Health Care Reform
1.) Young adults will be able stay on their parents’ insurance until their 26th birthday.
2.) Insurers will be barred from imposing exclusions on children with pre-existing conditions. Pools will cover those with pre-existing health conditions until health care coverage exchanges are operational.
3.) Insurers will not be able to rescind policies to avoid paying medical bills when a person becomes ill.
4.) Lifetime limits on benefits and restrictive annual limits will be prohibited.
5.) New plans must provide coverage for preventive services without co-pays. All plans must comply by 2018.
6.) New plans will be required to implement an appeals process for coverage determinations and claims.
7.) Businesses with fewer than 50 employees will get tax credits covering 35 percent of their health care premiums, increasing to 50 percent by 2014.
Beginning January 1, 2011
1.) Medicare will provide free annual wellness visits and personalized prevention plans. New plans will be required to cover preventive services with no co-pay.
2.) A plan to provide a vehicle for small businesses to offer tax-free benefits will be created.
Beginning January 1, 2013
1.) Health plans must implement uniform standards for electronic exchange of health information to reduce paperwork and administrative costs.
2.) Contributions to flexible savings accounts will be limited to $2,500 per year, indexed by the Consumer Price Index in subsequent years.
Beginning January 1, 2014
1.) No health plan or insurer may discriminate against any health provider acting within the scope of that provider’s license or certification under applicable state law (insurance companies cannot unfairly exclude doctors of chiropractic from practicing under state law, applicable to all health benefit plans both insured and self-insured).
2.) Chiropractors named as potential members of Community Health Teams to support the development of “medical homes” to enhance patient care, wellness and lifestyle improvements.
3.) Chiropractors are specifically included as part of the National Health Care Workforce Commission defined as “Health Care Professionals,” allowing them to provide comprehensive information to Congress and the Administration about how to align federal health care workforce resources with national needs.
4.) Citizens will be required to have acceptable coverage or pay a penalty of $95 in 2014, $325 in 2015, $695 (or up to 2.5 percent of income) in 2016. Families will pay half the amount for children, up to a cap of $2,250 per family. After 2016, penalties are indexed to Consumer Price Index.
5.) Workers who are exempt from individual responsibility for coverage but don’t qualify for tax credits can take their employer contribution and join an exchange plan.
6.) Companies with 50 or more employees must offer coverage to employees or pay a $2,000 penalty per employee after their first 30 if at least one of their employees receives a tax credit. Waiting periods before insurance takes effect is limited to 90 days. Employers who offer coverage but whose employees receive tax credits will pay $3,000 for each worker receiving a tax credit.
7.) Insurers can no longer refuse to sell or renew policies because of an individual’s health status. Health plans can no longer exclude coverage for pre-existing conditions. Insurers can’t charge higher rates because of heath status, gender or other factors.
8.) Health plans will be prohibited from imposing annual limits on coverage.
9.) Health insurance exchanges will open in each state to individuals and small employers to comparison shop for standardized health packages.
10.) Credits will be available through exchanges for those whose income is above Medicaid eligibility and below 400 percent of poverty level who are not eligible for or offered other acceptable coverage.
Looking Forward to Health Care Change,
Dr. Phil Kotzan, DC
