Health care reform: What happens next?
The new health care law will change the health care system in America over the next decade. Here is a look at some of the major provisions in the legislation and when they would take effect:
- Require insurers to cover preventive screenings such as immunizations for children and cancer screenings for women.
- Extend coverage to dependent children up to age 26 on their parents' policies.
- Give tax credits to businesses with no more than 25 employees and average wages of $40,000 to support coverage for their workers. The credit would be up to 35 percent of the employer's contribution if the employer pays 50 percent of the total premium.
- Introduce provisions to begin closing the doughnut hole for seniors in Medicare Part D, starting with a $250 rebate.
- Prohibit insurers from rescinding coverage (except in cases of fraud), placing lifetime dollar limits on benefits, or excluding coverage for children with preexisting conditions.
- Create $5 billion temporary high-risk insurance pool to provide coverage to individuals with preexisting conditions who have not had insurance for at least six months.
- Require insurers to provide rebates to customers if the insurers spend less than 85 percent of the premium dollar they collect on health care.
- Freeze Medicare Advantage reimbursement rates at 2010 levels.
- Begin assessing fees on pharmacy companies, estimated at $30 billion over 10 years.
- Begin aggressive measures to fight fraud, waste, and abuse.
- Launch national Medicare five-year patient-centered medical homes pilot.
- Increase funding by $11 billion for community health centers.
Effective 2012 - 2013
- Increase Medicare payroll tax by 0.9 percent on individuals making more than $200,000 and couples making more than $250,000. Unearned income, now exempt from the payroll tax, would also be subject to a 3.8 percent tax.
- Begin assessing fees on makers of durable medical equipment, estimated at $20 billion over 10 years.
- Impose limits of $2,500 on flexible spending account contributions for health expenses.
- Begin assessing fees on health insurers estimated at $70 billion over 10 years.
- Mandate that everyone purchase insurance. Those who do not will pay an annual penalty, at $95 or 1 percent of income, whichever is greater.
- Offer federal subsidies to qualified Americans to offset the cost of insurance.
- Begin insurance reforms that guarantee coverage and prohibit exclusions for preexisting conditions and annual dollar limits on coverage.
- Begin state-based health exchanges.
- Expand Medicaid to cover 15 million uninsured. From 2014 to 2016, the federal government will pay all of the costs for covering the newly eligible Medicaid beneficiaries.
- Require plans to offer essential benefits for individuals and small groups.
- Require employers who do not offer health benefits, or whose workers get coverage through an exchange, to pay a $2,000 penalty per employee. Pertains to employers that have 50 workers and the first 30 employees are exempt from the penalty.
- Raise penalties for not having insurance to $325 or 2 percent of income, whichever is greater.
- Raise penalties for not having insurance to $695 or 2.5 percent of income, whichever is greater.
Effective 2017 - 2018
- Begin 40 percent excise or "Cadillac" tax on expensive health plans: $27,500 for a family plan and $10,200 for an individual plan.