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Heath Care Reform ComponentsNowJul-2010Oct-2010Jan-2011Jan-2013Jan-2014Jan-2018Jan-2020
Source: Christian Science Monitor - Health Care Reform 101 (edited)
A. HEALTH EXCHANGES - States set up competitive health insurance exchanges for people who are unemployyed or work for a small company. Plans must meet government standards to be in the exchange. The federal government will provide states with start-up money. If a state declines, the federal government can open an exchange in that state. (start 2014)100%100%100%
B. MANDATORY INSURANCE - Mandate most US citizens and legal residents to purchase “minimal essential coverage” for themselves and their dependents either through their employer, or, if their employer doesn’t offer health insurance, through marketplace exchanges. (start 2014)100%100%100%
C. TAX ON HIGH INCOMES - For high incomes {$200,000/yr single $250,000/yr married}: Medicare Part A(Hospital) increased ) 0.9% to 2.35%; also for high incomes, new 3.8% tax on unearned income (dividends, interest, ...). (start 2014)
D. TAX EXPENSIVE PLANS: Excise tax on expensive health plans > $27,500 (start 2018)100%100%
Source: White House Overview of Health Reform (edited)
1. SMALL BUSINESS TAX CREDITS-- Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. (start 2010, 50% in 2014)35%35%35%35%35%50%50%50%
2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE-- Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. (start 2010). (in 2011, 50% discount on brand-name drugs in the donut hole; closes the donut hole by 2020.) $25050%>>>>>>100%
3. FREE PREVENTIVE CARE UNDER MEDICARE-- Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. (start 2011)100%100%100%100%100%
4. HELP FOR EARLY RETIREES-- Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. (start 90 days)temptemptemptempExchExchExch
5. ENDS RESCISSIONS-- Bans health plans from dropping people from coverage when they get sick. (start 6 months)100%100%100%100%100%100%
6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS-- Prohibits health plans from denying coverage to children with pre-existing conditions. (start 6 months, 2014 all persons)childrenchildrenchildren100%100%100%
7. BANS LIFETIME LIMITS ON COVERAGE-- Prohibits health plans from placing lifetime caps on coverage. (start 6 months)100%100%100%100%100%100%
8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE-- Tightly restricts new plans' use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. (start 6 months, 2014 all plans.) newnewnew100%100%100%
9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS-- Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. (start 6 months; in 2018 applies to all plans.)privateprivateprivateprivateallall
10. NEW, INDEPENDENT APPEALS PROCESS-- Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. (start 6 months)100%100%100%100%100%100%
11. ENSURING VALUE FOR PREMIUM PAYMENTS-- Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. (start 2011)85%85%85%85%85%
12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL)-- Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool. (start 90 days)temptemptemptemp100%100%100%
13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS' INSURANCE - Requires health plans to allow young people up to their 26th birthday to remain on their parents' insurance policy, at the parents' choice. (start 6 months).100%100%100%100%100%100%
14. COMMUNITY HEALTH CENTERS-- Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. (start FY 2010).100%100%100%100%100%100%100%100%
15. INCREASING NUMBER OF PRIMARY CARE DOCTORS-- Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. (start FY 2010)100%100%100%100%100%100%100%100%
16. PROHIBITING DISCRIMINATION BASED ON SALARY-- Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. (start 6 months)100%100%100%100%100%100%
17. HEALTH INSURANCE CONSUMER INFORMATION-- Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. (Start FY 2010)100%100%100%100%100%100%100%100%
18. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM-- Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. (start 2011)100%100%100%100%100%
Also: The bill directs more than $40 billion over 10 years into higher education, with $36 billion going to the Pell Grant program. $2 billion will fund grants for community colleges over the next several years. An additional $2.5 billion will be committed to historically black colleges and institutions primarily serving Hispanic students.
See also: Segal (Benifits Consultant) - Stat! Health Reform Weekly