Before jumping in to what the actual laws say, I decided it was a good idea to see what the White House website said about the reform.
To find it in case you were wondering, go to Whitehouse.gov. Hover on the issues tab and look for Health Care. Click. You’ll be directed to the “At a Glance” page. Go from there to the “About the New Law” tab. There is a nice neat synopsis similar to many others I’ve run across online . The basic points are:
- It will be put into practice over time
- Life time limits are no longer allowed
- Insurance companies will not be allowed to kick you off if you get sick or if there is a problem with your applicaiton
- Young people will be able to stay on their parents insurance until 26 years old or until they are offered insurance by their employer
- Nearly 600,000 who purchase coverage in the individual market could gain coverage.*
- No discrimination againsts kids with pre-existing conditions. No denial of coverage for those under 19 years old.**
- No annual limits
- Certain preventative procedures are not subject to out of pocket fees like co-payments and deductibles
- Appealing via third party coverage “decisions” – I think it means if you are denied something you can appeal the decision.
- Allowing better access to contracted providers without a referral and out of network emergency care
- By 2014 competative insurance market place***
- Bring down costs and improving quality across the board including Medicare, private insurance providers – projections across decades
- Resources to help “crack down” on rising insurance premiums and developing “health insurance exchanges where consumers will have the same health insurance choices as Members of Congress”
- Create a program for retirees that is affordable for businesses to help their retired employees whom aren’t eligible for Medicare
- Make it easier for small businesses to take advantage of the small business tax credit****
- Try to maintain efficiency in the system
- For Women and Families – they mention things already discussed such as the lifetime cap. The only new thing listed is about 80/20 rule which according to them means that they have to spend $.80 of each dollar that you pay on your actual care or improvements to that care. I’m unsure what this means, but hey it sounds good. Also, if an insurance company wants to raise it’s premiums 10% or more they must provide public proof and the states can block it if they want. Finally certain preventative care won’t be subject to a co-pay – think children’s vaccines.
- Seniors – Newly listed in this sections is mention about a 50% discount if you are in the donut hole. Closing of that hole by 2020. You can still choose your own doctor. There’s also reiteration of stuff listed before – think lifetime limits.
- Employers – More reiteration. There’s reference to discounts to small employers. They route you to the IRS website to see if your business might qualify for said discounts. Also, there is a new tool for usage, HealthCare.gov, which I ran into when I was first looking for a starting point for this research. It’s basically a health insurance search engine/generator thing. Kinda cool considering it can be hard to figure out what all your options are. I know I’ll be looking @ my options as my business grows. There is also a claim that this health care law won’t add to the deficit.
- Health Care Providers – There’s mention about how making health care coverage more affordable will cut down on losses due to under/uninsured patients. Also, there is a link to another page showing how red tape will be cut and it will be easier to spend more time with patients. The law created an “Innovation Center” which will apply to Medicare and Medicade and will “test new care and payment models”. From what I can gather the goal is to make it easier to get paid as a provider from Medicare or Medicade, both of which can be very difficult. Since the claim is that there aren’t enough doctors or nurses the law wants to support the growth of those work forces as well as to help create more health centers.
- People with Disabilities – There is mention of those with pre-existing conditions whom have been without health coverage for 6 months. There is a “Pre-Existing Condition Insurance Plan” which will help these people find plans within their states. Also, the law is supposed to build upon services that disabled people may need in their community.
That’s 16 bullet points taken from The Affordable Care Act page. That’s not all though. There are four other sections including: “Relief for You”, “Myths and Facts”, “Health Care News”, and “Health Care Stories. I’ll touch on the “Relief” section here.
This section is subdivided into more sections: “Women and Families”, “Young Adults”, “Seniors”, “Employers”, “Providers”, and “Disabilities”.
So there’s that bit of information. I know it’s a lot. Hopefully it’s not confusing. Stay tuned for my coverage of the rest of the White House info and for what I learn from the law itself!
*Don’t know what this means exactly, it’s rather vague.
**What about those over 19 years old. Do they get kicked off their parents insurance for pre-existing conditions after their 20th birthday? Not clear.
*** I believe this refers to what I understand as Health Care Kiosks, where you can go and compare plans and get help with questions. Though I might be remembering or understanding this incorrectly.
****Since smaller businesses have a rougher time providing health care, by making sure they know about the small business tax credit that would conceivably help them save a bit of money – or at least even out their expenditures a bit.