Tuesday, March 23, 2010

Health Care facts

In 2010 …
For people with health insurance coverage, your insurer will no longer be able to:
* Rescind your policy after you get sick (huh, who allowed them to do that before?)
* Limit your lifetime benefits
* Make you pay co-pays or deductibles for preventive services
* Exclude pre-existing conditions for your children (what about for you? wait 'til 2014)
* Spend less than 85 cents of every premium dollar on health services in the large group market or less than 80 cents in the small group and individual market.
For people without insurance, the bill
* Sets up a new federal, "high-risk" insurance pool that those with uninsurable medical problems can enroll in, funded with $5 billion. (Many states have such pools, but very few are able to afford the premiums, and it's unclear whether this new federal plan will be any more affordable.)
* For those 26 years old or younger, allows them to remain on their parents' insurance policies.
For older adults who hit the "donut" hole of Medicare drug coverage, the program will provide a $250 rebate (the first step in the legislation's plan to eliminate this nasty policy by 2020).
For small businesses (fewer than 25 workers) with average wages of less than $50,000, the feds will provide tax credits of up to 35% of their premiums. Considerable research shows that such tax incentives (a form of subsidy) result in very few newly insured workers; subsidies have to reduce the effective price of insurance a lot more, say 60-80%, to get much benefit.
For communities, the bill:
* Increases funding by $11 billion over 5 years for community health centers and for placement of doctors and nurses in areas with too few of them.
* Provides new funding for a "Prevention and Public Health Fund" to expand public health programs and a new grant program to support community-level efforts to reduce chronic diseases and other health disparities, especially in rural areas.
* Requires not-for-profit hospitals to better account for the benefit they provide their communities (in return for not paying taxes like other businesses) and how they meet community needs.
Don't see your favorite (or most hated) provision … health insurance exchanges, Medicaid expansion, individual mandate, Maserati health plan tax?

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