JANUARY 2011: LEGISLATIVE REPORT

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In This Issue:

  • HOW WILL HEALTH REFORM AFFECT ME?
  • IF YOU HAVE INSURANCE
  • IF YOU LOSE YOUR COVERAGE OR DON’T HAVE INSURANCE
  • IF YOU’RE A SENIOR CITIZEN
  • IF YOU OWN, OR WORK FOR, A SMALL BUSINESS
  • OTHER EARLY BENEFITS OF HEALTH REFORM

Last year, Congress enacted health reform legislation that will bring coverage to 32 million Americans.

Reforms are taking effect. This newsletter provides you with information that may improve your coverage this year.

In 2014, new health insurance exchanges will open in each state. Competition will lower costs and improve quality. Tax credits will help many working families pay for premiums, and subsidies will lower co-pays and deductibles. Insurers will be prohibited from discriminating against people with pre-existing conditions.

I hope that you will take a moment to read how the new law will affect you. If you want to learn more about the implementation of health reform, or if you have additional questions, please visit www.healthcare.gov. You can sign up to receive informative email updates as provisions of the law are implemented.

Sincerely,
Pete's Signature
Pete

JANUARY TOWN MEETINGS
SATURDAY, JANUARY 22, 2011
9:00-10:30 am
Fremont Senior Center
40086 Paseo Padre Parkway
Fremont
11:00 am-12:30 pm
San Leandro City Hall
City Council Chambers
835 East 14th Street
San Leandro

HOW WILL HEALTH REFORM AFFECT ME?

IF YOU HAVE INSURANCE

When your new insurance plan year begins (typically January 1), you have new rights:

  • Insurers cannot drop coverage if you get sick.
  • Lifetime limits on coverage are prohibited.
  • You can keep your children on your plan through age 26.
  • Your insurer must spend at least 80 cents of every dollar you pay in premiums on medical care.

Additionally, when you enroll in a new plan, you cannot be charged cost-sharing
for most preventive services, such as screenings and immunizations. You also have access to a new, independent appeals process if you are denied coverage by an insurance company.

IF YOU LOSE YOUR COVERAGE OR DON’T HAVE INSURANCE

  • Health reform created a new website, www.healthcare.gov, that allows you to compare health coverage options, including premiums and benefits of private plans. Visit the site to find out the best insurance plan for you.
  • If you have a pre-existing condition, you may be eligible to purchase the California Pre-Existing Condition Insurance Plan. Individuals with a pre-existing condition who have been uninsured for six months can qualify for this plan. Applications can be found at www.pcip.ca.gov or contact the California Pre-Existing Condition Insurance Plan at 877-428-5060 for more information.
  • If you are a young adult and you have not been offered employer-provided coverage, your parents may be able to keep you on their insurance policy until you are 26 years old.

IF YOU’RE A SENIOR CITIZEN

  • If you’re not yet Medicare-eligible but you’ve retired from your job, there is a program that helps employers continue early retiree coverage and keep premiums low. Check with your employer to see if they are participating. You can learn more about this program at www.errp.gov.
  • If you are enrolled in Medicare, most preventive services are now free.
  • If you fall into the Medicare Prescription Drug “donut hole” coverage gap, you will receive a 50 percent discount on all brand-name drugs while you’re in the donut hole. That discount increases annually until the donut hole is closed.

IF YOU OWN, OR WORK FOR, A SMALL BUSINESS

Just as in 2010, many small businesses will be eligible for tax credits for providing health insurance. These tax credits will cover up to 35 percent of employer premium contributions, depending on the size of your firm.

Small businesses qualify if they have fewer than 25 full-time workers, and their wages are less than $50,000 a year, on average. Employers must cover at least 50 percent of the cost of health care coverage. To see if your firm is eligible, please visit: http://go.usa.gov/CA8.

OTHER EARLY BENEFITS OF HEALTH REFORM

  • States will be provided new federal funds to examine proposed health insurance premium increases. These funds will help states finance ongoing efforts to protect consumers from unjustified rate increases.
  • Community health centers will see an increase in funding that will total $11 billion over the next decade. These serve an estimated 19 million people annually. In the 13th Congressional District, 27 community health centers will be helped by this new money.
  • To help address the shortage of primary care providers, health reform provides new Medicare and Medicaid incentive payments to encourage more doctors, nurses, and other providers to enter primary care.
  • A new student loan repayment program has been set up for doctors, nurses, and other professionals who work for governmental health agencies. Workers who serve more than three years in the public health workforce are eligible for the program.