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.