Basics of Health Care Reform Outlined
Over the past year the House and the Senate have been working on an effort to provide health insurance reform that lowers costs, guarantees choices, and enhances quality health care for all Americans. Building on that year-long effort, the President's final legislation included the best ideas from both sides of the aisle offered in the course of the debate.
Health reform will make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable, stabilizing family budgets, the Federal budget, and the economy:
• It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today. This helps 32 million Americans afford health care who do not get it today – and makes coverage more affordable for many more. Under the plan, 95% of Americans will be insured.
• It sets up a new competitive health insurance market giving millions of Americans the same choices of insurance that members of Congress will have.
• It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.
• It will end discrimination against Americans with pre-existing conditions.
• It puts our budget and economy on a more stable path by reducing the deficit by more than $100 billion over the next ten years – and more than $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.
Key Provisions of Health Reform that Take Effect Immediately
1) Small Business Tax Credits-Effective beginning calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
2) No Discrimination Against Children with Pre-Existing Conditions-Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
3) Help for Uninsured American with Pre-Existing Conditions until Exchange is Available (Interim High-Risk Pool)-Effective in 2010.
4) Ends Rescissions- Effective 6 months after enactment.
5) Begins to Close the Medicare Part D Donut Hole
Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50 percent discount on prescription drugs in the donut hole; also completely closes the donut hole by 2020.)
6) Free Preventive Care under Medicare
Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
7) Extends Coverage for Young People up to 26th Birthday through Parents' Insurance-Effective 6 months after enactment.
8) Help for Early Retirees-Effective in 2010.
9) Bans Lifetime Limits on Coverage-Effective 6 months after enactment.
10) Bans Restrictive Annual Limits on Coverage-Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all new plans and grandfathered group health plans.)
11) Free Preventive Care under New Private Plans-Effective 6 months after enactment.
12) New, Independent Appeals Process-Effective 6 months after enactment.
13) Ensures Value for Premium Payments-Effective on January 1, 2011.
14) Community Health Centers-Effective beginning in fiscal year 2011.
15) Increases the Number of Primary Care Practioners- Effective beginning in fiscal year 2011.
16) Prohibits Discrimination Based on Salary-Effective 6 months after enactment.
17) Health Insurance Consumer Information
Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in fiscal year 2010.
18) Holds Insurance Companies Accountable for Unreasonable Rate Hikes- Starting in plan year 2011.