This Year, Health Care Reform

What’s in the health Care Bill? Nancy-Ann DeParle, White House Director of Health Reform, outlined some of the main benefits Americans will start to see this year:

1. This year, children with pre-existing conditions can no longer be denied health insurance coverage. Once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.
2. This year, health care plans will allow young people to remain on their parents’ insurance policy up until their 26th birthday.
3. 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. This year, restrictive annual limits on coverage will be banned for certain plans. Under health insurance reform, Americans will be ensured access to the care they need.
4. This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary subsidized high-risk pool.
5. In the next fiscal year, the bill increases funding for community health centers, so they can treat nearly double the number of patients over the next five years.
6. This year, we’ll also establish an independent commission to advise on how best to build the health care workforce and increase the number of nurses, doctors and other professionals to meet our country’s needs. Going forward, we will provide $1.5 billion in funding to support the next generation of doctors, nurses and other primary care practitioners — on top of a $500 million investment from the American Recovery and Reinvestment Act.
7. 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.
8. This year, discrimination based on salary will be outlawed. New group health plans will be prohibited from establishing any eligibility rules for health care coverage that discriminate in favor of higher-wage employees.
9. Beginning this fiscal year, this bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance companies.
10. 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.
11. Starting in 2011, this bill 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.
12. 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.
13. This year, this bill will provide help for early retirees by creating a temporary re-insurance program to help offset the costs of expensive premiums for employers and retirees age 55-64.
14. This year, this bill starts to close the Medicare Part D ‘donut hole’ 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.’

That’s a lot of much-needed change.

Photo credit: Official White House Photo by Chuck Kennedy