U.S. Senator Tim Johnson

Please visit my online resource center to learn about the health care reform law and what it means to you.

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act. This historic legislation will expand access to quality, affordable health care to millions of Americans, end unfair practices by health insurance companies and reduce the deficit. Additional improvements to the new law were enacted through the Health Care and Education Affordability Reconciliation Act and signed into law by the President on March 30, 2010. On June 28, 2012 the Supreme Court upheld the constitutionality of the new law.

Although some of the reforms will take time to be implemented, millions of Americans will see immediate benefits of reform, including those who currently have coverage. On September, 23, 2010, consumer protections from health reform measures took effect to put consumers in control of their care and end insurance industry abuses. The reforms, part of a provision in the law called the New Patient’s Bill of Rights, will help improve care, protect choice and reduce costs for South Dakota families.

It is now illegal for insurance companies to deny children care because of a pre-existing condition, and children are allowed to remain on their parents’ plans until the age of 26. Uninsured adults who had been denied coverage in the past because of a pre-existing condition now have the option to join a high risk pool and receive coverage. Insurance companies are barred from dropping coverage just because someone got sick and actually needed the coverage they had bought, and people no longer face lifetime caps on health care benefits or restrictive yearly limits under their plans. Because prevention is both cheaper and more effective than treating illness when it strikes, preventive services and immunizations arel no longer subject to co-payments under all new plans. Additionally, eligible small businesses choosing to offer coverage to workers can receive a tax credit of up to 35% of premiums, which will help more businesses offer coverage for their employees.

Taken together, the health care legislation and the package of improvements will make coverage more affordable for 150,000 uninsured and underinsured South Dakotans, provide tax credits for up to 16,400 small business owners in our state, prohibit insurance companies from excluding coverage of pre-existing conditions for South Dakota’s 199,000 children and 190,000 adults, close the prescription drug “donut hole” for 131,000 South Dakota seniors, and make their preventive services free of co-payments.

As many South Dakotans know all-too-well, accessing health care services in a rural area can be challenging. I am pleased that several provisions in the reform package will begin to address the disparities in reimbursement for high-quality health care in rural areas. With reform, health care professionals who serve patients in rural areas will receive much-needed increases in reimbursement from Medicare, and new incentives will help grow the health care workforce in our state. Through the reauthorization of the Indian Health Care Improvement Act, South Dakota will also see an increased investment in improving Indian health. Additionally, the bill includes increased funding for the community health centers that currently provide care to the medically underserved in many communities across South Dakota.

It has been a challenge to craft legislation that meets our nation’s pressing health care needs in a fiscally responsible manner. This historic reform makes common sense changes to our health care delivery system and takes an important step towards giving people a “fair shake” by helping everyone access coverage and making sure that coverage is meaningful. The Supreme Court has upheld the constitutionality of the law and it is time to move forward while continuously working to improve upon the reforms that have been made.  

You can find further information on the health care reform law through my online resource center.

More than 20% of the uninsured in our state are children. This statistic is staggering and completely unacceptable. Basic health coverage for our young people is essential in order to ensure that all Americans have the chance to live long, healthy, and productive lives.

The State Children’s Health Insurance Program has helped provide health insurance coverage to targeted low-income children whose parents earn too much money to qualify for Medicaid but not enough to purchase private health insurance. I voted for the creation of SCHIP in 1997 to provide health insurance to targeted low-income children whose parents earn too much money to qualify for Medicaid but not enough to purchase private health insurance. I have also fought to increase SCHIP funding so that the program can cover as many uninsured children as possible. After 14 years, this program has successfully reduced the number of uninsured children and currently covers more than 5 million children in the United States, including nearly 12,000 South Dakota children each month.

I was pleased one of the Senate’s first accomplishments in the 111th Congress was to pass the Children’s Health Insurance Program (CHIP) Reauthorization Act on January 29, 2009. President Obama signed this bill into law on February 4, 2009. This new law will provide coverage to an additional 4.1 million uninsured children across the United States, including as many as 6,000 South Dakota children. In addition, the legislation provides states resources to conduct outreach activities to find and enroll eligible children, provides mental health parity in the program, and allows children whose private insurance does not include dental coverage to enroll in the CHIP dental plan. Finally, I was especially pleased that child advocacy organizations and faith-based groups, including my own church, the Evangelical Lutheran Church in America, supported this legislation.

I was also proud to support passage of the Patient Protection and Affordable Care Act, signed into law by President Obama on March 23, 2010.  This historic legislation will expand access to quality, affordable health care to millions of Americans, end unfair practices by health insurance companies and reduce the deficit.  Additional improvements to the new law were enacted through the Health Care and Education Affordability Reconciliation Act and signed into law by the President on March 30, 2010. 

The health reform law includes key protections for children.  It is now illegal for insurance companies to deny children care because of a pre-existing condition, and children are allowed to remain on their parents’ plans until the age of 26.  Insurance companies will be barred from dropping coverage just because someone got sick and actually needed the coverage they had bought, and people will no longer face lifetime caps on health care benefits or restrictive yearly limits under their plans.  Because keeping your child healthy is both cheaper and more effective than treating illness when it strikes, preventive services and immunizations will no longer be subject to co-payments under all new plans.  Taken together, the health care legislation and the package of improvements will prohibit insurance companies from excluding coverage of pre-existing conditions for South Dakota’s 199,000 children. 

With states facing serious fiscal shortfalls, it is imperative that the federal government ensure that Medicaid programs receive the support needed to remain viable. I have been a strong supporter of Medicaid because I know how instrumental the program is in providing health care coverage for many Americans who would otherwise fall into the growing ranks of the almost 50 million uninsured. I have worked with colleagues to defeat legislative attempts to cut funding from Medicaid.

As a member of the Appropriations Committee, I will do all I can to fend off misguided cuts to Medicaid and other crucial health safety net programs. We need to support legislative initiatives that will increase, rather than decrease, access to care in rural communities.

Medicare was implemented in 1965 to assist the nearly 28.5% of elderly Americans who lived in poverty and could not afford medical insurance coverage. As a result of Medicare' s successes over more than 40 years, elderly Americans now maintain healthy, active lives well past the average life expectancy of Americans during the first half of the 20th Century. I strongly support Medicare and realize how critically important it is to thousands of South Dakotans and their families who rely on this health program. I have supported numerous pieces of legislation to ensure the program is expansive to the needs and interests of both beneficiaries and providers.

I was proud to support passage of the health care reform measure, signed into law by President Obama on March 23, 2010.  This historic legislation makes great strides in strengthening the Medicare program and improving health care for seniors.  Throughout the reform effort, it has been absolutely imperative that seniors see no reduction in benefits or increase in out-of-pocket costs for traditional Medicare services.  Health care reform provides incentives for providers to offer their patients high-quality care, rather than simply paying them more every time they order a new procedure or test.  In addition, the reform measure reduces drug costs for beneficiaries, eliminates co-payments for preventive care like immunizations and annual wellness visits, and ensures Medicare will be available for future generations.

As a member of the Appropriations Committee and the Rural Health Caucus, I will do all I can to fend off misguided cuts to Medicare, and continue to working to ensure that seniors have access to critical programs that help them continue to lead active and productive lives.

The Medicare Prescription Drug Improvement and Modernization Act of 2003 added a prescription drug benefit to the program and fundamentally changed Medicare as we know it. While I supported the more comprehensive Senate version of the legislation, I voted against final passage of the bill. I believe that Congress should have enacted a simple plan so people could have shown their Medicare card to their pharmacist and then received a discounted price. This program has been a frustrating and confusing experience for seniors, as well as their family members, physicians, and local pharmacists.

Part D, which went into effect January 1, 2006, falls short in addressing the rising cost of prescription drugs. The program has resulted in gaps in coverage, premium rates that vary wildly from one year to the next, and formularies, the lists of prescription drugs a plan covers, that change even more frequently. Rural communities in particular are struggling to make Part D work for their citizens. Many seniors are losing money under the plan because they are spending more on premiums, co-payments and deductibles than the value of the benefits they will receive in a given year.

Medicare beneficiaries should have access to a real, reliable drug benefit, and that is why I support several changes that will improve this program. These changes would require the federal government to negotiate lower prices for prescription drugs; close the coverage gap known as the "donut hole"; extend the annual open enrollment period; and allow seniors to change plans during the year if they are not happy with the initial plan they selected. I am proud Congress passed legislation that eliminated late enrollment penalties for Medicare beneficiaries who are eligible for the Low Income Subsidy Program.

I was proud to support passage of the health care reform measure, signed into law by President Obama on March 23, 2010.  This historic legislation makes great strides in strengthening the Medicare program and improving health care for seniors.  Health care reform includes much-needed relief for Medicare beneficiaries struggling with high drug costs.  Seniors who reach the gap in the Medicare Part D prescription drug coverage known as the “donut hole” in 2011 will receive a 50% discount on their prescription drugs.  Additionally, the donut hole will be incrementally closed by 2020.

I am also a proud cosponsor of the Medication Therapy Management Empowerment Act, which will improve and expand medication therapy management (MTM) for Medicare beneficiaries with chronic disease.  Recognizing that MTM services can play a critical role in reducing medical errors and containing health care costs, this bill would ensure pharmacists receive appropriate reimbursement for helping Medicare beneficiaries make the best possible use of their medications.

In South Dakota, we face numerous public health challenges, many exacerbated by the rural nature of our communities. Public health involves many activities at the local, state and national levels. Such work involves surveillance of diseases, diagnoses of health hazards in communities, health education and health promotion regarding both chronic and infectious disease, and ensuring access to essential health care services.

Some of the public health challenges we are facing in South Dakota include: 1) Cancer and stroke death rates which parallel the U.S. averages, 2) A motor vehicle death rate which ranks in the top 10 in the nation, 3) Occupational fatality death rate which ranks 10th highest in the nation, and 4) Teen deaths from accident, homicide or suicide ranking 10th highest in the nation. South Dakota also suffers from one of the highest incidences of Fetal Alcohol Spectrum Disorders (FASD) in the nation, high rates of diabetes among the elderly and Native Americans, significant smoking rates, and limited numbers achieving recommended levels of physical activity and high rates of obesity.

Addressing these public health issues is a challenge within itself, but finding workable solutions within a rural context presents additional challenges that we must consider. Rural states and communities face a continuing problem of attracting and retaining the proper mix of public health professionals.

Whether the threat is from a newly emerging infectious disease, bioterrorism, or a chronic health care condition, improving our public health capacity will yield countless benefits to individuals, communities and our state as a whole.

As part of my efforts to improve public health in South Dakota, I have introduced legislation to improve the federal government’s response to the problem of Fetal Alcohol Spectrum Disorders (FASD). FASD is an umbrella term that describes a range of physical and mental birth defects that can occur in a fetus when a pregnant woman drinks alcohol. Alcohol exposure during pregnancy is a leading cause of non-hereditary cognitive disability in the U.S. Many children affected by maternal drinking during pregnancy have irreversible conditions, including severe brain damage, which causes permanent, lifelong disability.

While there is no known cure, FASD is 100% preventable. That is why I have led efforts to advance legislation that would address this public health threat and I look forward to reintroducing the Advancing FASD Research, Prevention, and Services Act during the 112^th Congress. My bill will help states and communities develop and implement targeted outreach programs; improve coordination among Federal agencies involved in establishing strategies to improve outcomes for individuals with FASD by establishing stronger communication lines; improve support services for individuals living with FASD and their families; strengthen educational outreach efforts to doctors, teachers, judges, and other whose work puts them in contact with people with FASD, or with women who might be at risk for drinking during pregnancy.

Rural states like South Dakota face numerous challenges when it comes to meeting the health needs of our communities. We can and should continue to push for improved access to quality health care, and we need to attract more health professionals to our state's underserved areas. A key to this endeavor is ensuring adequate reimbursement by Medicare and Medicaid. I have supported many legislative efforts to guarantee rural interests are accounted for in federal payment policies, including: ensuring fair reimbursement to critical access hospitals and rural health clinics, expanding access to mental health services, and improving the payment methodology for physicians and other health care providers. I have also long supported increased funding for community health centers, workforce development, and the expansion of telehealth services.

I am pleased that several provisions in the health care reform law will build on our state’s strengths and ensure that health care providers are paid fairly for treating Medicare patients, particularly in rural areas.  With reform. health care professionals who serve patients in rural areas will receive much-needed increases in reimbursement from Medicare, and new incentives that will help grow the health care workforce in our state.

As a member of the bipartisan Senate Rural Health Caucus, I will continue to push for improvements to these critical health care programs, which can provide stability for the rural areas of our state. The Rural Health Caucus has a strong history of working across the aisle for the benefit of rural health care providers and their patients. I look forward to continuing that important work in the current Congress.

As a member of the bipartisan Senate Rural Health Caucus, I will continue to push for improvements to these critical health care programs, which can provide stability for the rural areas of our state. The Rural Health Caucus has a strong history of working across the aisle for the benefit of rural health care providers and their patients. I look forward to continuing that important work in the current Congress.