President Barack Obama signed historic health reform legislation on Tuesday, March 23, 2010. This legislation will provide security and stability for people with coverage, and new, affordable choices for those without insurance. The bill is expected to reduce the number of uninsured Americans by 32 million by 2014 (when the bill is fully implemented), and prevent people from becoming uninsured due to a loss of income, being between jobs, or due to health status.
Many changes will happen within these 4 years of implementation and several changes, such as providing some financial assistance for Medicare beneficiaries who reach the Part D donut hole this year, will take effect immediately. As summarized in an article by Health Access, for Californians in 2010, the health reform will:
1. Prevent people from being denied coverage based on “pre-existing conditions.”
- Soon, people who are uninsured due to a pre-existing condition will be able to buy insurance through a special insurance program. Right now, Californians are left in a lurch: our state has a small, underfunded “high-risk pool” that currently has a waiting list–even though it is estimated that over 400,000 have been denied coverage due to health status.
- Within 6 months of passage, no new health plan will be able to discriminate against children with pre-existing conditions.
- In a few years, no insurance plan will be able to deny coverage to anyone for pre-existing conditions.
2. Provide people with more security, by outlawing the worst insurance company abuses. Insurance companies will:
- No longer be able to cancel insurance coverage retroactively when you get sick. Over 6,000 Californians had their coverage rescinded in the past several years, and health reform would end the practice of rescission.
- No longer be able to put lifetime limits on the dollar value of benefits
- No longer be able to place co-payments or cost-sharing on key preventive benefits
3. Provide real relief to young adults and their families, to seniors, and to small businesses. Health reform will:
- Allow young adults up to age 26 to stay covered on their parents’ insurance
- Reduces prescription drug costs for seniors. Seniors whose spending falls into Medicare’s prescription drug donut hole will have hundreds of dollars of immediate help and the entire coverage gap will be eliminated over time.
- Gives subsidies to small businesses. Small businesses choosing to offer coverage to workers will receive a tax benefit of up to 35% of premiums.
The Senate also started its debate today on a package of “reconciliation” improvements that were passed by the House of Representatives. They are expected to vote on the package before the end of the Easter recess at the end of the week.
More details on how health care reform will directly affect Medicare beneficiaries is coming soon. Note that no Medicare benefits will be cut due to reform; all legislative changes affecting Medicare are positive for beneficiaries. Medicare Advantages payments are frozen which could result in MA plans deciding to drop some of their non-Medicare covered benefits, and/or raise premiums and copayments. While CHA sees this as a positive step (MA payments being frozen) as MA plans on average cost Medicare 14% more than if the same services were provided through fee-for-service Medicare, many MA plans do not and have marketed these legislative changes as negative for their enrollees.
Stay tuned for more info!