On Sunday March 22nd, 2010 the House voted 220-207 to pass health care reform. The bill passed the Senate 56-43. President Obama signed the bill on Monday March 23rd.
3 Months from final passage the bill provides immediate access to coverage for people with no insurance due to a pre-existing condition. Which means that before Independence day on July 4th, 2010, Americans who had no coverage because they were already sick will become free from the worry of huge healthcare bills destroying their lives.
The drawback is that the coverage comes at a high cost – through so-called “High Risk Pools” of hard to insure people and the cost for that insurance is extremely high. Still better than no insurance at all, guaranteeing them they won’t have to sell their homes or force them to go bankrupt to pay for massive hospitalization costs.
The Washington Post says that Healthcare doesn’t actually kick in until:
2014
- Provides subsidies for families earning up to 400 percent of the poverty level — or, under current guidelines, about $88,000 a year — to purchase health insurance.
- Requires most employers to provide coverage or face penalties.
- Requires most people to obtain coverage or face penalties.
By 2019
- Expands health insurance coverage to 32 million people.
From the New York Times:
The uninsured are clearly the biggest beneficiaries of the legislation, which would extend the health care safety net for the lowest-income Americans. The legislation is meant to provide coverage for as many as 32 million people who have been shut out of the market ??? whether because insurers deem them too sick or because they cannot afford ever-rising insurance premiums. For people already covered by a large employer ??? most Americans, in other words ??? the effect would not be as significant. And yet, just about everyone might benefit from tighter insurance regulations.
The following is Q&A is from WhiteHouse Health Care Website but each question and answer is on a separate page. It is aggregated here to make it more accessible – please distribute freely to make it available to your audience – by distributing this link: https://bit.ly/9r6wwR
Take a few minutes to find out what health insurance reform would mean for you and your family. To begin, select which one describes your situation:
Situation 1 – I have insurance through my work
Keep your doctor and plan if you like it, but your plan will be strengthened and you’ll be protected from insurance company abuses.
Q: Will my premiums / costs go up because of health reform?
A: No.
According to the independent and non-partisan Congressional Budget Office, people who get coverage through their employer today will likely see lower premiums.
Reform will lower premiums by reducing administrative costs, increasing competition between insurance companies and creating a larger pool of insured Americans.
And remember, the cost of doing nothing is high. In ten years, health care spending for each employee at an average big company will be $28,530.
Q: Will my coverage at work change?
A: No. If you like the health plan you have, you will be able to keep it.
Nothing in the health reform bill will require you to change your coverage. What the bill will do is strengthen the coverage you get at work by making it easier to understand and adding some clear rules to rein in the worst insurance company abuses.
Language explaining what’s in your plan will have to be simple and clear so that you know what your benefits are and what’s covered.
Insurance companies will no longer be allowed to place a lifetime limit on the amount of care they pay for. And in some cases insurance companies with excessive overhead costs will be required to give you a rebate. And, if your adult children are living at home up to age 26 they can be covered under your family policy.
Q: Will the government take my choice of doctor away?
A: No.
Nothing about the President’s proposal will interfere with the choice of doctors you have today. The legislation will not cause you to change the coverage you have at work today.
Q: What are you going to do about all the confusing forms I have to fill out?
A: Make it simple.
Health reform will require plans to use clear and plain language on insurance forms so that you can easily understand what benefits and what doctors are covered in your plan. And, it will standardize forms to reduce the confusing and overwhelming paperwork that all Americans have to confront today.
Situation 2 – I own a small business
You won’t be required to provide health insurance to your employees, but if you choose to, new tax credits will make covering your employees more affordable. You will also have access to a new insurance exchange to find the best deal, and the entire process will be simpler.
Q: Will I be required to provide coverage that I can’t afford?
A: No.
The President’s proposal does not require that small businesses provide coverage to their employees. Instead, the President’s proposal provides tens of billions of dollars in new tax-credits to small businesses to make it easier for them to provide coverage if they choose to do so.
Today, small businesses pay up to 18 percent more than large firms for the same health insurance policy. The independent and non-partisan Congressional Budget Office found that with health insurance reform, premiums for small businesses will go down.
In addition, you will be protected from sudden, arbitrary rate hikes because a worker get sick; because insurance companies will no longer be permitted to base the cost of coverage on health status.
Q: Why would it be easier to provide coverage than it is today?
A: Reform will provide at least three tangible benefits that will make it easier and cheaper for small businesses to provide coverage:
First, by allowing small businesses to buy coverage through an insurance exchange—the marketplace where you can shop for health insurance—small businesses will get the benefit of pooling together their employees with millions of others, which will lower their own exposure, lower risk and ultimately lower costs.
Second, operating through an exchange will reduce administrative costs for small businesses and their employees by enabling them to easily and simply compare the prices, benefits, and quality of health plans.
Third, many small businesses will be able to get a tax credit to help cover the cost of the coverage they offer.
Q: Will I be able to pool with other small businesses to buy coverage?
A: Yes.
The President’s proposal bill gives small business owners the leverage that big businesses enjoy by allowing them to buy coverage through the exchange. This gives them greater buying power in the market place and spreads the cost of coverage across a much larger pool – both of which help to hold down premiums.
Q: Will my employees be able to buy coverage if I cannot afford to provide it?
A: Yes.
Employees at small businesses that don’t offer coverage can get tax credits to purchase coverage.
Q: Will my taxes go up to pay for the cost of covering the uninsured?
A: No.
Your business taxes will not go up. Instead, you may be eligible for new tax credits to help offset the cost of covering your employees.
Q: What are you going to do about all the confusing forms I have to fill out?
A: Make it simple.
Health reform will require plans to use clear and plain language on insurance forms so that you can easily understand what benefits and what doctors are covered in your plan. And, it will standardize forms to reduce the confusing and overwhelming paperwork that all Americans have to confront today.
Situation 3 – I have medicine
Health reform protects Medicare. Medicare will be made more financially secure and seniors who hit the prescription drug “donut hole” will be protected from high costs for their medicines.
Q: Will my benefits be cut?
A: No.
Your guaranteed Medicare benefits will not be cut.
In addition, you will have benefits you don’t have today: Preventive services like cancer screenings at no cost, and a substantial reduction in prescription drug prices if you fall into that gap in coverage known as the “donut hole”. Over time the bill closes this coverage gap completely. And the Medicare Trust Fund will be extended for more than 9 years, making sure that the Medicare program will be there for seniors now and in years to come.
Q: Will I be able to keep my doctor?
A: Yes, you will. Health insurance reform will not affect the choice of doctors you have today and it won’t affect your relationship with your doctor.
The legislation aims to increase the number of primary care providers, giving you greater access to doctors than you have today.
Q: Will my quality of care be affected?
A: It will improve.
The Act creates incentives for providing care that relies on teams of primary care doctors, specialists, and nurses working together to coordinate and monitor care more effectively. These new models encourage doctors to better coordinate a patient’s care, track prescriptions, and avoid duplication of treatments or tests. This will help improve the quality of care, prevent medical complications, and save money.
The bill will also provide stronger incentives for hospitals to reduce avoidable and harmful readmissions, cut down on medical errors, and prevent healthcare acquired infections that occur too frequently.
Situation 4 – I don’t have insurance
You will have access to new insurance choices in the same insurance marketplace where all members of Congress will buy their insurance, receive tax credits to help you afford coverage if needed, and get protections from insurance company abuses like denying you coverage based on pre-existing conditions.
Q: Can I afford coverage?
A: Clearly, the system we have today is broken. If you don’t have health coverage, there’s no limit on how much insurance companies can charge you, and they can decide to refuse to sell you a policy at their whim. Health insurance reform will change all of that.
For the first time in history, there will be limits on how much anyone will have to pay to receive health care coverage. And depending upon your income, you may be among the tens of millions of Americans who will get a tax credit to to help pay for your coverage.
And for the first time in history, insurance companies will no longer be allowed to simply tell you “no”. They will be required to offer coverage regardless of your health status, and they cannot jack up rates or drop you from your coverage when you get sick.
Q: Can I get insurance if I have a pre-existing condition?
A: Yes.
One of the most important aspects of this reform is to finally end the practice of insurance companies denying you coverage based on your health status.
Soon after the law is enacted, insurance companies will no longer be allowed to deny coverage to children with pre-existing conditions. Uninsured adults with pre-existing conditions will have access to a high-risk pool. And once the insurance exchange marketplace is up and running, insurance companies will no longer be allowed to deny coverage to anyone based on their health status.
Q: Am I going to be forced into a government plan?
A: No.
You will be able to shop among private insurance plans that will be sold in the insurance exchange—a marketplace where you can choose what is right for you and where members of Congress will also buy their insurance. Today many markets are dominated by one or two insurance companies. That will change, and you will have many more affordable choices than you have today.
Q: How will I know which plan is best for me?
A: A new website will be available to provide easy to understand information that will help consumers make informed choices based on their needs. In addition, the new insurance marketplace – the exchange – will provide consumer assistance offices with trained experts to help you “navigate” the health care choices and help you enroll in the plan you choose.
Q: Can I buy insurance in another state?
A: Yes.
If you live in a State that is part of an inter-state compact, you can purchase coverage in a neighboring State. These interstate markets will continue to provide basic consumer protections, access to essential benefits, and other insurance reforms that are included in health reform.
Q: Will the government decide what treatment I can get?
A: No.
Treatment decisions will be made by your doctor and you, just as they are today. The government will not interfere with your relationship with your doctor.
Situation 5 – I buy my own insurance
You will have access to new insurance choices in the same insurance marketplace where all members of Congress will buy their insurance. Either way, there will be new protections from insurance company abuses, and tax credits will make coverage more affordable.
Q: Will I pay more than I am paying today?
A: No.
You will likely pay less—perhaps much less. If you buy coverage like you have today on your own, premiums are expected to drop by 14 to 20 percent. If you get coverage through your job, premiums could decline by up to 3 percent.
In addition, many Americans buying coverage in the individual market will qualify for tax credits that reduce their premiums by an average of nearly 60 percent – and they will get better coverage than what they have today.
Q: Will I have to pay higher co-pays and deductibles?
A: Highly unlikely.
Health insurance reform will limit what you have to pay out of pocket, a protection that does not exist today. And for the first time, no one will be required to pay more than a set percentage of their income on health care coverage.
And, if you like the coverage you have today, you can keep it.
Q: Can I still see specialists?
A: Yes.
With health insurance reform, you will have more secure and comprehensive coverage. All plans in the exchange will be required to provide a package of essential benefits – a guarantee that is not available today – and the package will include preventive services at no cost. Consumers shopping in the exchange will choose from options that provide different levels of cost-sharing so that they can pick a plan that best meets their needs and financial circumstances.
Q: Will I be able to challenge coverage decisions by my insurance plan?
A: Yes.
Every insurance plan will be required to have a process for resolving disputes around your benefits and coverage, and you’ll be able to appeal any plan decisions that you disagree with to an independent appeals process.
Beyond that, States will receive support to set up independent offices to assist consumers with filing insurance complaints and appeals.
Q: What are you going to do about all the confusing forms I have to fill out?
A: Make it simple.
Health reform will require plans to use clear and plain language on insurance forms so that you can easily understand what benefits and what doctors are covered in your plan. And, it will standardize forms to reduce the confusing and overwhelming paperwork that all Americans have to confront today.
Q: What will happen if my insurance company raises my rates?
A: The President’s plan requires public disclosure of the percent of premiums applied to overhead costs, so that you can be certain you are getting the best value for your premium dollars.
If your insurance company spends too much of your premium dollars on overhead, such as big salaries, administrative costs and marketing, they will be required to give you a rebate.
Until the insurance exchange marketplace is up and running, there will be a process for annual reviews of all requested increases in premiums. Insurance companies that raise rates arbitrarily will not be allowed to sell policies in the new insurance marketplace. This process continues even once the Exchange is up and running.