What Health Care Reform Means for You and Your Family

March 26, 2010 - 12:44

After more than a year of public debate, Congress has taken an historic step by enacting the Patients Protection Affordable Health Care Act -- legislation that will benefit every American.  My goal has always been to pass a health care reform bill that would reduce the escalating costs of health care and provide American families with affordable, quality health coverage without adding to our federal deficit.  This bill achieves all of those goals.
 
The alarming rise in the cost of health care was one of the driving factors behind our health care reform efforts. In 1996, the average cost of a health care policy for a Maryland family was approximately $6,000; 10 years later, in 2006 that cost had risen to nearly $12,000 and by 2016 the same insurance policy was projected to increase to almost $24,000 – if we had done nothing to reform our system. Health insurance premiums have been rising at a rate three times faster than wages, and by 2016 health insurance premiums were expected to consume 32.2 percent of the projected median family income in Maryland.  The health care reform signed into law by President Obama is expected to reduce health insurance premiums for Maryland families.
 
Together, the Patients Protection Affordable Health Care Act and the Health Care and Education Affordability Reconciliation Act, which is a series of improvements to the base bill, will reduce overall health care costs while preserving choice of health care plans and providers. The Congressional Budget Office estimates the new health care reform law will cut the deficit by over $100 billion in the first 10 years and more than $1 trillion in the second decade, all while extending benefits to 32 million uninsured Americans. Critical to keeping down costs will be the creation in 2014 of individual and small business exchanges, which will leverage buying power and provide greater choice of health care plans.
 
It is important that every Marylander understand what provisions are in the new law, how they will affect you and your family, and when they will take effect.  Below is a chart that details the bill’s major provisions that will take effect over the next few months.  You can find links to the full bill text at my website
www.cardin.senate.gov.

Senator Cardin is a member of five Senate committees:  Foreign Relations, Judiciary, Environment and Public Works, Budget, and Small Business and Entrepreneurship.  His web site is: cardin.senate.gov. He also can be found at YouTube.com/SenatorCardin and you can follow Senator Cardin on twitter at www.twitter.com/SenatorCardin.

FROM DAY ONE: IMMEDIATE BENEFITS OF HEALTH REFORM
On March 23, 2010, President Obama signed health insurance reform into law. Starting from day one and throughout the next year, our families, small businesses, seniors, and young Americans will begin to feel the real and positive impact of reform. The following table describes some of those benefits.
BENEFITHELP FOR …WHAT THIS MEANS FOR AMERICANS
Effective Upon Enactment
(Immediate Eligibility for these Benefits)
Small Business                Tax CreditsSmall BusinessesProvides tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35% of premiums will be immediately available to firms that choose to offer coverage. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
Closing Medicare            Part D "Donut Hole"SeniorsProvides a $250 rebate to Medicare beneficiaries who hit the “donut hole” in 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
Effective 90 Days After Enactment
Help For The Uninsured Until Exchange is AvailableFamiliesProvides access to insurance for Americans who are uninsured because of a pre‐existing condition – through a temporary high-risk pool.
Effective 6 Months After Enactment
No Discrimination Against Children With Pre-Existing ConditionsYoung               AmericansProhibits health plans from denying coverage to children with pre‐existing conditions. (Beginning in 2014, this prohibition would apply to all persons.)
Extends Coverage Up To 26th Birthday Thru Parents' InsuranceYoung             AmericansRequires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice.
Ends RecissionsFamiliesBans health plans from dropping people from coverage when they get sick.
Bans Lifetime Limits on CoverageFamiliesProhibits health plans from placing lifetime caps on coverage.
Bans Restrictive Annual Limits on CoverageFamiliesTightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
Patient ProtectionsFamilies                 WomenFor new plans, choice of doctors will be protected by allowing members to pick any participating primary care provider, prohibiting insurers from requiring pre-authorization before a woman sees an ob-gyn, and ensuring access to emergency care.
Fair Appeals ProcessFamiliesAt a minimum, provides beneficiaries with a notice of internal and external appeals processes and allows beneficiaries to review their file and present evidence in their appeal. 
Effective Beginning January 1, 2011
Free Preventive Care Under MedicareSeniorsEliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program.
Free Annual CheckupsSeniorsAnnual wellness check-ups for all seniors with no copays or deductibles.
Ensuring Value for Premium PaymentsFamiliesRequires 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%. Insurers that do not meet these thresholds must provide rebates to policyholders.
Office of U.S. Senator Benjamin L. Cardin - updated 3/25/2010

 

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