Health Reform Update - 3/24/10

There’s been plenty of talk recently about what the health reform bill will mean for Americans. Today, we want to focus on the 10 best immediate benefits that health care reform will have for everyone. These are just a few of the changes that are incorporated into the house bill, and they include the provisions that the Senate is currently voting on.

1) Small business tax credits.
• Tax credits of up to 35% of premiums are immediately available to small businesses that offer coverage. In 2014, these credits will increase to offset 50% of the cost.
2) Closing the Medicare Part D Donut Hole
• All Medicare enrollees that hit the donut hole this year will receive a $250 rebate. Beginning next year, brand-name drugs will be discounted by 50% in the donut hole. By 2020, the donut hole will be completely closed.
3) Free preventative care
• Beginning January 1, 2011, there will be no copays or deductibles for any preventive services paid for by Medicare.
• Starting in 6 months, all new private plans will be required to offer preventive services without charging copays or deductibles.
4) Ending recissions
• Starting in 6 months, health insurance companies will no longer be allowed to drop people when they get sick.
5) No lifetime or annual limits on coverage
• Starting in 6 months, insurance companies will not be allowed to place lifetime limits on benefits.
• Beginning in 6 months, new regulations would restrict the use of annual benefit limits to deny services to patients. In 2014, annual limits would be banned from all new plans.
6) No discrimination against children with pre-existing conditions
• In 6 months, insurance companies will be banned from denying coverage to children based on pre-existing conditions. In 2014, this rule will be applied to people of all ages.
7) New appeals process
• Creates a new and effective internal and external appellate process to allow a patient the opportunity to challenge decisions made by his or her insurer.
8) Premiums must go towards paying for care
• Starting January 1, 2011, all large-group market insurers must spend at least 85% of the cost of premiums on providing actual care. Insurers that cover individuals or small groups must use at least 80% of premiums to pay for care. Companies that don’t do this will have to refund their policyholders.
9) Immediate creation of a high-risk pool
• In 90 days, a temporary subsidized “high-risk pool” will open for people who cannot get insurance due to pre-existing conditions. This pool will close once the exchange opens and insurance companies are banned from denying coverage to adults (in 2014).
10) Health insurance consumer information
• Provides immediate funding to state governments to create programs that will help patients learn their rights and file complaints and appeals when care is denied.