u.s. health care reform: what's in? what's out? what's coming?

What’s In, What’s Out &

What’s Coming?

Legal stuff

Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues. Photo Credits: BigStock Photo

NOTE: The following is a brief overview only (as of July 2013) and does not include Medicare/Medicaid provisions. The summary is from the perspective of an individual who purchases health insurance or an employer that sponsors health benefits.

U.S. Health Care Reform

Health Reform

THE AFFORDABLE CARE ACT SIGNED 23

EFFECTIVE DATES FOR INITIAL ROLLOUT

2010 – 2018

90 67

Total Number of Provisions Number in

Effect

Source: Kaiser Family Foundation

3.5 Million +

What’s in?

COVERAGE FOR ADULT CHILDREN UP TO AGE 26

PRE-EXISTING CONDITIONS INSURANCE PROGRAM (PCIP) CLOSED TO NEW APPLICANTS

FULL COVERAGE FOR CERTAIN PREVENTIVE SERVICES

UNIFORM SUMMARY OF BENEFITS & COVERAGE

3.5 Million +

REMOVED HEALTH SAVINGS PLAN COVERAGE FOR OVER-THE-COUNTER

MEDICATION (UNLESS PRESCRIBED BY A PHYSICIAN)

10% TAX ON TANNING SALONS

SMALL BUSINESS TAX CREDITS

INCREASED TAX ON NON-QUALIFIED EXPENSES FOR HEALTH SAVINGS PLANS

20%

INCREASED ITEMIZED DEDUCTIONS FOR MEDICAL EXPENSES

from 7.5% of adjusted gross income

10%

PROHIBITED LIFETIME LIMITS, CANCELLING COVERAGE & PRE-

EXISTING CONDITION EXCLUSION FOR CHILDREN

3.5 Million +

What’s out?

THE CLASS ACT INSURANCE PROGRAM FOR LONG-TERM CARE

SUSPENDED INDEFINITELY

Out for

now

SMALL BUSINESS HEALTH OPTION PROGRAM (SHOP)*

THE BASIC HEALTH PLAN

THE EMPLOYER MANDATE

* Multiple plan option delayed

3.5 Million +

What’s coming?

INDIVIDUAL MANDATE FOR COVERAGE

(2014)

ERASED PRE-EXISTING CONDITIONS EXCLUSIONS (ADULTS-2014)

STATE-BASED INSURANCE EXCHANGES

(2014)

TAX CREDITS/SUBSIDIES TO ELIGIBLE INDIVIDUALS (2014)

NO LIFETIME/ANNUAL LIMITS ON ANY COVERAGE (2014)

3.5 Million + DEFINED CATEGORIES OF ESSENTIAL HEALTH BENEFITS GO INTO EFFECT

(2014 – INDIVIDUAL & SMALL GROUP)

Wellness Programs

ALLOWS EMPLOYERS TO OFFER REWARDS TO EMPLOYEES UP TO 30% OF THE COST OF COVERAGE FOR PARTICIPATION IN PROGRAM (2014)

Cathy Miller, Business Writer

Go to my health care blog for a 3-part series that explains more about:

Health Care Reform: What’s In – What’s Out & What’s Coming?

www.SimplyStatedHealthCare.com

Cathy Miller, Business Writer

Business site:

www.SimplyStatedBusiness.com