What health insurance reform will do for you, starting this year

It’s a historic day for health care in America. The House will pass the Senate bill and the President will sign. The reconciliation effort–odds and ends of the House and Senate compromise–still has to run some roadblocks in the Senate, but soon we’ll have a national program for covering the uninsured. The major provisions don’t take effect until 2014–for example, requiring you to have coverage and preventing insurers from turning down adults with pre-existing conditions. But you’ll see some valuable changes in just three to six months after the President signs the bill.

Here’s a brief summary. Odds are, you’ll find at least one change that relieves you of some of your health care worries right away:

For young people
–You’ll be allowed to stay on your parents’ group plan or individual policy until you’re 26. If you get out of school and can’t find a job, or land a gig with no benefits, medical care will still be open to you. If you’re a parent, you’ll probably be equally relieved that your kids aren’t going bare. A few states mandate a higher age for keeping children on the plan, if the parent requests it, but in most states, young people have had to leave the plan at 19 or 21. Insurers will also be banned from denying coverage to to children with pre-existing conditions.

For people buying new private plans–Preventive services will be free, with no co-pays or deductibles.

For early retirees--You’ll get access to an insurance risk pool, at lower cost, if you’re retired, between 55 and 64 and not in a retiree group plan. You’ll switch to coverage through a health insurance exchange when it becomes available in 2014.  Studies have shown that, people in this age group who have gone uninsured during the years up to 65,  enter Medicare sicker than their peers, spend more time in the hospital and cost more to treat. Now, insurance will be possible.

For the uninsured of all ages--You, too, get immediate access to a temporary high-risk pool until the new insurance exchanges are in place.

For the seriously ill--The bill bans insurance companies from the reprehensible (and, for them, highly profitable) practice of canceling the policies of people who get an expensive illness. That’s a process called “rescission.” The company re-investigates your medical history, decides that your original application failed to report a pre-existing condition and kicks you out, even though you’ve been paying premiums for years. From now on, rescissions are out. Insurers will also be restricted from putting lifetime dollar limits on new coverage (although the limits on existing coverage will stand, for now).

For small businesses–Tax credits of up to 35 percent for firms that choose to offer health coverage to their employees. That’s effective immediately.

For seniors–If you’re on a Medicare drug plan and need a lot of prescription drugs, the House would give you a $250 rebate this year when you hit the “donut hole.” Next year, brand-name drugs in the donut hole would be discounted by 50 percent. The Senate has no such provision, so you’ll have to wait for reconciliation to see how this comes out.

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Question // 03/22/2010 at 8:25 am

Thank you for this information. What is the downside of this bill? Will we pay higher taxes? Will people who have good coverage now be penalized in any way?

Jane // 03/23/2010 at 10:34 pm

People with good coverage can keep what they have. If it’s an individual policy and your income is moderate, you will get subsidies to help you pay, in 2014. Also in 2010, high income people will have their taxes raised to help pay for the uninsured–namely, people not lucky enough to have employee policies, or who aren’t accepted by insurers because of pre-existing conditions, or don’t have a high incomes to buy insurance themselves. Taxes will hit singles earning $200,000 or more and couples with $250,000 or more.

J // 03/22/2010 at 11:34 am

Thank you for posting this information. I am emailing this page to friends and family.

I’ve seen too many uninsured and underinsured friends destroyed by medical expenses over the past ten years. I am glad Americans will have better financial protection soon.

Shirley Gallagher // 03/24/2010 at 8:07 pm

I am so impressed with the way you simplify this bill. I wish that this would be published in our newspaper, The Cincinnati Enquirer. It seems that all the papers publish is information that frightens the average reader.

Judy Sanders // 03/26/2010 at 1:46 pm

Hi Ms. Bryant:
Thanks for the update. This is a good start, but only a start. America can not move forward without healthcare, secure borders, and decent education for all. The rich should help the poor since we all float in this boat together!

James D. Kane // 07/06/2010 at 9:49 am

I agree with Ms. Sanders that for America to prosper, there should be better healthcare, security and education. Helping our fellow citizens would definitely help this nation little by little. But I just hope this doesn’t make other people lazy not to get a job, just because they’re still covered anyway.

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