We are at the half way mark – with 6 more months to go. So, what are you doing about the Patient Care
Act. Is your company ready? Are your employees ready for these changes? Is it your job to inform them? HHS.gov provides a good rundown on items that
are coming around the bend. It’s
probably a good idea to start thinking about and planning for this. For details of what’s to come, please see
below. This information can also be accessed by going to the Health and Human Services website: www.hhs.gov/healthcare/facts/timeline/timeline-text.html#2014. Like it or not, its coming. Such is life, such is change, be prepared.
NEW CONSUMER PROTECTIONS
- Prohibiting
Discrimination Due to Pre-Existing Conditions or Gender. The law
implements strong reforms that prohibit insurance companies from refusing
to sell coverage or renew policies because of an individual’s pre-existing
conditions. Also, in the individual and small group market, the law
eliminates the ability of insurance companies to charge higher rates due
to gender or health status. Effective January 1, 2014. Learn
more about protecting Americans with pre-existing conditions.
- Eliminating
Annual Limits on Insurance Coverage. The law prohibits new plans
and existing group plans from imposing annual dollar limits on the amount
of coverage an individual may receive. Effective January 1, 2014.Learn how
the law will phase out annual limits by 2014.
- Ensuring
Coverage for Individuals Participating in Clinical Trials. Insurers
will be prohibited from dropping or limiting coverage because an
individual chooses to participate in a clinical trial. Applies to
all clinical trials that treat cancer or other life-threatening
diseases. Effective January 1, 2014.
IMPROVING QUALITY AND LOWERING COSTS
- Making
Care More Affordable. Tax credits to make it easier for the
middle class to afford insurance will become available for people with
income between 100% and 400% of the poverty line who are not eligible for
other affordable coverage. (In 2010, 400% of the poverty line comes out to
about $43,000 for an individual or $88,000 for a family of four.) The tax
credit is advanceable, so it can lower your premium payments each month,
rather than making you wait for tax time. It’s also refundable, so even
moderate-income families can receive the full benefit of the credit. These
individuals may also qualify for reduced cost-sharing (copayments,
co-insurance, and deductibles). Effective January 1, 2014.
- Establishing the
Health Insurance Marketplace. Starting in 2014 if your employer
doesn’t offer insurance, you will be able to buy it directly in the Health
Insurance Marketplace. Individuals and small businesses can buy affordable
and qualified health benefit plans in this new transparent and competitive
insurance marketplace. The Marketplace will offer you a choice of health
plans that meet certain benefits and cost standards. Starting in
2014, Members of Congress will be getting their health care insurance
through the Marketplace, and you will be able buy your insurance through
Marketplace too. Learn more
about the Health Insurance Marketplace.
- Increasing
the Small Business Tax Credit. The law implements the second
phase of the small business tax credit for qualified small businesses and
small non-profit organizations. In this phase, the credit is up to 50% of
the employer’s contribution to provide health insurance for
employees. There is also up to a 35% credit for small non-profit
organizations. Effective January 1, 2014. Learn
more about the small business tax credit.
INCREASING ACCESS TO AFFORDABLE CARE
- Increasing
Access to Medicaid. Americans who earn less than 133% of the
poverty level (approximately $14,000 for an individual and $29,000 for a
family of four) will be eligible to enroll in Medicaid. States will
receive 100% federal funding for the first three years to support this expanded
coverage, phasing to 90% federal funding in subsequent years. Effective
January 1, 2014.
- Promoting
Individual Responsibility. Under the law, most individuals who
can afford it will be required to obtain basic health insurance coverage
or pay a fee to help offset the costs of caring for uninsured
Americans. If affordable coverage is not available to an individual,
he or she will be eligible for an exemption. Effective January 1,
2014.
