What Healthcare Reform REALLY Does For Us

| March 24, 2010 | 7 Replies

In an historic vote late Saturday evening, the US House passed into law the Patient Protection and Affordable Care Act on a mostly party line vote of 219-212. The Act will be made into law (the bill passed by the US Senate 60-39) upon signature by President Obama.

On Tuesday, March 23, 2010, President Obama signed the bill into law in a ceremony attended by members of Congress, the US Senate, staff and an 11-year old advocate of healthcare reform who had lost his mother to cancer. There’s been a lot of confusion and misinformation spread about the bill as to what it contains and when certain aspects of the legislation go into effect. The terms of the new law were discussed in impressive clarity by Rachel Maddow and Barney Frank. See also, this article from the New York Times.

As of March 23, 2010, consumers will be entitled to the following:

– Tax credits go to small businesses for buying health insurance for their employees, and;

– The so-called “doughnut hole” for seniors under Medicare Part D (drug) coverage is going; if you’ve reached the total for 2009, you will be immediately sent a rebate check of $250.00, and;

– Pre-existing conditions will no longer be allowed for denials of health insurance coverage on new policies issued, and;

– States will be required to maintain their existing Medicaid and children’s health insurance coverage based on policies currently in effect. While states can expand their programs, they are not allowed to cut back on eligibility and are not allowed to put in place any paperwork requirements that would make it harder for people to sign up for coverage, and;
Freestanding birth centers” are now eligible for Medicaid payments, and;

– Another provision that appears to take effect right away is an expansion of Medicare to cover certain victims of “environmental health hazards,” which was aimed specifically at the town of Libby, Mont.

– A requirement that the secretary of health and human services establish criteria “for determining whether health insurance issuers and employment-based health plans have discouraged an individual from remaining enrolled in prior coverage based on that individual’s health status.”

On April 23, 2010,

– The secretary of health and human services must post on the Internet “a list of the authorities provided to the secretary under this act.”

In June, 2010,

– High Risk Insurance pools open to cover those with any pre-existing conditions (June 1, 2010),; and

– The Secretary of HHS must “develop a standardized format to be used for the presentation of information relating to coverage” — so that consumers have a more understandable way of comparing health benefits — like medical, surgical, hospital and prescription drug coverage — offered by private insurers (June 23, 2010).

On September 23, 2010,

– Children may not be excluded from any coverage because of pre-existing conditions, and;

– Insurers will not be allowed to deny coverage because you get sick (so called “rescissions”), and;

– No more lifetime limits on coverage or benefits allowed, and;

– Children are covered under your policy, if you want, until age 26.

On January 1, 2011

– Insurers are required to spend 80-85% of premiums on providing actual medical care, or you must be given a rebate for the difference, and;

– Medicare patients will be provided with free preventative care with no fees or co-pays allowed.

In 2014

– A total ban upon any exclusions because of pre-existing conditions, and;

– A total ban upon annual limits of coverage or benefits under any health insurance policy, and;

– Health insurance exchanges will be open for business under the new federal guidelines as outlined above to promote competition and bring down costs to consumers.

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Category: Health Care Reform

About the Author ()

imothy E. Hogan is a trial attorney, a husband, a father of two awesome children and a practicing Roman Catholic in St. Louis, Missouri. Mr. Hogan has done legal and political work in Jefferson City, Missouri for partisan and non-partisan social change, environmental and consumer protection groups. Mr. Hogan has also worked for consumer advocate Ralph Nader in Washington, DC and the members of the trial bar in the State of New York. Mr. Hogan’s current interests involve remaining a full time solo practitioner pioneer on the frontiers of justice in America, a good husband and a good father to his awesome children.

Comments (7)

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  1. Tim Hogan says:

    The Washington Post has an interactive site for finding out some benefits which you may personally get under the new law.

    http://www.washingtonpost.com/wp-srv/special/poli

  2. curious says:

    What I want to know is should I continue to save money for my retirement and long term care (nursing home) or should I just enjoy my money–perhaps take some cruises, maybe buy a used car for my grandchildren? Aren't I silly to save for my own long term care–won't the goverment pay for my nursing home? Does Obamacare indeed pay for this? If so, will the free nursing home be a shared room or will I get a private room? I think I'm going to like Obamacare.

    • Erich Vieth says:

      Curious. I suspect you are being facetious. Based on demographics, I'm assuming that within 20 years, there will be about a half-dozen elderly people to each room at nursing homes, leading to widespread acceptance to euthanasia. I'm only being partly facetious. But this is Tim Hogan's post, and I'll wait to see what he has to say.

  3. Tim Hogan says:

    Curious, I still have Life Insurance and an LTC and LTD policy, as well as an IRA, Roth IRA (when I may make contributions)and an SEP. Proper planning prevents piss poor poverty when I get older.

    You should do likewise because the healthcare reform only addresses some 3-5% of the future projected annual expenditures on healthcare and doesn't address your stated spurious concerns.

    As for Social Security and Medicare, the GOP alternative budget will eliminate those as federal programs. If you want to see anything from Social Security and Medicare, you had better vote Democratic!

  4. Niklaus Pfirsig says:

    Curious,

    I am a member of the politically invisible majority. I support a family of 4 on less that $50,000 per year. I, my wife and one of my two sons have chronic health problems, and I have been unable to build any significant savings due to the rampant fraud that resulted from the deregulation of financial entities under the Bush administration.

    The past 3 years, I have seen my expenses, including medical expenses rise due to copay hikes, and due to my wife being dropped from Tenncare (the Tennessee medicaid waiver program) due to state legislation that stopped the private insurance companies from dumping their less profitable patients into the public system. In the past month this has cost me a little over $800 in copays and uncovered expenses, pretty much wiping out my savings.

    I would love to be able to build up a nest egg. My wife did have some money in a mutual fund from back when she could still work, but after one of those greedy bastard banker that Bush signed our tax money to got done raiding the cookie jar, the total value is about $28.

    So if you're even in Nashville, let me know and you and I can meet in a dark alley and I can introduce you to the REAL world where well over half of the population live.

  5. Erich Vieth says:

    Governor Mitt Romney's plan, which closely resembles Barack Obama's, was heaped with praise by the conservative Heritage foundation. But that was before Obama pushed an extremely similar program. When a conservative pushes the idea, it's a good "conservative" idea. When a Democrat pushes a similar idea, it's socialism.

    http://thinkprogress.org/2010/04/10/heritage-romn

  6. Tim Hogan says:

    HHS did a quick review of the benefits of the Affordable Care Act (ACA) to Missourians:

    http://www.healthcare.gov/law/resources/mo.html

    I supplied a correction that Missouri’s Republican General Assembly refused to establish any health insurance exchanges under Missouri law which will cost us millions in lost grant monies under the ACA. Under the ACA, if states fail and refuse to establish health insurance exchamges, HHS will do it for them. The exchanges are to be formed to allow full implementation of the ACA and access by consumers to lower premium, higher benefits health insurance polices under the ACA.

    The Republicans in Missouri want the ACA to fail, so they have done and will do whatever they can to slow or stop its successful implementation.

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