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Updates

What will health insurance reform mean for you?

Posted on June 28, 2010

Americans will begin to see significant benefits of the health care reform bill when it takes effect this year, with other important reforms following shortly after. How will you benefit? Check out just some of the ways health insurance reform could help you.

Health insurance reform will immediately begin to lower health care costs for American families and small businesses.

  • This year, small businesses that choose to offer coverage will begin to receive tax credits of up to 35 percent of premiums to help make employee coverage more affordable.
  • This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary high-risk pool.
  • This bill starts to close the Medicare Part D donut hole in 2010 by providing a $250 rebate to Medicare beneficiaries who hit the gap in prescription drug coverage. And beginning in 2011, the bill institutes a 50% discount on prescription drugs in the donut hole.
  • Starting this year, new private plans will be required to provide free preventive care: no co-payments and no deductibles for preventive services. And beginning January 1, 2011, Medicare will do the same.

With health insurance reform, Americans will see an immediate expansion of coverage:

  • This year, children with pre-existing conditions can no longer be denied health insurance coverage. The bill outlaws that practice for new health plans as well as grandfathered group plans.
  • This year, new health care plans and select grandfathered plans will allow young people to remain on their parents’ insurance policy up until their 26th birthday.
  • This year, insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage.
  • The health reform bill will increase the number of primary care doctors, nurses, nurse practitioners and physician assistants through new investments. This funding takes effect in the next fiscal year.

Health reform will immediately curb some of the worst insurance industry practices and strengthen consumer protections:

  • Beginning this year, this bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.
  • Starting January 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services. Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services. Any insurers who don’t meet those thresholds will be required to provide rebates to their policyholders.
  • This bill holds insurance companies accountable for unreasonable rate hikes. Starting in 2011, it helps states require insurance companies to submit justification for requested premium increases. Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance exchanges.

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