A Brief Breakdown of Healthcare Reform Changes

HEALTHCARE REFORM: What happens when?

This is a reproduction of an article published by The World Institute on Disability. It was written by By Julia Day, MSW with contributions from Bryon MacDonald, Disability Benefits 101 Information Services, California Work Incentives Initiative, World Institute on Disability on April 5, 2010. It is currently posted on at Disability Benefits 101. To access the article
click here: http://disabilitybenefits101.org/news/news_2868.htm

Beginning Changes (exact dates are yet to be determined)
• Children can no longer be denied coverage because of pre-existing conditions
• Private healthcare providers cannot place a $ limit on coverage.
This would be especially important for those diagnosed with serious illnesses, such as cancer, who face steep medical bills.
• The elimination of Medicare Prescription Drug Plan’s "doughnut hole" -- otherwise known as the coverage gap -- in its prescription drug program begins.. Middle-class consumers who qualify will get a 250-dollar rebate from Medicare.
• Starting in three months, if you've been denied health insurance because of a pre-existing condition, you'll be eligible for federal dollars to buy enter the High Risk Insurance Pool
• Starting at six months, insurance companies won't be able to drop those who fall sick.
• Adult offspring may remain on family healthcare coverage plans until age 26.
Changes in 2011
• In 2011, the Medicare doughnut hole gets smaller as Medicare recipients start getting half-off on brand-name drugs. The whole doughnut hole disappears by 2020.

Changes in 2013
• In 2013, wealthy families earning over a quarter-million dollars a year would see a three-point-eight percent tax hike, but only on their investment income. It's not on their regular salary. What does come out of their paychecks is a bigger bite for Medicare payments.
• There will be $5 billion set aside to provide temporary coverage to uninsured Americans with pre-existing conditions. The money will help those people until the new health care exchanges are put into effect in 2014.
Changes in 2014
HEALTH INSURANCE EXCHANGES
• Health insurance exchanges will be created to make it easier for small businesses, the self-employed and the unemployed to pool resources and buy less expensive coverage.
• Once the exchanges open, insurers will no longer be able to turn away people with pre-existing conditions or charge them more.
MANDATED COVERAGE
• Individuals would be required to buy coverage in or pay a fine of $95 or 1 percent of income, whichever is greater. Fine increases in 2015 to $325 or 2 percent of income, and in 2016 it would rise to $695 or 2.5 percent of income.
• The plan, however, includes a hardship exemption for poorer Americans, and subsidies will be provided to families of four making up to $88,000 annually.
MEDICAID EXPANSION
• Medicaid will be expanded to include more Americans, including childless adults living near poverty.
• Medicaid expands dramatically, the insurance pools begin
• Medicaid will cover a family of 4 whose household income is no more than 133% of FPL (approx. 29-thousand dollars a year).
TAX BREAK FOR FAMILIES
• Tax credits will be provided to families to help offset the costs of health care premiums. The amount of tax credits will be based on annual household income.
INSURANCE POOLS
• Those who have no healthcare coverage and do not qualify Medicaid or Medicare, will be required to buy coverage through State Insurance Pools
• Each exchange will have a variety of plans from which to choose
• Each will offer ompetitive rates and your premium will be capped at a percentage of your income.
• The unemployed will be able to enter the state’s insurance pool immediately after leaving employment; lose your job one day and enter your state's insurance exchange for a new policy that very same day.
• If no insurance is purchased the first year there will be a fine of $95 unless:
o If the least expensive plan available would cost above 8% of current income there will be no fine
o Catastrophic coverage would be available as needed.
What happens in 2020?
• “Cadillac“ insurance plans will be taxed.
• Employers will be additional taxes when offering “first class” plans with high annual premiums; more than $10,000 for a single person and $27,000 for couples. Very few Americans are offered such pricey plans.