The 411 on the Health Care Bill

As many of you are probably aware, the Health Reform Bill passed Sunday night by a narrow margin in the House of Representatives. As the health care debate continues to heat up, many of us are sitting back wondering exactly what changes - and benefits - the American people will see as a result of this bill.

I came across an interesting article by Kaiser Health News entitled "The Immediate Effects of The Health Reform Bill," by Julie Appleby and Kate Steadman. In my opinion, this article does a great job of explaining both the short term and long term effects we can expect from the health reform bill.

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Changes that would occur this year include:

1. Dependent children could remain on their parents' health insurance plans until age 26.
2. Some senior citizens would get more help paying for drugs in Medicare.
3. People with health problems that left them uninsurable could qualify for coverage through a federal program.

Some of the items that go into effect in the first year include:

• New help for some uninsured: People with a medical condition that has left them uninsurable may be able to enroll in a new federally subsidized insurance program that is to be established within 90 days. The legislation appropriates $5 billion for this, although that may not be enough to cover all who apply; it's not clear how much consumers would pay as their share of the cost. About 200,000 people are covered in similar state programs currently, at an estimated cost of $1 billion a year, says Karen Pollitz, a research professor at Georgetown University.


• Discounts and free care in Medicare: The approximately 4 million Medicare beneficiaries who hit the so-called “doughnut hole” in the program’s drug plan will get a $250 rebate this year. Next year, their cost of drugs in the coverage gap will go down by 50 percent. Preventive care, such as some types of cancer screening, will be free of co-payments or deductibles starting this year.


• Coverage of kids: Parents will be allowed to keep their children on their health insurance plan until age 26, unless the child is eligible for coverage through a job. Insurance plans cannot exclude pre-existing medical conditions from coverage for children under age 19, although insurers could still reject those children outright for coverage in the individual market until 2014.


• Tax credits for businesses: Businesses with fewer than 25 employees and average wages of less than $50,000 could qualify for a tax credit of up to 35 percent of the cost of their premiums.


• Changes to insurance: All existing insurance plans will be barred from imposing lifetime caps on coverage. Restrictions will also be placed on annual limits on coverage. Insurers can no longer cancel insurance retroactively for things other than outright fraud.


• Government oversight: Insurers must report how much they spend on medical care versus administrative costs, a step that later will be followed by tighter government review of premium increases.

Source: Kaiser Health News. To read in its entirety, click here.
Photo Credit: Kaiser Health News

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Until Next Week,

Michelle D.