Health Reform – What it means for you in 2010

I Googled “health reform explained” and my search came back with over 25 million hits. That’s ridiculous. It’s complicated, sure. But 25 million??

Everyone from whitehouse.gov to the major news outlets to bloggers, pundits, and NPOs have their own take on what health reform – excuse me – The Patient Protection and Affordable Care Act – means for the average person. Rumors abound, as does a great deal of misunderstanding and misinformation. So what the heck, I’ll add my two cents in the hopes of making things a bit clearer.

The health reform package that was signed into law last month is a 2,000+ page document. No, I don’t think everyone needs to read the whole thing — unless of course, you want to. In a nutshell, it makes sure that almost all Americans can get health insurance and that the insurance companies can’t pick & choose who to cover.  Everything else in the plan falls under this umbrella – from purchasing pools to employer mandates, to government subsidies to help people pay for it all.

Most of the provisions won’t happen until 2014 – and others will be phased in over a period of years. But some of the benefits are happening this year – even now – and that’s good news for a lot of folks. Here’s a quick rundown on how reform impacts you in 2010:

  • Maybe the most important change takes effect by Fall: Insurance companies can no longer drop coverage for you when you get sick. This is BIG news for many people. There have been way too many horror stories about this; I mean, why else would you have HEALTH insurance, except to cover you when you actually NEED it? Duh.
  • Young adults can now remain on their parents’ policy until age 26. Important for those new college grads that are either job hunting or obtain that first job without benefits. At least parents will gain some peace of mind for a while. And some insurers, UnitedHealthcare and Wellpoint among them, are speeding up implementation so there’s no gap in coverage. Kudos to them for doing the right thing.
  • Uninsured Americans with pre-existing conditions can get affordable insurance coverage this year. What this means is that if you have been unable to afford or obtain insurance because of a pre-existing condition (think asthma, back problems, diabetes, etc.) you will now have access to an affordable plan through a temporary high-risk pool. This stays in effect until the insurance exchange (purchasing pool) is available. The downside, of course, is that premiums may still be too high for many people, even with help from the government. I’m taking a wait-and-see on this one.
  • Children with pre-existing conditions can no longer be denied coverage. Within the next six months, every new health plan, plus grandfathered group health plans, must cover children with pre‐existing conditions; in 2014, this extends to everyone. Great news for a lot of kids and their parents.
  • A ban on annual and lifetime limits on coverage. Health insurance companies can no longer put yearly or lifetime caps on coverage.  So if you or a family member require extensive, expensive treatment, such as for cancer, they can’t come back to you & say your benefits have been all used up.
  • Free preventive care under new private plans. New private plans must cover preventive services with no co‐payments no matter what the deductible. That’s good if you sign up with a new plan – unfortunately, existing plans are exempt from this provision, and exactly what is considered a preventive service is still being worked out.

There are additional provisions relating to Medicare, small businesses, and accountability for insurance companies. Details on those are also widely available. I suggest healthreform.gov as one of the more reliable sites about the new plan. But of course, feel free to peruse any of the 25 million other sites out there. Wonder which ones Sarah Palin visited?

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9 thoughts on “Health Reform – What it means for you in 2010

  1. Thanks for clarifying a topic that’s confusing to navigate. As a small business owner, I’m in the process of sorting through my options as insurance through my husband’s employer, troublingly, is no longer an option. I am trying to determine if there are tax credits through COBRA, and if they are more favorable than the 35% you mentioned above.

    1. Hi Adina,

      There is a lot of information on the IRS.gov site about this, but like most information from them it’s convoluted and confusing. http://www.irs.gov/newsroom/article/0,,id=204505,00.html. If your husband got laid off within the time period specified under the guidelines, he should be eligible for COBRA.

      Probably the best thing to do is to speak with your accountant and have him/her work up the numbers both ways. COBRA subsidies are beneficial to the laid off workers, not so much to employers.

  2. Bravo. I’m looking forward to your navigating us through “healthcare reform,” by explaining what’s really going on and what it all means to me and my family. Well done.

  3. You put a very confusing mass of information into an easy to understand outline. I appreciate the info. Thanks.

  4. Liz, this is good, clear and concise information. I’m wondering about health care rates. The gov’t has been talking about “affordable healthcare” for months and months, yet my premium just went up. I’m a small business of one — I have indivual converage, and I am now to pay $370 a month for health coverage. My premium went up as it does every year, yet coverage is the same. So my question is: where is the “affordable” in all of this?

    1. Hi Claudia,
      good question. There are small business tax credits available to help cover premiums – 35% this year and 50% in 2014. As a company with less than 50 employees, you will be exempt from the mandate; however you will have the opportunity to shop for a new plan under a small business purchasing pool – which should result in lower premiums. That doesn’t kick in for a few years, though. So if you can, take advantage of the tax credits in the meantime. It will take a few years for the bumps to smooth out, but in the long run, you should see some price benefits.

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