Health Reform Timeline Complicated, Ambitious
The health care reform bill and its accompanying reconciliation package are complicated and include an ambitious timeline. USA Today provides an interactive timeline that boils down the 2,700-plus pages into easy-to-understand dates. While many provisions start in 2010 (including an immediate tax on tanning salons), various provisions won’t kick in until 2018.
According to the USA Today article, here are revision dates that will impact everyone:
- Temporary high-risk insurance pool: A $5 billion pool would be created in June to provide health to individuals who have pre-existing conditions and have been uninsured for at least six months.
- Pre-existing conditions: Insurers will be barred beginning September from denying coverage to children who have pre-existing medical conditions.
- Adult dependent children: Insurers will have to provide coverage for adult dependent children up to 26 years old beginning September.
- Insurance coverage limits: Payers would be prohibited beginning September from placing lifetime limits on how much they pay out to individual policyholders and from rescinding coverage except in cases of fraud.
- Preventive services: Insurance companies will be required to cover preventive services such as immunizations and cancer screenings for women beginning September.
- Medicare Part D “doughnut hole” filled: Beginning New Year’s Day, drug companies would provide a 50 percent discount on brand name drugs for seniors who face a gap in coverage.
- Primary care boost: Primary care physicians and general surgeons who practice in areas lacking primary care doctors would receive a 10 percent bonus payment from Medicare beginning Jan. 1 and ending 2015.
- Help for long-term care: A voluntary long-term care program called CLASS, beginning Jan. 1, would allow subscribers, after five years of contributions, to get a $50 per day cash benefit to help pay for long-term care.
- Rebates from payers: Beginning Jan. 1, insurers would be required to provide rebates to enrollees if they spend less than 85 percent of their premium dollars on care as opposed to administrative costs.
- Health savings accounts: A national contribution limit of $2,500 to tax free accounts for health costs will standardize the limit. Currently, employers set the limit.
- Good and bad tax news: 1) Employees will be able to deduct 10 percent of unreimbursed medical expenses rather than 7.5 percent; BUT 2) the Medicare tax would increase from 1.45 percent to 2.35 percent on earnings over $200,000 for individuals and $250,000 for family. Medicare tax also would be imposed on investment income.
- Individual mandate: Beginning Jan. 1 most Americans would be required to buy health insurance or pay fines of $95 or $285 per family or 1 percent of taxable household income, whichever is greater.
- Employer penalty: Starting the same day, employers with 50 or more employees would pay a fine if any full-time workers qualified for federal health care subsidies.
- Medicaid expansion: Medicaid will expand to include anyone under 65 whose income eligibility was up to 133 percent of the federal poverty line or $29,327 for a family of four.
- Subsidies: Also beginning New Year’s Day, federal subsidies, varying by household income, would help offset the cost of buying insurance for citizens and legal residents who qualify.
- Health insurance exchanges: State-based exchanges would offer places where uninsured individuals and small businesses could comparison shop for policies.
- Individual mandate: This penalty for not carrying insurance would increase to $325 per family member and $975 per family or 2 percent of taxable household income, whichever is greater, starting Jan. 1.
- Individual mandate: Penalties increase to $695 per family member (up to $2,085) or 2.5 percent of taxable household income, whichever is greater.
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