Health Insurance Lifeline to Uninsured Americans

Recent Census Bureau estimates place the number of uninsured Americans in excess of 45 million. The new health care reform law is meant to change by offering the following help, initializing at the dates indicated:

June 23, 2010

The new law offers near-immediate help for uninsured Americans with pre-existing conditions through a temporary high-risk pool which will offer insurance to those with such conditions until the health insurance Exchanges (see information on these in the “2014” section of this article) are operational in about 3½ years.

September 23, 2010

The new law requires that health insurance plans allow young people up to their 26^th birthday to remain on their parents’ insurance policy, at the parents’ choice. This rule applies to young adults not offered their own employer provided coverage.

October 1, 2010

The health care reform package significantly increases funding for Community Health Centers that serve low-income Americans. The increase is designed to allow for nearly a doubling of the number of patients served by these Centers over the next 5 years.

New incentives also begin that are designed to steer more new doctors, nurses and nurse practitioners into primary care, providing more front-line choices for those who need an affordable primary care doctor.

2014

2014 is a major benchmark year under the new health care reform law. At the time, the law stipulates that the private industry work and government management needed to get the new health insurance Exchanges up and running must be completed. Private health insurance offered in the Exchanges is meant to be a substantial improvement over the current system of health insurance coverage in the following ways:

• Individuals and small businesses will be able to compare and purchase health insurance online (among other places) at prices shaped by organized and promoted competition between private insurers offering coverage.
• Individuals will be able to choose amongst several benefits packages that provide comprehensive health care services with different levels of cost-sharing.

Affordability safeguards applying to health insurance options in the Exchanges:

• The new law provides insurance premium tax credits to limit the amount individuals and families up to 400% of the federal poverty level are required to spend on health insurance premiums.

• The law also subsidizes co-pay and patient cost sharing on a sliding scale basis, phasing out at 400% of poverty, to help keep care under the plans in the Exchanges affordable.

• At the same time (i.e. 2014) Medicaid eligibility rises to 133% of the federal poverty level.

Consumer-friendly features of insurance packages offered in the Exchanges:

• Insurers in the Exchanges cannot exclude individuals with pre-existing conditions, nor charge higher premiums for pre-existing conditions, nor exclude coverage for specific conditions.

• There is also a strict ban on higher premiums for women.

• Premiums for older Americans cannot be more than three times higher than a company’s offering for its youngest age category.