New Rules on Health Insurance

On September 23rd, 2010

• Children can’t be denied health coverage because of a pre-existing condition. ^{HR 4872: SEC. 166. LIMITATIONS ON PREEXISTING CONDITION EXCLUSIONS IN GROUP HEALTH PLANS IN ADVANCE OF APPLICABILITY OF NEW PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS.}
• No lifetime or annual limits on coverage. ^{HR 3590: SEC. 2711. NO LIFETIME OR ANNUAL LIMITS}
• You can’t be dropped by your insurer when you get sick (known as rescission.) ^{HR 4872: SEC. 162. ENDING HEALTH INSURANCE RESCISSION ABUSE}
• Preventive care won’t require a co-payment or deductible for new insurance. ^{HR 3590: SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES}
• Children can stay on their parent's insurance through the age of 26. ^{HR 3590: SEC. 2714. EXTENSION OF DEPENDENT COVERAGE.}

On January 1st, 2011

• Insurance companies are required to spend 80-85% of premiums dollars on medical services. ^{HR 3590: SEC. 2718. BRINGING DOWN THE COST OF HEALTH CARE COVERAGE. (b)(1) Requirement to provide value for premium payments.}
• If your insurer fails to do so, they must provide you with a rebate. ^{HR 3590: SEC. 2718. BRINGING DOWN THE COST OF HEALTH CARE COVERAGE. (b)(1)(B) Rebate amount.}

On January 1st, 2014

• Waiting periods for new coverage cannot be greater than 90 days. ^{HR 3590: SEC. 2708. PROHIBITION ON EXCESSIVE WAITING PERIODS.}
• No one can be denied coverage because of a pre-existing condition. ^{HR 3590: SEC. 2704. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS OR OTHER DISCRIMINATION BASED ON HEALTH STATUS, HR 4872: SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLUSIONS.}

Have a pre-existing condition?

On June 21st, 2010

• If you’ve been denied coverage because of pregnancy, or have in the past had cancer, migraines, asthma, heart disease, diabetes, depression or any other condition, you’ll be able to sign up for insurance through a temporary public plan. This plan will cover you until 2014, when you’ll switch to private insurance. ^{HR 3590: SEC. 1101. IMMEDIATE ACCESS TO INSURANCE FOR UNINSURED INDIVIDUALS WITH A PREEXISTING CONDITION.}

Are you on Medicare?

On September 23rd, 2010

• $250 will be credited back to you for out-of-pocket medicine in the “donut hole.” ^{HR 3590: SEC. 1401. REFUNDABLE TAX CREDIT PROVIDING PREMIUM ASSISTANCE FOR COVERAGE UNDER A QUALIFIED HEALTH PLAN.}
• Medicare will expand to more small, rural hospitals to make care easier to get to. ^{HR 3590: SEC. 3123. EXTENSION OF THE RURAL COMMUNITY HOSPITAL DEMONSTRATION PROGRAM.}

On January 1st, 2011

• Brand-name drugs not currently covered will be discounted 50%. ^{HR 3590: SEC. 3301. MEDICARE COVERAGE GAP DISCOUNT PROGRAM.}
• All preventive care will be free of co-payments and deductibles. ^{HR 3590: SEC. 4104. REMOVAL OF BARRIERS TO PREVENTIVE SERVICES IN MEDICARE.}

Are you a business owner?

For 2010

• Small businesses receive a tax credit of up to 35% of health insurance premiums. ^{HR 3590: SEC. 1421. CREDIT FOR EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL BUSINESSES}

On January 1st, 2014

• Tax credits for small businesses increase to 50% of premiums. ^{HR 3590: SEC. 1421. CREDIT FOR EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL BUSINESSES}
• Insurance pools will be available so small businesses can get the kind of insurance deals big businesses get. ^{HR 4872: SEC. 113. INSURANCE RATING RULES.}
• Employers with more than 50 employees must provide insurance or pay a fine for any worker that receives federal assistance. ^{HR 3590: SEC. 4980H. SHARED RESPONSIBILITY FOR EMPLOYERS REGARDING HEALTH COVERAGE.}

Are you a doctor or hospital?

With 32 million more insured patients, you’ll soon be able to focus on heath care instead of worrying about if a patient does or doesn’t have insurance. ^{HR 3590: SEC. 1501. REQUIREMENT TO MAINTAIN MINIMUM ESSENTIAL COVERAGE.}

What if I can’t afford it?

On January 1st, 2014

Individuals making less than $43,000 or families making less than $88,000 a year will receive assistance, making insurance cheap or free, based entirely on need. ^{HR 3590: SEC. 1331. STATE FLEXIBILITY TO ESTABLISH BASIC HEALTH PROGRAMS FOR LOW-INCOME INDIVIDUALS NOT ELIGIBLE FOR MEDICAID.}

What does it cost
and how is it paid for?

These changes will average $94 Billion a year over the next ten years. It is paid for as shown and will not add to the deficit. ^{HR 3590: SEC. 1563. SENSE OF THE SENATE PROMOTING FISCAL RESPONSIBILITY.}

• $10 billion a year from drug companies, equipment makers, and hospitals. ^{HR 3590: SEC. 10904 and SEC. 10905}
• If you’re single, you’ll pay 0.9% more in taxes on earned income and investment income over $200,000. ^{HR 3590: SEC. 9015. ADDITIONAL HOSPITAL INSURANCE TAX ON HIGH-INCOME TAXPAYERS.}
• If you’re married, you’ll pay 0.9% more in taxes on earned income and investment income over $250,000. ^{HR 3590: SEC. 9015. ADDITIONAL HOSPITAL INSURANCE TAX ON HIGH-INCOME TAXPAYERS.}
• Employers with more than 50 employees will be fined if their employees need tax payer assistance to buy insurance. ^{HR 3590: SEC. 4980H. SHARED RESPONSIBILITY FOR EMPLOYERS REGARDING HEALTH COVERAGE.}
• Anyone above poverty level must have insurance or they’ll be fined $95 to $695. ^{HR 3590: SEC. 5000A. REQUIREMENT TO MAINTAIN MINIMUM ESSENTIAL COVERAGE.}
• Indoor tanning will be taxed at 10%. ^{HR 3590: SEC. 10907. EXCISE TAX ON INDOOR TANNING SERVICES IN LIEU OF ELECTIVE COSMETIC MEDICAL PROCEDURES.}
• In 2018, insurance companies will be taxed for high-cost health plans. ^{HR 3590: SEC. 10901. MODIFICATIONS TO EXCISE TAX ON HIGH COST EMPLOYER-SPONSORED HEALTH COVERAGE.}