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Key Issue: Health Care Reform


Update: House of Representatives Passes Sweeping Health Reform Bill 

Ensuring quality, affordable health care for everyone in America is fundamental to our economic future and critically important to our nation's children and their families. Students can't learn unless they come to school healthy. 

Stay Informed


On March 23, President Obama signed the Patient Protection and Affordable Care Act into law. Even though many critical benefits will go into effect this year, some pieces of the health care reform picture will take longer to take shape. NEA will continue to analyze the law’s provisions and will pass on information to its members as it becomes available.

Key Benefits for Active and Retired NEA Members, Children, and Families

  • Uninsured Children and Families Will Have Access to Coverage. An estimated 32 million children and adults who could not afford and/or were denied insurance due to a pre-existing medical condition(s) will be able to obtain quality, affordable coverage.
  • Young Adults Can Stay on a Parent’s Plan. Young people who cannot afford and do not have access to quality health care coverage can stay on a parent’s plan until they reach the age of 26.
  • Immediately Establishes a Plan for the Uninsured. Adults and children who have been uninsured for six months or more due to a pre-existing condition can obtain coverage right away through a special insurance program that will include premium and cost sharing help for lower-income families.
  • Establishes a Competitive Health Insurance Market. People will have the same choice of health plans that Members of Congress will have. Members of Congress and their employees will be required to purchase coverage from the newly established Health Insurance Exchange.
  • Ends Insurance Company Abuses. Health insurers can no longer apply lifetime limits on the dollar value of health care coverage and cannot cancel a policy when someone gets sick.
  • Assists Employers Providing Retiree Health Benefits. A reinsurance program will assist employers with high medical costs for early retirees age 55 and older but not eligible for Medicare coverage.
  • Eliminates the Doughnut Hole. Medicare-eligible people who fall into Medicare’s prescription drug “doughnut hole” receive $250 right away to help them pay for the gap. It also provides deep discounts for prescriptions purchased in the doughnut hole and eventually closes the gap.
  • Eliminates Cost Sharing for Preventive Services. Cost sharing for covered preventive care services will be prohibited under Medicare and eventually all plans.
    Stops Excessive and Unnecessary Payments to Private Insurers Who Run Medicare Plans. The bill reduces unnecessary and expensive subsidies made to private insurers who offer Medicare Advantage plans and limits the cost sharing requirements imposed by these plans.
  • Maintains Employer-sponsored Coverage for Most Americans Who Currently Have It. Nothing in the bill requires employers to drop or change coverage, so employees who currently have employer-sponsored coverage should continue to get their health benefits in the same manner that they do.

Provisions that take effect immediately (PDF)

The Excise Tax on High-Cost Health Plans

The National Education Association and other groups fought vigorously against the provision, leading to important improvements in the tax.

Below are the key changes to the excise tax in the Health Care and Education Affordability Reconciliation Act of 2010.

  • The tax will not take effect until 2018.
  • Dollar thresholds were increased to $10,200 for single coverage and $27,500 for family coverage ($11,850 and $30,950 for retirees and employees in high risk professions).
  • The dollar thresholds are indexed to inflation and will be automatically increased in 2018 if CBO is wrong in its forecast of the premium inflation rate between now and 2018.
  • Stand-alone dental and vision plans are exempt.
  • Employers will be permitted to reduce the cost of the coverage when applying the tax if the employer’s age and gender demographics are not representative of the age and gender demographics of a national risk pool.