Health Reform What am I paying for?

Health Care Reform - Timeline

The federal health care reform
legislation, known as the Patient Protection and Affordable Care Act,
signed by the President on March 23, 2010, and the Health Care and
Education Reconciliation Act approved by Congress, signed by the
President today, will expand the availability of health care coverage
to millions of Americans. While some of the measures will be
implemented this year, many do not take effect until 2014 and some
extend out to 2020.

Below is a high-level overview of the
timeline. It is important to note that many of these reforms and their
effective dates are subject to the rules and regulations process both
at the state and federal levels – which could alter the intended timing
of implementation.

2010

New Programs:
* Temporary retiree reinsurance program is established
* National risk pool is created, small business tax credit is established
* $250 rebate for Medicare members who reach the ”doughnut hole”

Insurance Reforms:
* Prohibits lifetime benefit limits – based on dollar amounts
* Allows restricted annual limits on the dollar value of certain benefits
* Coverage rescissions/cancellations are prohibited (except for fraud or intentional misrepresentation)
* Cost-sharing obligations for preventive services are prohibited
* Dependent coverage up to age 26 is mandated
* Internal and external appeal processes must be established
* Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited
* New health plan disclosure and transparency requirements are created

2011

Insurance Reforms:
* Uniform coverage documents and standard definitions are developed
* Minimum medical loss ratios are mandated

Medicare Reforms:
* Medicare Advantage cost sharing limits effective
* Medicare beneficiaries who reach the doughnut hole will receive a 50% discount on brand name drugs
*
A 10% Medicare bonus will be provided to primary care physicians and
general surgeons practicing in underserved areas, such as inner cities
and rural communities.
* Medicare Advantage plans would begin to have their payments frozen.

Other:
* Employers are required to report the value of health care benefits on employees' W2 tax statements.
* Annual industry fee for pharmaceutical manufacturers of brand name drugs.
*
Voluntary long term care insurance program would be made available to
provide cash benefit for assisting disabled individuals to stay in
their homes or cover nursing home costs. Benefits would start five
years after people begin paying a fee for coverage.
* Funding for community health centers would be increased to provide care for many low income and uninsured people.

2012

* Hospitals, physicians, and payers would be encouraged to band together in "accountable care organizations."
* Hospitals with high rates of preventable readmissions would face reduced Medicare payments.

2013

*
Individuals making $200,000 a year or couples making $250,000 would
have a higher Medicare payroll tax of 2.35% on earned income —up from
the current 1.45%. A new tax of 3.8% on unearned income, such as
dividends and interest, is also added.
* Medical expense
contributions to flexible spending accounts (FSAs) limited to $2,500 a
year—indexed for inflation. In addition, the thresholds for claiming
itemized tax deduction for medical expenses rise from 7.5% to 10% of
income.
* Medical device manufacturers would have a 2.9% sales tax
on medical devices; devices such as eyeglasses, contact lenses, and
hearing aids would be exempt.
* Eliminates deduction for expenses
allocable to Medicare Part D subsidy for employers who maintain
prescription drug plans for their Medicare Part D eligible retirees.

2014

Coverage Mandates & Subsidies:
* Individual and employer coverage responsibilities are effective.
* Individual affordability tax credits are created and small business tax credits are expanded.

Health Insurance Exchange & Insurance Reforms:
* State individual and small group health insurance exchanges operational.
*
Guaranteed issue, guaranteed renewability, modified community rating
and minimum benefit standards (“essential benefits” plan) effective.
* Lifetime and annual dollar limits are prohibited for essential benefits.
* Pre-existing condition exclusions are prohibited.

Taxes & Fees:
* Addition of new taxes on health insurers

Medicaid and Medicare Reform:
*
Medicaid expanded to cover low income individuals under age 65 up to
133% of the federal poverty level—about $28,300 for a family of four.
* Minimum medical loss ratio of 85% required for Medicare Advantage plans

2018

Taxes & Fees:
*
Tax (“Cadillac tax”) imposed on employer sponsored health insurance
plans that offer policies with generous levels of coverage.

2020

Medicare Reform:
*
Doughnut hole coverage gap in Medicare prescription benefit is fully
phased out. Seniors continue to pay the standard 25% of their drug
costs until they reach the threshold for Medicare catastrophic coverage.

Resource Easy To Insure ME http://www.easytoinsureme.com/