March 21, 2010 8:18 PM

Short-term Benefits From Health Care Reform

By
David Hancock
Topics
Health Care ,
Democrats ,
Economy ,
White House ,
Congress ,
Obama Administration

Along with the longer term changes of the health reform, some changes will take place soon after the bill becomes law -- unless there are last minute changes in the House debate Sunday night. Speaker of the House Nancy Pelosi says the key reforms which take place in the short term after President Obama signs the law include:

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 health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment

5. ENDS RESCISSIONS-- Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.

6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS-- Prohibits 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 plans from placing lifetime caps on coverage. Effective 6 months after enactment.

8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE-- Tightly restricts new plans' use of annual limits to ensure access to needed care. 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 plans.)

More Coverage of the Health Care Reform Debate:

Latest Developments on the Health Care Vote

Latest Vote Count

Health Care Bill Summary: A Look At What's in the Bill

Health Care Bill Clears Procedural Hurdle

Obama to House: Health Care Reform is in Your Hands

CBS Sunday Morning: Obama's Bill of Health

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CBSNews.com Special Report: Health Care

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. (Beginning in 2018, this requirement applies to all plans.)

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 insurance for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool. Effective 90 days after enactment.

13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS' INSURANCE - Requires health 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 new 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 benefits to adults who become functionally disabled. Effective on January 1, 2011.


Add a Comment See all 38 Comments
by RossoCorsa48 March 24, 2010 2:39 PM EDT
It would be far less costly to lower costs by improving health rather than simply adding subscribers to insurance policies. The lower claims rate should be sufficient to control cost more effectively than legislative meddling by the mental midgets in Congress. The problem would be in getting the average American to stop eating themselves sick! Look at your swollen fellow citizens and recognize the health care crisis they are creating that others will fund. Americans needs to shut the pie-hole on their faces and simply exercise! When business needs to cut health care costs by installing gyms, offering free lunch cafeterias with healthier foods as part of compensation (who doesn't like what appears to be free?), and offering incentives to take control of one's own behavior, the results are almost always more beneficial than anticipated. The cost savings are huge when we take care of ourselves as an everyday strategy.
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by rogerapecl March 26, 2010 4:08 PM EDT
You are right on. We need to take more personal responsibility for our actions. Its easier to take your colesltrol pill while eating the salami sandwich infront of the football game. I heard on the news of a woman who was trying to gain weight of 1000lbs. She was already at 650lb. How about the idiots that ride motor bikes without a helmet. Give me a break. I happen to be one of Obamas chosen that make money and will be previledged to pay just a bit more.
by I-ride-a-sporty April 1, 2010 7:07 PM EDT
I agree keep a nation healthy you keep medical prices down, problem being that the gap between health care costs and cost of insurance keeps rising and rising. And to add the final nail in the coffin (as to government intervention) insurance premiums keep rising, and coverage keeps falling. effectively, they did away with self-regulation and incurred the inevitable government regulation, also take a look at benefit 3 and 9, they also seem to agree.
by chipsmydog March 23, 2010 8:36 PM EDT
There is nothing new here. The God hating fear mongers want cradle to grave care from the mythological bottomless purse of the Fed. They are afraid of dying and will do anything and give up anything to put off Judgment Day.

The tyrants in Washington love power and influence. They will do anything to get it; even tell the fear mongering God haters that they can live a long, long time for free.

Fact Jack: every time the Fed gets bigger, the lowest level worker is the person who suffers the most and ironically is the one who votes for their own demise. (And you thought that Christ hating humanistic progressive public schools were a neutral societal engineering utopia.)
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by verypublishedwriter March 23, 2010 8:02 PM EDT
I'm a novelist and memoirist who has written internationally bestselling books, as well as stories that are taught in university creative writing classes. And my work has been nominated for awards you've heard of. The reason I tell you this is that, as a self-employed person, I have not been able to purchase insurance for almost 20 years.

I am 57 years old and, I hope, in quite good health. The last time I tried to buy insurance was 10 years ago and I was told by a Blue Cross underwriter that he would not underwrite me because I'd been prescribed an anti-depressant. "It's been proven," he said, "that people who take Prozac jump off of buildings."

Today, approaching 60, if an insurance "provider" chose to underwrite me, my premiums would exceed $1,500 each month. That's more money than I make a month, doing work that means something to a good-sized chunk of people. And the amount of money I torture forth from my gut is pretty typical for a working artist, regardless of the artist's field of endeavor.

I'm elated that healthcare reform legislation has been signed into law. As our forward-looking, forward-understanding, forward-moving president has said, "It's the right thing to do." As a writer, I admire such understatement.

All best, Davis Miller
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by ghirardi March 29, 2010 10:13 AM EDT
I find it hard to believe you could not find someone to sell you health insurance. I have had no problem. $1,500 a month is what many business are paying today for their employees, although cheaper insurance is available. Many people would prefer premium benefits rather than more income to be excessively taxed. As a successful writer, you could choose to work at an university where benefits are available or choose another profession where income and benefits are offered. I like many people choose or keep a job that I don't care for or is less risky to maintain benefits or financial security for my family. I am responsible for myself and my family, not the government.
Good luck.
by 1renegade March 22, 2010 11:03 PM EDT
As a small business owner this may have me running for cover! You see I'm that nasty business man that has done very well. The government wants to punish me for being sucessful. I started my company with my wife 8 years ago. I have grown to 21 employees and 3 locations. None of my people pay for health insurance because I foot the bill. This health care bill may be changing all of that if I'm forced to do certain things.

The sad thing I see is all you folks degrading those of us who leave the cave and kill something everyday. Just so you "Nay sayers" would like to know the least paid person in my company was just over 52k. So when these mandates kick in it could force slower expansion or even layoffs. I also do 8% 401k match and profit share percentage based on time vested. So, get out of my face with the you need to take care of me because you're wealthy B.S.
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by FTFOne March 23, 2010 2:39 PM EDT
Good job,1renegrade!! I like the way you think. thanks for making things happen for your.self and your family but also your 21 employees!!! Keep it up 1renegrade...we need more just like you! Contact me if you get a few minutes. barryscafe@gmail.com Barry
by beDecent March 24, 2010 1:56 PM EDT
From a different article, probably linked somewhere within this article:

? Businesses with fewer than 25 employees that pay an average of no more than $40,000 will get a tax credit - up to 35 percent of the company's share of their total health care premium.

? Companies with 26-49 workers are unaffected.

? Businesses with 50 or more workers must offer coverage or pay $750 per worker. That penalty applies for every employee if even one signs up for government-subsidized insurance.
...
When you add it all up, most small businesses could save up to 4 percent on what they pay for employee health insurance.

How is your company any different, 1renegade? Where did you get the idea that "these mandates" (presumably the ones listed within the article you're commenting on) "could force slower expansion or even layoffs"? Now don't go scaring all of your employees with falsities you picked up on FOX News.

Congratulations on all your success, but check your ego; nobody hates you because of it--it's your greed. Your taxes will go up to help out the unfortunate sap who was laid off in 2008 and was diagnosed with bone cancer in 2009. It's called social responsibility; our country is only as strong as its weakest citizen. I need to do some fact checking to support the following statement, but I'm going to make it anyway: Mine will, too, and I make 13K less than your least-paid employee. And I don't mind. There's a large amount of our fellow countrymen suffering, and some now have an end in sight.

WHAT JERKS, those Dems, trying to help out the lesser-fortunate citizens rather than sweeping them under the rug.
by Petepilot62 March 22, 2010 12:28 PM EDT
Finally America, welcome to the 21st century, what a radical idea...that the worlds wealthiest, most progressive nation , should ensure the health of its citizens. Wow,its only about 100years overdue!
Reply to this comment
by Clark Nova March 23, 2010 3:07 PM EDT
By any realistic definition of wealth we are not the wealthiest nation and we have not been the most progressive nation for many decades.
by beyer1944 March 22, 2010 11:02 AM EDT
I love #11. Maybe that will make it more difficult for the insurance companies to give HUGE bonuses to their executives, while they refuse to pay for my Lipitor, which I need because all the other statins I have tried make my muscles ache. Blue Cross/Blue Shield refused me, even after my Dr. called and begged. Take that, jerks!!!
Reply to this comment
by bikertoo March 22, 2010 10:16 AM EDT
Nothing was 'fixed' last night.

Medical costs were not contained.People who couldn't afford insurance are now told that its going to be against the law to not have the insurance they can't afford to pay for for those uncontained medical costs.

Insurance companies now have a lead time to do what the credit card companies did with their lead time. The checks and balances against the increases are something only a politician believes will occur.

Tax credits do nothing for putting groceries on the table next week. Only someone who doesn't have to worry about their own bills believes that the tax credits are going to provide any relief on a day-to-day basis. A tax credit on April 15 doesn't put macaroni on the table next Tuesday.

States are going to HAVE to develope more revenue for what is passed on to and mandated of them. Its going to be a larger version of my second paragraph above. You do know where that additional revenue is going to have to come from, don't you?

Now, while you folks wanna argue politics and political parties and throw ridiculous insults at each other, the American worker, American businesses and the American income are about to be gouged once again.

Do something about medical costs and carte blanche treatment techniques if you want to improve health care, create affordable health care or even have health care.

The only thing fixed last night was any challenge to the rape of America.
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by edmonton1958 March 31, 2010 8:32 AM EDT
hey idiot, if you work and make 1300.00 a month. lets see you buy your precious republican health insurance. I guess you can always file bankruptcy
by quotelawrence March 22, 2010 10:09 AM EDT
I wish everyone would quit thinking of what we can get out of America, because Health-care is just another way to pronoun the entitlement plan, as a 50+ year old American citizen, I wonder who has won in America during this nations beginning European settlers came and gave their all to be Americans, being a descendant from European origin, we fought every battle from the war of Independence, to the civil war, and still we are fighting wars, we fight for our position in the checkout lines, because everyone who is on american soil is entitled to get the Social Security monies I have paid in, all my life, they want, my possessions, my hopes, and my children's hopes, and then I hear people complaining that others have it better so they should pay, it is not them, that will pay it is us, and this is the current "Just US"
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by tsigili March 22, 2010 10:00 AM EDT
Wow. A 50% increase in insurance costs in a single year. Even for those with insurance, that is going to equate to a cut in pay, in a depression. That was really intelligent.
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by rockcutr March 22, 2010 9:53 AM EDT
Oh nuts. Now folks are going to have to work for a living. To further surpport the insurance industry.
It is refreshing to see Republicans all in a steaming pile of fresh dukey. They are the real stinkers here.
Fair retro action from 88 years of bush...oh, sorry 8 years. Just seemed lots longer. He now works for his wife. Stumping for Iranian womens rights. What a hoot.
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