Health care reform

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act – one of the most significant pieces of legislation in the nation’s history.

The reforms take huge steps toward removing obstacles to quality, low-cost health insurance for millions of Americans, and guaranteeing that workers won’t need to fear the loss of health coverage if they lose their job, switch jobs or become self-employed.

Although some of the health reforms passed into law will not take effect for two or three years, Americans will see many significant provisions of the bill implemented this year.

Consumer protections

The new health law provides a broad range of protections. Already, carriers are prohibited from denying coverage to children with pre-existing conditions. But consumers will also have access to new resources that will make it easier to appeal a carrier’s determination – including denial of coverage – on new applications for coverage. At the same time, the law also provides protection on the “back end” – prohibiting carriers from using rescission to cancel policies retroactively.

Starting this year – for new individual policy holders – the law will begin phasing out annual and lifetime caps on the amount carriers will pay to cover health care expenses. What’s more, the federal government is working to control rising policy costs by awarding grants to states that are moving to require insurance companies to justify their premium increases.

Constituents who utilize Medicare, Medicaid and Children’s Health Insurance Programs (CHIP) should expect more security in federal efforts to fight fraud and waste in those programs.

View the full implementation timeline.

Expanded coverage

The legislation is already moving to deliver health insurance to millions of Americans who were uninsured – or facing the prospect of becoming uninsured. In July, states began taking applications for enrollment in federally funded high-risk pools, providing coverage for individuals with pre-existing conditions. Families under CHIP coverage also received breathing room from state efforts threatening to tighten enrollment – at least until state-based health insurance exchanges are implemented in 2014.

Another PPACA provision helped families with children under age 27 by extending coverage to those dependents until their 27th birthday. And more small employers (with fewer than 25 workers) will receive tax credit incentives to provide employer-sponsored coverage.

In addition, individuals and families in the individual market who enrolled in policies on or after September 23 will benefit from the addition of free preventive health services.

Seniors and retirees

For seniors, the legislation will ultimately bring a raft of changes. They begin in 2010 with immediate relief for an estimated 4 million seniors who hit the “donut hole” – the coverage gap in their Medicare prescription drug benefit.

But that’s just the tip of the iceberg. Health reform will impact Medicare in dozens of ways, from driving cost containment and boosting program funding, to increasing Medicare services covered and providing support for primary care physicians.

Support for providers in rural and underserved areas

Starting in 2010, the law provides incentives – including scholarship and loan repayment incentives – to increase the number of primary care doctors, nurses and physician assistants working in underserved areas. For health care providers working in rural areas, the legislation includes increased payments to encourage them to continue serving their communities.

Tags: health reform, individual mandate, Medicare, prescription drug benefit, preventive health services, resources, state health insurance exchanges