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Financial News for
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Key Provisions
of Health Reform that Take Effect Immediately March 30, 2010 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 available to firms that choose to
offer coverage. Effective beginning
calendar year 2010. (Beginning in
2014, the small business tax credits will cover 50 percent of premiums.) 2) No Discrimination Against Children with Pre-Existing
Conditions Prohibits new health plans in all markets plus
grandfathered group health plans from denying coverage to children with
pre–existing conditions.. Effective 6 months
after enactment. (Beginning in
2014, this prohibition would apply to all persons.) 3) Help for Uninsured American with Pre-Existing
Conditions until Exchange is Available (Interim High-Risk Pool) Provides access to affordable insurance for Americans who
are uninsured because of a pre–existing condition through a temporary
subsidized high–risk pool. Effective in 2010. 4) Ends Recissions Bans insurance companies from dropping people from
coverage when they get sick. Effective
6 months after enactment. 5) Begins to Close the Medicare Part D Donut Hole Provides a $250 rebate to Medicare beneficiaries who hit
the donut hole in 2010. Effective
for calendar year 2010. (Beginning
in 2011, institutes a 50 percent discount on prescription drugs in the donut
hole; also completely closes the donut hole by 2020.) 6) Free Preventive Care under Medicare Eliminates co–payments for preventive services and exempts
preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011. 7) Extends Coverage for Young People up to 26th Birthday
through Parents' Insurance Requires new health plans and certain grandfathered plans
to allow young people up to their 26th birthday to remain on their parents’ insurance
policy, at the parents’ choice. Effective
6 months after enactment. 8) Help for Early Retirees Creates a temporary re–insurance program (until the
Exchanges are available) to help offset the costs of expensive premiums for
employers and retirees for health benefits for retirees age 55–64. Effective in 2010. 9) Bans Lifetime Limits on Coverage Prohibits health insurance companies from placing lifetime
caps on coverage. Effective 6
months after enactment. 10) Bans Restrictive Annual Limits on Coverage Tightly restricts the use of annual limits to ensure
access to needed care in all new plans and grandfathered group health
plans. These tight restrictions will
be defined by HHS. Effective 6
months after enactment. (Beginning in 2014, the use of any annual limits
would be prohibited for all new plans and grandfathered group health plans.) 11) 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. Effective 6 months
after enactment. 12) 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. Effective 6 months
after enactment. 13) Ensures 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. Effective on January
1, 2011. 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. Effective beginning in
fiscal year 2011. 15) Increases the Number of Primary Care Practioners Provides new investments to increase the number of primary
care practitioners, including doctors, nurses, nurse practitioners, and
physician assistants. Effective
beginning in fiscal year 2011. 16) Prohibits 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. Effective 6 months after enactment. 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. Effective
beginning in fiscal year 2010. 18) Holds Insurance Companies Accountable for Unreasonable
Rate Hikes Creates a grant program to support States in requiring
health insurance companies to submit justification for all requested premium
increases, and insurance companies with excessive or unjustified premium
exchanges may not be able to participate in the new Health Insurance
Exchanges. Starting in plan year
2011. Source: Whitehouse.gov Printer-friendly: Click here to
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