3-26-10 Reconciliation is over – Now what?
Earlier this week, the House passed two bills: the Senate’s health care bill, and a reconciliation bill that included around 150 pages of changes. The reconciliation bill bounced from the House to the Senate and back to the House, finally passing and heading to President Obama’s desk. Mr. Obama is expected to sign it sometime next week.
So what happens now? The bill’s various provisions take effect during different years, and won’t entirely take effect until 2020. Here is a timeline of some of the provisions that will directly affect patients.
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What Takes Effect When?
2010
Later this year, insurance companies will no longer be allowed to cut off customers’ coverage when they become ill. Insurers also will not be allowed to establish lifetime coverage limits.
Insurers will no longer be able to exclude children with preexisting conditions. Adults with preexisting conditions who have not had insurance for six months will be able to get subsidized coverage in a “high-risk” pool through a program that expires in 2014. Children of insured individuals will be able to stay on their parents’ plans until they turn 26.
In about three months, a temporary “reinsurance” program begins to help employers maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.
Medicare drug recipients in the “coverage gap” will get a $250 rebate.
A new appeals process begins to help customers appeal decisions made by their insurance companies.
New private plans will be required to provide preventative care at no direct cost to patients.
2011
Medicare will provide recipients some preventative care at no direct cost. This will include a once-a-year “wellness visit” and an individualized prevention plan. New Medicare plans will offer preventative services with no direct cost to patients.
Medicare drug recipients in the “coverage gap” will get a 50% discount on prescription drugs.
The fine for withdrawing money from a medical savings account for nonmedical expenses will double, from 5 percent to 10 percent.
2012
The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.
2013
Insurers will raise premiums on male customers to help female customers pay for their unique healthcare needs.
2014
Low-income adults without children will now be eligible for Medicaid. From 2014 o 2016, the federal government will pay states 100 percent of the cost of expanded Medicaid coverage.
State Health Insurance Exchanges for small businesses & individuals open.
Individuals will be required to have health insurance coverage or pay a fine. This fine begins at $95.00 per individual.
People making up to 400 percent of the federal poverty level will be eligible for tax credits to help them buy coverage on the Health Insurance Exchanges.
Health plans will no longer be able to exclude people due to pre-existing conditions.
2015
Medicare will begin a new payment program for physicians designed to reward quality of care rather than the amount of services rendered.
The fine for not having health insurance increases to $325 per individual.
2016
The fine for not having health insurance increases to $695 per individual. After 2016, fines will increase at the general rate of inflation.
2018
The “Cadillac Tax” on high cost, employer-provided plans begins. Every dollar beyond the first $27,500 of a family plan or $10,200 for an individual plan is taxed at 40 percent. This tax rate is tied to the rate of inflation. If medical costs continue to increase faster than the rate of general inflation, this tax will impact increasingly cheaper plans.
2020
The federal government cuts payments to states for the cost of expanded Medicaid coverage by 10 percent.
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This timeline only reflects the bill as it stands today. A bill with as far-reaching effects as this one, stretching across as many years as this one, is almost guaranteed to be changed, especially considering that there will be major elections before the major changes begin in 2014. Legislation is like the weather – the farther out you look, the harder it is to predict.
Sources and More Information:
HealthReform.Gov
http://www.healthreform.gov
The White House Blog – What’s in the Health Care Bill? http://www.whitehouse.gov/blog/2010/03/23/whats-health-care-bill
OpenCongress - It’s Over! House Gives Final Approval to Health Care Reform
OpenCongress – House Gives Final Approval to Historic Health Care Bill
Reuters – FACTBOX-US healthcare bill would provide immediate benefits
http://www.reuters.com/article/idUSN1914020220100319
CNN – House passes Senate’s health care ‘fixes’ bill
http://www.cnn.com/2010/POLITICS/03/25/health.care.main/index.html?hpt=T1
CNN – Timeline: When health care reform will affect you
http://www.cnn.com/2010/POLITICS/03/23/health.care.timeline/index.html
