Recently, President Obama and the U.S. government passed a Health Care Reform Bill that is likely to see the greatest reform in the health care system since 1965 when Medicare was first introduced. These changes will affect in some way or another every U.S. citizen. Some people will benefit greatly from the mandatory changes. Others will find themselves paying higher taxes and premiums, depending on their income levels. The changes are to come into effect gradually over the next four to 10 years with some changes being implemented immediately. Here’s a brief overview of some of the most significant changes in the Health Care Reform Bill.
Health Care for Uninsured Persons with Preexisting Conditions
Perhaps one of the most significant changes is that by 2014, health insurance companies will no longer be allowed to deny coverage on the basis of preexisting medical conditions. To fill the gap while this is being instituted, people with preexisting conditions will in the interim be given access to health care through a temporary high-risk pool. This change is to start nine months from the enactment of the bill.
Health Cover for Children with Preexisting Conditions
Like adults, children with preexisting medical conditions are also no longer denied coverage. This is one of the first changes to be implemented in the health care reform policy and will come into effect six months after the final enactment.
Free Preventative Screenings for Medicare
Up until this point in time, Medicare policy holders had to pay co-payments for medical consultations, including preventative screenings and check-ups. From January 2011, there will no longer be any co-payments on preventative care. All preventative screening tests and consultations will be covered in full by Medicare. In addition, preventative services will be exempt from deductibles.
No More Insurance Rescission
This reform is to provide great benefit to people who faithfully pay insurance premiums over the years and who may require extensive medical treatment later in life. Previously insurance companies had a habit of rescinding the policy a few months after a person became ill, leaving them without medical coverage when they needed it most. Coming into effect six months after the enactment of the bill, insurance companies will no longer be allowed to cancel policies on this basis.
Reforming the Medicare Part-D Donut Hole
Many Medicare beneficiaries who have regular prescriptions are affected by the “donut hole.” This essentially means that there is a gap in the payment policy which needs to be filled by the patient in order for them to get their medication. This benefit sees people receiving a $250 rebate immediately for affected policy holders. Starting from 2011 the bill implements a 50 percent discount on brand name medication for seniors who find themselves in the donut hole. The aim is that by 2020, the donut hole will be completely eliminated. Assistance for Early Retirees
Owing to the recession, many companies offered more elderly employees early retirement. The bill helps to create immediate relief for businesses by offering a temporary re-insurance program to help them offset the costs of health care benefits of retirees between the ages of 55 and 64 years of age. The change comes into effect 90 days after the enactment of the bill and is due to end once the State Health Insurance Exchanges become available.
The End of Lifetime Coverage Limits
Previously, health insurance companies were allowed to implement lifetime coverage limits. This meant that coverage could be cancelled if the policy holder exceeded their expected lifespan. Coming into effect six months after the final enactment of the bill, health care insurance policies will no longer be able to implement lifetime coverage limits.
Tax Credits for Small Businesses
Starting in 2010, small businesses who offer employees health care insurance benefits will receive tax credits up to 35 percent of the cost of the premium payments. This is provided as an incentive for more small businesses to have their employees on a health plan. From 2014, the tax credit will increase to 50 percent of the insurance premiums paid when health care becomes mandatory.
Greater Accountability from Health Insurance Companies
Starting from January 2011, health insurance companies will be required to prove that they are spending at least 80 percent of policy holders’ insurance premiums on actual health care medical expenses. This is to ensure that policy holders are being looked after and that the premiums are not being used for marketing campaigns or executives’ salaries. Larger companies will have to account for 85 percent of their spending. Any health insurance companies not meeting this requirement will be required to rebate their policy holders. Extended Coverage for Young Adults
This provides relief for young adults up to the age of 26 years. They will now be allowed to stay on their parents’ policies until that age and receive medical benefits. This is subject to the parents agreeing to this option.
More Health Care Centers and Staff
The bill has assigned funding to increase the number of community health care centers and to train up much needed medical staff. Specific programs to fund the training doctors, nurses and other health care professionals are to be implemented.
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