What Does Health Care Reform Mean For Me?

The passage of the recent health-care reform bill has left many Americans confused about how it will affect them. Learn what immediate changes of health-care reform could affect you.

Many Questions!

Will I loose my health insurance coverage through my employer? Will my insurance costs increase? Will the government dictate what type of health insurance policy I have? These are just a few of the questions Americans have had since President Obama signed into law the $938 billion Health Care and Education Reconciliation Act of 2010 on March 23. And after a year-long debate about reform and a bill that’s over 2,000 pages long, it’s no wonder people are confused.

So how will the new health-care reform bill affect you? As with any matter this complicated, it all depends—on your age, your income, and other factors. Following is a brief overview of some of the most-talked-about changes that could affect you in the immediate future.

I currently have private insurance

If you currently have health insurance through your employer, you do not need to change your coverage and you will continue to have the choice of doctors you have today. The same holds true if you purchase individual insurance on your own. In addition, it is unlikely that you will have to pay higher deductible or co-pays as a result of health care reform.

The following provisions are scheduled to be effective within six months of the bill’s enactment:

• No discrimination against children with pre-existing conditions. Employer plans and new plans in the individual market are prohibited from denying coverage to children with pre-existing conditions.
• Rescissions are prohibited. Health plans cannot drop people from their coverage when they get sick.
• Lifetime limits, also called lifetime caps, on coverage are banned.
• Annual limits on coverage will be tightly regulated.
• Free preventive care under new plans. New private plans will be required to cover preventive services with no co-payments. Preventive services will also be exempt from deductibles.
• No discrimination based on salary. New employer health plans are prohibited from using salary levels as a basis for health-care coverage eligibility.

I am a senior

If you are a senior on Medicare, you will not notice any changes to your guaranteed benefits and you will continue to have the choice of doctors you have today. Several provisions in the health-care bill meant to help seniors will take effect within the year. They include:

• The “donut hole” created by Medicare Part D will begin to close. Effective for the 2010 calendar year, a $250 rebate will be provided to Medicare beneficiaries who spent more than $2,700 but less than $6,154 on prescription drugs. In 2011, participants will receive a 50 percent discount on brand-name prescription drugs and the hole will be completely closed within 10 years.
• Creation of a temporary re-insurance program for early retirees. This will help protect coverage for early retirees ages 55 to 64.
• Free preventive services under Medicare. Co-payments for preventive services will be eliminated and deductibles for preventive services will be exempt.

I am uninsured

If you are currently uninsured, you may have access to new insurance choices. Impending changes that will take effect for the uninsured include:

• Creation of an interim high-risk pool. Effective 90 days after enactment, those who are uninsured due to a pre-existing condition will have immediate access to insurance until the health insurance exchanges are up and running in 2014.
• Extends coverage for young adults. Effective six months after enactment, young adults will be allowed to remain covered on their parents’ insurance policy up to age 26.

I own a small business

If you are a small business owner, you will not be required to provide health insurance to your employees.

However, if you choose to do so, you could see a tax credit of up to 35 percent of the premiums your business pays to cover your workers. (There is also a credit of up to 25 percent for small nonprofit organizations.)

To qualify for the credit, your business must cover at least 50 percent of the cost of health care coverage for your workers, pay average annual wages below $50,000, and have less than the equivalent of 25 full-time workers.

For an interactive chart showing how health-care reform will affect your personal situation, visit the tools available at the Washington Post and the whitehouse.gov.

See this article for a more complete timeline of health-care reform changes to occur now and in the coming years.

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