greater emphasis on preventive care. Visit www.americanheart.org/accesstocare and www.heartsforhealthcare.org for more information.

WASHINGTON, September 10, 2009 -- The President has reminded us that health care reform is not about politics, it’s about real people who wake up each day hoping that a medical emergency won’t throw them into bankruptcy. We all agree that the current health care system is not working well for the insured, it’s not working well for the underinsured and it’s certainly not working for the uninsured. That’s why we’re pleased the President has brought the debate back to where it started – focusing on the needs of Americans who cannot access affordable, quality health care. We cannot forget the children with congenital heart defects who surpass their lifetime insurance coverage limits before they’re toddlers, we cannot forget the families who lose their homes because of high out-of-pocket medical expenses to treat a chronic illness, and we cannot forget those who go without needed, even lifesaving care because they can’t access or afford insurance. Their stories must be the reason why Congress must continue in their efforts to find common ground and pass meaningful health reform this year. We urge Congress to not lose sight of the goal we all share - to build upon what works in our health care system and fix those parts that are broken and simply unsustainable.

The American Heart Association and its American Stroke Association division believe the health care reformbills being considered in the House and the Senate represent significant steps towards meaningful healthreform. The Association has worked hard to make sure that the America’s Affordable Health Choices Act (H.R.3200) and the Affordable Health Choices Act in the Senate will make coverage more available, affordable,adequate and understandable for heart disease and stroke patients. The bills contain the following provisionsthat will benefit cardiovascular disease patients and their families and those at-risk for heart disease or stroke:



HEALTH CARE WILL BE MORE WIDELY AVAILABLE

· Heart disease and stroke patients and others with pre-existing medical conditions will no longer be deniedinsurance coverage due to their health needs.
· Those who currently have health insurance coverage and like their plan will be able to keep it.
· Those who are uninsured or who currently must rely on the expensive individual and small group markets will beable to buy the health plan of their choice through a national pool called an Exchange that will provide consumerswith the benefit of competitive, group insurance rates.· Doctors and their patients will decide what care is the right treatment – not insurance companies or thegovernment.
· In exchange for guaranteed, affordable coverage regardless of health status, individuals will be responsible forobtaining health insurance coverage – just like they are with their automobiles.coverage to their employees.


HEALTH CARE WILL BE MORE AFFORDABLE
· People, including heart disease and stroke patients, will no longer be charged higher premiums because of theirmedical condition, gender, or occupation.
· Annual or lifetime caps on essential medical care will be prohibited.
· There will be limits on out-of-pocket costs so that families are protected from bankruptcy.
· The practice of charging older people significantly higher premiums because of their age will be limited.
· Assistance based on financial need will be available to individuals and families with low and moderate-incomes tohelp make coverage affordable.
· The smallest employers will receive assistance to help them provide affordable coverage to their employees.

HEALTH CARE COVERAGE WILL BE ADEQUATE
· Consumers will be assured that essential health care services will be covered, including hospital care, ambulatorycare, prescription drugs, preventive services, emergency care, and rehabilitative and habilitative services.
· Preventive care will be fully covered by Medicare and private health insurance plans with no cost sharing.
· The bills will ensure that patients will have access to an adequate number and type of providers so they canreceive the specialized care they need without incurring out-of-network costs.
· Consumers will be given easily understandable information about their health insurance benefits, costs andquality.
· The bills include incentives to improve the quality of care delivered to patients, including a greater emphasis onprimary, preventive and coordinated care.





You can learn more about the AHA’s principles and healthcare reform efforts at http://www.heartsforhealthcare.org/ and www.americanheart.org/accesstocare.

Eighty million Americans suffer from cardiovascular diseases and too many of them cannot afford the health care they need. Lack of health insurance and barriers to accessing quality care pose tremendous problems for patients who have difficulty affording essential treatments. Insurance policies with high premiums and practices that penalize those with pre-existing conditions create a challenging and expensive reality for heart disease and stroke survivors. That is why the American Heart Association is working to achieve a meaningful reform that serves the best interests of patients. What to learn more? Check out the FAQ

Frequently Asked Questions About Health Care Reform
Q: Why does the American Heart Association support health care reform?
A: We believe that the bills before Congress, while not perfect, will make care more available andaffordable for the millions of individuals with heart disease and stroke who are uninsured or haveinadequate coverage. The bills preserve what works in our current health care system; include animportant and long overdue emphasis on preventing illness; and will help to improve the quality of carethat everyone receives. The bills also make sure that individuals are protected from insurers that evadetheir obligations to pay for needed care.

Q: Will health care reform lead to a “government takeover” of health care or result in “socializedmedicine,” as some claim?
A: No. The bills before Congress preserve our nation’s current employer-based private health insurancesystem, with public programs such as Medicare and Medicaid continuing to be available as a safety netfor older and low-income Americans. The “government takeover” concern is largely based on the publichealth insurance option that may be available as a choice under some of the bills. It’s very important tonote, however, that each person, not the government, would decide whether a private plan or a publicplan is the right plan for him or her – if the public plan choice is available at all.

Q: Will health reform lead to rationing of care, as some have said?
A: No. This concern is based on provisions in the bill that authorize “comparative effectiveness research.”This is research that evaluates which drugs or other treatments work best for different medicalconditions and different patients. The American Heart Association supports this research because it willprovide doctors and their patients with more and better information to help them decide the best courseof treatment. Ultimately, however, doctors and patients − not insurance companies or the government −will decide what treatment is best.

Q: Will I be able to keep my current health insurance coverage if I want to?
A: Yes. If you currently have health insurance coverage and you like that coverage, you’ll be able to keepit. We recognize, as does President Obama and Congress, that most Americans who are currentlyinsured receive their coverage through their employer and two-thirds of them are satisfied with thatcoverage.

Q: Why does the American Heart Association support a requirement for individuals to obtain healthinsurance coverage?
A: The American Heart Association supports the principle of individual responsibility, provided that thecoverage is made affordable. Under health care reform, insurance plans will no longer be able to denycoverage to those with preexisting conditions or charge them higher premiums because of their medicalneeds, which will help tremendously in making coverage available and affordable for heart disease andstroke patients. In return, however, individuals can’t be allowed to wait until they have an accident ordevelop a chronic condition to sign-up for insurance because then coverage would be unaffordable foreveryone.

Q: Will the health care reform bills mean that I will pay more if I have good coverage now?
A: The goal of health care reform is to make health care more affordable for individuals and families as wellas for our nation. Americans pay more for our health care than any other country, in part because weare covering the uninsured in a very inefficient way after they get sick and seek care at an emergencyroom. Some estimate that individuals with insurance pay up to $1,100 more per year through higherpremiums and taxes because of uncompensated care received in public hospitals and emergencyrooms.

Q: Why should I care about health care reform if I already have insurance coverage and like what Ihave?
A: Most importantly, health insurance reform will provide American families with peace of mind that they willalways have access to quality, affordable coverage, even if they lose their job, switch jobs, or move.Reform will also ensure that insurance companies can no longer cancel your insurance if you get sick orput annual or lifetime limits on the coverage for which you’ve been paying. And reform will help to get ahandle on rising health care costs so that insurance is affordable in the future.

Q: What does health reform mean for Medicare beneficiaries?
A: The reform bills will improve coverage for Medicare beneficiaries and improve the quality of care theyreceive. For example, the House bill would close the coverage gap (or “donut hole”) in prescription drugcoverage that many Medicare beneficiaries currently face. It would also eliminate cost-sharing forpreventive services in Medicare and improve the extra assistance provided to low-income Medicarebeneficiaries. None of the bills would cut Medicare benefits or increase seniors’ out-of-pocket Medicarecosts.

Q. I’ve heard claims that health care reform will deny older Americans end-of-life care. What is thisabout?
A. Nothing could be further from the truth. The House health reform bill includes a provision that wouldprovide reimbursement to physicians who provide counseling to Medicare patients about the care theychoose to receive if they have a living will or an advance directive. These consultations are notmandatory, occur only upon the request of the patient, and in fact are designed to make certain that thepatient’s wishes come before those of insurance companies or hospitals.

Q: I’ve heard that health reform will cost at least $1 trillion – is this true?
A: The $1 trillion cost that has been reported in the media is the cost over a 10-year period (an average of$100 billion a year). It is also important to note, however, that Congressional budget rules require thatthe health reform bills be fully paid for so that they won’t add to our national debt. The cost estimatealso doesn’t take into account the private savings that would result from health reform through suchprovisions as improved care coordination and a greater emphasis on preventing disease. Finally, weneed to consider the cost of delay and inaction. Without reform, costs are projected to continue toescalate, 16 million more Americans are projected to lose their coverage over the next decade, andmillions more will have their out-of-pocket health costs rise substantially.

Q: Why is there such a rush to enact health reform? Shouldn’t Congress take its time and getreform right?
A: Of course, we all want health reform to be done correctly, in a manner that builds on what works aboutour current system and fixes what doesn’t. But time is also of the essence in order for reform to actuallybe accomplished. Many in Congress have been working for years on health reform, and the AmericanHeart Association has been working behind the scenes to shape the development of the current healthinsurance reform legislation since last year. The Congressional schedule also dictates that healthreform be done by the end of this year or early next year at the latest, or history has shown that anotheropportunity for significant reform won’t happen for another 15 to 20 years, if at all.

Q. Will health care reform provide coverage to illegal immigrants?
A. The health reform proposals currently being considered by Congress do not extend coverage to illegalimmigrants. The American Heart Association remains committed to improving the cardiovascular healthof all U.S. residents, including undocumented individuals. We recognize that as a society we arealready paying a high cost for ignoring the health care needs of these individuals (through higheremergency department utilization, preventable and avoidable hospitalizations and the associated costsof untreated cardiovascular disease).

You can learn more about the AHA’s principles and healthcare reform efforts at http://www.heartsforhealthcare.org/ and www.americanheart.org/accesstocare.

Len Ward, 26, a Louisville, Ky., freelance writer, was born with a rare condition called endocardial cushion defect. Fortunately, he’s been symptom-free since his second open-heart surgery at 8 years old.

Check out Len's view of Healthcare Reform!
http://www.cfah.org/hbns/preparedpatient/current.cfm
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Your parents still might be willing to do your laundry, but if you’re over 18, they can’t make your medical decisions. Are you ready to navigate the adult health care system?

Len Ward, 26, a Louisville, Ky., freelance writer, was born with a rare condition called endocardial cushion defect. Fortunately, he’s been symptom-free since his second open-heart surgery at 8 years old.

“I have a cardiologist,” Ward says. “He’s a children’s cardiologist but he’s well-versed in my condition. He’s the only one who knows that much about it. For the foreseeable future I will be sticking with these doctors.”

All too often, the health care system fails to keep up when children with chronic conditions reach adulthood, says Patience White, M.D., a professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences.

“It’s not unusual” for a 26-year-old to be with a medical condition to be without a medical home or age-appropriate health care, says White, who is chief public health officer of the Arthritis Foundation. Moreover, “the bulk of young American adults do not interface with the health care system during their adult years.”

So what’s wrong with that?

You Have Adult Health Needs

Emerging adults “may not have heart disease but they have risky behaviors,” says Angela Diaz, M.D., medical director of the Mount Sinai Adolescent Health Center. Young adulthood is a time for “safe experimentation,” but in fact, common not-so-safe behaviors include unprotected sex, substance abuse, violence and preventable injuries.
Regular screenings can pick up problems that would otherwise progress unrecognized and untreated.

“I didn’t have insurance in college; I was fortunate not to get sick,” recalls Ebonie Williams, a social worker in Manassas City, Va. But that was then: “Now I have a limited form of lupus; it was just diagnosed last summer.”

You might need to get your lifestyle in synch. Obesity rates for young adults are skyrocketing. Balanced nutrition also can be a problem if you’re a vegetarian or vegan. Maybe you want to quit smoking, but find you can’t do it alone.

What the System Offers

The Guidelines for Adolescent Preventive Services say that check-ups should include blood pressure and BMI monitoring along with a comprehensive exam with cholesterol tests, STD screening, and for women, Pap smears. Providers can make sure tattoos or piercing sites are intact and infection-free.

Older teens are “wonderful health care consumers,” Diaz says. “For instance, we have a 24-hour on-call doctor. The kids use this appropriately, they don’t abuse it.”

A the Mount Sinai Center, 10,000 New York City teens and young adults have access to free “mental health, reproductive care, primary and acute care, and specialty care: for obesity, eating disorders, Gay/Lesbian health issues, interpersonal violence, and pregnancy prevention and treatment,” Diaz says.

Inevitably, though, comes the time to cut the apron strings. At the Sinai center, “the official age is 10 to 22,” Diaz says. “Sometimes they don’t want to go.”

Bridge to Adulthood

Young women who seek out birth control providers may also find unexpected resources. “More and more women are turning to Planned Parenthood for basic health care, from contraception to pelvic exams to cancer screenings,” says Cecile Richards, the federation president, adding that the “health centers are obviously a critical entry point into the health care system for millions of Americans.

Another “bridge” might be the military health system; for others, it’s college.

The University of Maryland Health Center in College Park serves a student body of 37,000 strong. Kelly Kesler, MS, CHES, is assistant director of health promotion at the health center, which includes a women’s health center, mental health unit and an urgent care clinic as well as an orthopedic surgeon onsite once a week.

Between freshman and senior year, students do pick up patient skills, Kesler says.

Some health visit basics they might not have known: “Okay, you can’t just walk in and they’re going to see you right now. You need to make an appointment,” Kesler says. Or at the pharmacy, “some student had never had to bring in their own prescriptions. Some aren’t sure of the difference between a generic and name-brand medication.”

“I can’t emphasize enough the importance of prevention: learning stress-management techniques now, basics like sleep hygiene,” Kesler says. Above all, college health care “is an opportunity for students to learn about advocating for themselves.”

Skills for the Heath-Savvy

Although you seldom see adult patients in pediatric practices, it still “is a shock when a youth and their family learn that they cannot continue to be seen by their pediatrician,” White says. “The fact that there’s no posted policy that warns you that you will have to move on to an adult health care provider is amazing.”

The transition process “is pretty straightforward,” she says. “You need to know how to communicate about your medical condition and what to do to stay healthy, have a copy of your medical record, know how to make a doctor’s appointment and get your prescriptions. You should learning these skills at 13 and have a transition plan by age 14.”

Yet some 25-year-olds might not be able to say with confidence (1) “I know my medication and dosages,” (2) “I know when to call my health provider to report a change in illness status” and (3) “I have an emergency plan.”

Can you fill in the blanks about your family medical history? Could you locate your medical records? Could your kids?

“I believe my current cardiologist has all my medical records,” Len Ward says. He doesn’t sound too sure. “I wouldn’t know where to start,” says Ebonie Williams.

Taking control of your medical record doesn’t have to be a big deal, White says: “I just discuss what’s in it and give it to kids on a flash drive; you just download it. They just put it on their computer. I ask them to keep it in a secure place where it stays confidential.”

Hard Times, Hard on Your Health

In light of his self-employment and preexisting condition, Len Ward considers health insurance a lost cause. “I’m always thinking, ‘when is the other shoe going to drop?’” he says.

“This age need access and services but are least likely to get it,” Diaz says. “This really needs to be looked at in health care reform.”

Shani Muhayman, 28, is currently unemployed. She budgets “severely” to keep health insurance through COBRA. “It costs $374 a month,” she says. “It’s a bit much to afford that and rent and everything else.” She’s hopes to find a job in the Washington, D.C., school system before her coverage runs out.

According to a recent Medical Expenditure Panel Survey, “young adults in the 19 to 24 and the 25 to 29 age groups were at greatest risk of being uninsured, with over a third without health insurance.”

Advises White, “Look at your parent’s insurance; find out how long you’re covered, or if you qualify for SSI (Supplemental Security Income), which often includes health insurance. These are two options to research.”

Youthful Plusses

A spirit of independence and advocacy can serve you well.

As a new college graduate, Muhayman recalls, “I applied for work at a nonprofit. I asked about health insurance and was told they did not offer it at the time." So she negotiated: “As a condition for me to get the job, I said I would be willing to begin the process of looking for health insurance” for the organization. They took her up on the offer.

Although Len Ward wryly advises peers: “don’t be a freelance comic book writer; have a better plan than I did,” things are looking up, with his first book due to come out in November. He recently went to Capitol Hill with the American Heart Association to lobby for health care reform, and just returned from a yearly gig as a counselor at a camp for kids with heart conditions.

Idealism and resilience are important attributes, here’s another:

“Students have an advantage over older folks like us,” Kesler says. “They are very much attuned to health technology. They visit respected health consumer Web sites, they can use their iPhones as pedometers and they can use a variety of apps to track their health” online.

Here is one advocate's thoughts on Healthcare in America and his family's struggles..
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"I have worked extremely hard my whole life, and as a young family, no one ever told us to budget for getting sick. Like many other Americans our medical expenses are through the roof."
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There are a multitude of ugly diseases that blanket our Earth. Every hour, each one of them attempts to claim unsuspecting new victims straight from the day of our birth and constantly throughout our lives. I was taught that this is what God had intended for us in exchange for Adam & Eve’s disobedience and sin. We all grimace when the young are afflicted yet almost expect it to consume us too, as we steadily grow older. Lucky are those who can skate through their entire lives, personally unaffected by disease and all of its negative consequences.

In my family, our youngest daughter, Amber, was born so premature that at only 27 weeks, her lungs were not developed, and her weight dropped below two pounds.

She was hospitalized for six months and on Oxygen 24/7 for years later. Today she is a beautiful 21 year-old woman, who suffers only with Asthma. My oldest daughter Amanda has recently had spots of skin cancer removed. My wife Cindy suffers with terrible Spinal Pain, and feels that she can’t afford to take the time off work to have the necessary surgery. Her brother Todd died suddenly at the age of 32, from complications in medicines while treating his Non-Hodgkin’s Lymphoma. My sister Suzanne now deals with both Cervical and Skin Cancer. Together we both lost our parents, to Heart-Related Diseases.

You see I always thought that I was the healthy one. In over 50 years I never even broke a bone in my body. However that thought changed a few years back when an Aortic Anurysium amplified my Heart Attack and Cardiac Arrest. I had 1/3 of my heart removed and what remains is now held together with Dacron and Teflon patching and super glue. My health began failing me earlier than I had ever expected. I am also taking numerous medicines for Type 2 Diabetes. A back injury now has me side-lined and I have been recently diagnosed with Sleep Apnea.

However, you won’t ever hear me complaining about being ill, for I now know that this is what God had intended for me. I have learned that when you are “Sick” you call in sick to work, take some pills, stay at home a few days, then return, when you feel better. When you are “Diseased” you are most likely never to get any better. Plenty of Americans suffer way much more than I do. Many are dealing with their illness without having health benefits at all. Many more have debilitating diseases far greater than my family has ever experienced.

What I do complain about is not the fact that I am ill, but I am getting sick over the rising cost of our medications. The current national push is for affordable Health Care for all Americans. Sickened people, who already have affordable health care, have a difficult time just being able to afford the prescription medicines. How about some Affordable Medicinal Care for all Americans!

I have worked extremely hard my whole life, and as a young family, no one ever told us to budget for getting sick. Like many other Americans our medical expenses are through the roof.

Between my wife and myself we now have at least 15 prescriptions that need to be refilled monthly, and as my doctor has once told me “If you don’t take your meds, you will die.”

I am slowing discovering that living diseased means: Spending your very last dollar, found under sofa cushions, on food for your family. Having your teeth pulled out one at a time, because you can’t afford to get them fixed. Avoiding the police cars because your automobile is now 6 months overdue for an expensive inspection. Having to pay for “Out of Pocket” expenses to 7-10 different types of “Specialists Doctors” for your constant care and testing. There have been many weeks we had to decide what medicines we can’t purchase today, just to have cash for food for the following week. The first thing you eliminate is the Cable TV and cell/phones. No money for parking at work, only means you now have a collection of un-paid tickets, just waiting for the collection day. We are always looking over our shoulder waiting to get caught from numerous angles. The collection agencies have your house phone constantly ringing off the hooks while you are forced to borrow cash from your children and friends, while not knowing when you’ll ever get to pay them back. This type of (Living?) is all so very new to us. We have worked hard all our lives and we still do, but our paychecks go to the Pharmaceutical Companies.

I estimate, since my Heart Attack, that I have taken over 25,000 individual doses of medicine.

I do believe, like millions of other Americans that Health Care has to be re-invented. Something does need to be changed. Our medical expenses are increasing at an alarming rate. Who can afford that? It is not our fault that we have been stricken with illness and now many Americans are becoming financially stricken as well.

I have tried to turn a bad thing into a good thing by helping other people who are living with Heart Disease. I am an Advocate of The American Heart Association and recently became a State Field Representative. As an Advocate I have spent time in Washington DC doing whatever it takes to get Congress and the Senate to increase funding for Heart and Stroke Research. In my home state of Pennsylvania I have joined other active Advocates of the A.H.A. in petitioning our State politicians for those very same ideals, as well as pushing for clean indoor air for everyone. This was highlighted for me by witnessing our Governor, Ed Rendell, as he signed the new “Clean Indoor Air Act.” into law.

I have spent the last 3 summers, lecturing about “A Patients Perspective on living with Heart Disease” to students attending The National Youth Leadership Forum on Medicine at Villanova University. I believe that working together as Americans we can accomplish any goal. I also believe that working together with the American Heart Association we can help re-invent health care.

Gene Juillet

Schwenksville, Pennsylvania