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Health Care Reform and You: What Goes into Effect this Year

The recently passed health care reform bill means stability and security for families and individuals who are satisfied with their health insurance, choices for those who aren’t, and a host of new consumer protections.  Many provisions to protect consumers and extend coverage go into effect this year.    These include:  

Reform prohibits health insurers from denying coverage to children with pre-existing conditions.  

The bill begins to close the Medicare Part D donut hole to help make prescription drugs more affordable for America’s seniors.  Effective immediately, reform provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Beginning in 2011, it institutes a 50% discount on brand-name drugs in the donut hole and completely closes the donut hole by 2020.

Small business tax credits will help small businesses afford coverage for their employees. Tax credits of up to 35% of premiums are immediately available to small businesses and family farmers that choose to offer coverage. Beginning in 2014, the small business tax credits will cover 50% of premiums.

Reform extends coverage to young adults by requiring health plans to allow young adults to remain on their parents’ insurance policy, at the parents’ choice, up to their 26th birthday.

The bill bans insurance companies from dropping people from coverage when they get sick and prohibits health insurance companies from placing lifetime caps on coverage.

Immediate help is available for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool.  

Reform bans restrictive annual limits on coverage to ensure access to needed care.

The bill eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program.

Free preventive care will also be available under new private plans.  Reform requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles.

The number of primary care doctors will increase.  Reform provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals.