Quick Wins: Who Will Be Helped Right Away By the New Health Care Reform Law?

From our friends at Community Catalyst: National health care reform will have immediate benefits for Americans seeking quality, affordable health care. Focusing on the benefits that these policies will have on real people’s lives will help gain greater support for the new law, and put a human face on the issues that are being resolved.

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Seniors enrolled in Medicare

Lower Prescription Costs
In June 2010

• $250 rebate to people enrolled in Medicare Part D who reach the doughnut hole

In 2011

• 50% discount on brand‐name drugs for people in the doughnut hole

Focus on Prevention
In 2011

• No co‐payments for preventive services like mammograms and colonoscopies, and these services are exempt from deductibles

What does it mean?

Seniors who spend over $2,800 on prescription drugs and enter the doughnut hole will get more help paying for the medication they need. Seniors will also be able to get preventive care to stay healthier.

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Small businesses

Tax Credits to Help Cover Employees (for businesses with no more than 25 full-time equivalent employees, annual average wages of less than $50,000, and cover at least 50% of their employees’ premiums)

In 2010

• Tax credits to offset up to 35% of the employer’s portion of their workers’ premiums

In 2014

• Tax credits will increase to offset up to 50% of premiums

What does it mean? Small businesses who offer their employees health insurance will get help covering that expense, so they can invest in growing their businesses.

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People with chronic health conditions

No Lifetime Limits on Coverage
September 2010

• Health insurance companies can no longer place lifetime caps on coverage

Insurers Cannot Deny Coverage to Children with Pre‐Existing Conditions

September 2010

• Children with special health care needs will be able to get insurance that will cover necessary treatment of their illnesses

Special Insurance Available to People with Pre-existing Conditions
June 2010

• An interim high risk pool will provide immediate access to insurance for people who have not been able to get coverage because of a pre‐existing condition

What does it mean? Children and adults with chronic health care needs will not have to worry about running out of health benefits while fighting their illnesses. Currently, many people have no options for insurance coverage because of a health condition. And, while not a perfect solution, the temporary high risk pool will give them access to insurance until the new law covers everyone with pre-existing conditions in 2014.

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Young adults

Option to Stay on Insurance
September 2010*

• Health plans have to allow young adults to remain on their parents’ health insurance up to their 26th birthday

What does it mean? Young adults just starting out will continue to stay healthy and have protection in the case of an accident, and their parents will no longer have to worry about their children who cannot afford insurance.
* Note: Some insurers are implementing this provision early, allowing this population to be covered on their parents’ plans now. However, some employers are not offering this option and both must agree in order for consumers to receive this benefit earlier than the law mandates.