Health care reforms in the USA

[iNurseUK, RN]

IMMEDIATE BENEFITS OF HEALTH REFORM -AS PASSED BY THE HOUSE OF REPRESENTATIVES

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1 SMALL BUSINESS TAX CREDITS

Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)

2 BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE

Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)

3 FREE PREVENTIVE CARE UNDER MEDICARE

Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

4 HELP FOR EARLY RETIREES

Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive premiums for employers and retirees for health benefits for retirees age 55‐64. Effective 90 days after enactment.

5 ENDS RESCISSIONS

Bans insurance companies from dropping people from coverage when they get sick. Effective 6 months after enactment.

6 NO DISCRIMINATION AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS

Prohibits new health plans in all markets plus grandfathered group health plans from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)

7 BANS LIFETIME LIMITS ON COVERAGE

Prohibits health insurance companies from placing lifetime caps on coverage. Effective 6 months after enactment.

8 BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE

Tightly restricts the use of annual limits to ensure access to needed care in all new plans and

grandfathered group health plans. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all new plans and grandfathered group health plans.)

9 FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS

Requires new private plans to cover preventive services with no co‐payments and with preventive

services being exempt from deductibles. Effective 6 months after enactment.

10 NEW, INDEPENDENT APPEALS PROCESS

Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.

11 ENSURING VALUE FOR PREMIUM PAYMENTS

Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

12 IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE

(INTERIM HIGH‐RISK POOL)

Provides immediate access to affordable insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary subsidized high‐risk pool. Effective 90 days after enactment.

13 EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH

PARENTS' INSURANCE

Requires new health plans and certain grandfathered plans to allow young people up to their 26th birthday to remain on their parents' insurance policy, at the parents' choice. Effective 6 months after enactment.

14 COMMUNITY HEALTH CENTERS

Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.

15 INCREASING NUMBER OF PRIMARY CARE DOCTORS

Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

16 PROHIBITING DISCRIMINATION BASED ON SALARY

Prohibits group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

17 HEALTH INSURANCE CONSUMER INFORMATION

Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.

18 CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM

Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide home and community-based services to adults who become functionally disabled. Effective on January 1, 2011.

I'm surprised that this isn't a hot topic.

[kcochrane]

Actually there are have been many threads on this topic. and they get pretty heated.

That is a great list..but with 2,000 pages what else is in this bill. :)

[roser13, ASN, RN]

Reform seems to be hard-won in this country. The two-party system (at least as it's currently practiced) virtually ensures that the negatives of any forward movement will be emphasized.

S.I.G.H. We will get there.....

[greenfiremajick]

I'm surprised that this isn't a hot topic.

I'm surprised it hasn't been moved to the politics section.........................

[mammac5]

What is the origin of this list?

[HouTx, BSN, MSN, EdD]

LOL - I am sure it ain't over yet. Who knows what we are actually going to end up with? Like everything else in a democracy, progress is a hit-or-miss, trial & error process. We continue to make it up as we go along.

What we can be absolutely sure of? The ongoing battle will make (or break) political careers. Compliance with all the requirements is probably going to be so complex that it will give rise to a dozen new industries who can provide that service - just like it happened with HIPAA. So maybe in a very bass-ackwards way, it will end up stimulating the economy after all -- just not like it was designed.

In the meantime, I'll just continue to hang out -- livin' the dream.