Health Reform – What does it all mean?
Health reform: it’s on the front of every newspaper and the lead on every newscast in the country. But, based on their coverage so far, all we really know is that the Democrats in Congress are rejoicing and the Republicans are vowing to fight it tooth and nail.
But what does it all mean? How will these thousands of pages of legislation actually affect you – the patient?
For starters, it means that 32 million Americans who are currently uninsured will have coverage. Basic insurance – which must meet certain criteria – will be more affordable, the insurance industry won’t be allowed to deny you coverage because of a pre-existing condition and you won’t have to risk losing your insurance because you’ve reached a lifetime spending cap.
Of course, things can never be that simple, can they?
There are still pages and pages of additional changes and reforms that will unfold over the next few years. Some will be evident to the public – like the state-based American Health Benefit Exchanges where people can go to buy coverage for themselves and their families. Others, like the way hospitals and insurance companies process claims, will happen behind the scenes so that patients shouldn’t even notice anything’s changed. All of this will roll out over the next few years – with most of the major reforms happening around 2013 and 2014 (Read the full text of the bill here). But you’ll want to keep track of several changes taking effect this year. They include:
- An end to pre-existing condition exclusions for children (effective in 6 months)
- The establishment of a temporary national high risk pool which will provide coverage to adults who can’t get or afford insurance because of pre-existing conditions; you have to prove that you’ve been without insurance for six months in order to qualify (effective in 90 days)
- Expansion of dependent coverage for children up to age 26 for all individual and group policies (effective in 6 months)
- An end to lifetime spending limits on coverage (effective in 6 months)
- A website built to help identify health coverage options – this will ultimately serve as a standard format for presenting information on coverage options (effective July 1, 2010)
- A requirement for all qualified plans to cover many preventive services, including recommended immunizations, preventive care for infants, children and adolescents and additional preventive care for women (effective in 6 months)
- A 10% sales tax on payments for indoor tanning services (effective immediately)
- Fill the “donut hole” in Medicare prescription drug coverage by increasing initial coverage limits by $500; if the Reconciliation Bill passes the Senate, this savings will change slightly to a $250 rebate for Medicare Part D (effective immediately)
We know, it’s a lot to take in – and it’s still only a portion of the entire plan for reform. Here at Alegent, we’ve been monitoring the entire debate and, now that it’s been signed into law, we’re working to make sure we fully understand all of the provisions and what they mean for your care. We’ll do our best to let you know if something is coming up that may affect your coverage or, most importantly, your care.
In the meantime, please let us know if you have any questions about health care reform. We want to make sure we’re putting out information that makes sense to you and that will ultimately help you understand what’s really going on. And we also want to hear your stories. Have you been living without health insurance because you couldn’t afford it or you were denied coverage?