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Health Care Reform Information

posted Jul 1, 2011, 1:11 PM by Douglas County Democrats   [ updated Jul 1, 2011, 2:17 PM ]

After an exhaustive year of debate, today President Obama signed into law a health reform bill that will lower costs for American families and small businesses, expand coverage to millions and end the worst insurance company practices ‐‐‐ something Presidents have tried to do for decades. And these benefits will begin to take effect this year.


 The Senate will still need to pass some technical corrections to the bill, but now that it has been signed, Americans will begin to see the benefits of health reform this year, with additional important changes coming later. American families and small businesses will see costs go down immediately because of this bill.


In 2010 the bill will:


• Make providing employee coverage more affordable for small businesses by giving a tax
credit of up to 35% of premiums to small businesses that choose to offer coverage.

• Create a temporary high‐risk pool to provide affordable insurance options to adults who are denied coverage because of pre‐existing conditions.

• Provide a $250 rebate for Medicare recipients who fall in to the Part D donut hole – the first step towards closing the donut hole for good. The bill will also provide a 50% discount on prescription drugs which fall into the donut hole beginning in 2011.

• Require new private plans to cover preventative care – with no co‐payments or deductibles. Medicare will also provide free preventive care beginning January 1, 2011.

• Create a temporary reinsurance program for early retirees – this will help employers and
retirees age 55‐64 struggling to pay expensive premiums. Health reform will immediately expand coverage


This year:

• Insurers will no longer be able to deny children coverage because of pre‐existing conditions – this applies to new plans and grandfathered group plans. Never again will insurance companies be able to deny coverage to a child because of his or her health.

• Young adults will be able to remain on their parents’ insurance policy until they turn 26 – this applies to new and grandfathered plans.

• Americans will be guaranteed access to the care they need. Insurance companies will no longer be able to drop coverage when someone gets sick or impose lifetime caps – restrictive annual limits will be banned for new plans and grandfathered group plans.


In the next fiscal year:

• Community health centers will be able to nearly double the number of patients they treat over the next 5 years with additional funding.

• New investments in the bill will increase the number of medical professionals throughout the country – we’ll have more primary care doctors, nurses, nurse practitioners and physician assistants. Immediately, health reform will strengthen consumer protections and reign in insurance companies.

• This bill will ensure consumers can appeal decisions private insurers make about their plans by creating a new, independent appeals process beginning this year.

• The bill will crack down on insurance companies and ensure they are spending your premium dollars on medical services – in the individual and small group market, insurers will be required to spend 80 percent of premiums on medical services and for the large group market, they’ll be required to spend 85 percent. Insurers who don’t meet those requirements will have to send rebates to policyholders. This will begin on January 1, 2011.

• Insurers will no longer be able to discriminate based on income beginning this year. For new group plans, insurers will not be able to implement eligibility rules that unfairly benefit higherwage employees.

• This bill will end the practice of unreasonably hiking up rates beginning in 2011. Insurance companies will be required to submit justification for all premium increase requests. Companies who make excessive increases or cannot justify increases, may not be allowed in the new health insurance exchanges.

• The bill will help states create consumer assistance offices with funding coming this fiscal year. These offices will help consumers file complaints or appeal decisions from insurance companies.

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