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Health Care Reform in a Nutshell

Health Care Reform in a Nutshell Featured Image
Have you read the health care bill yet? All 2,000 pages of it? We didn’t think so.

Thankfully, the fine folks at Reuters have created a summary of what is to be expected. Obviously there’s a lot more to it, but this is a good start:

Healthcare reform in 2010

  • Insurance companies will be barred from dropping people from coverage when they get sick.
  • Lifetime coverage limits will be eliminated and annual limits are to be restricted.
  • Insurers will be barred from excluding children for coverage because of pre-existing conditions.
  • Young adults will be able to stay on their parents’ health plans until the age of 26 instead of being dropped at age 19, or when they finish college.
  • Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.
  • A temporary reinsurance program will be created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.
  • Medicare drug beneficiaries who fall into the “doughnut hole” coverage gap will get a $250 rebate.
  • A tax credit will become available for some small businesses to help provide coverage for workers.
  • A 10% tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.

Healthcare reform in 2011

  • Medicare will provide 10% bonus payments to primary care physicians and general surgeons.
  • Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service.
  • New health plans will be required to cover preventive services with little or no cost to patients.
  • A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.
  • Payments to insurers offering Medicare Advantage services will be frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.
  • Employers will be required to disclose the value of health benefits on employees’ W-2 tax forms.
  • An annual fee will be imposed on pharmaceutical companies according to market share. The fee will not apply to companies with sales of $5 million or less.

Healthcare reform in 2012

  • Physician payment reforms will be implemented in Medicare to enhance primary care services and encourage doctors to form “accountable care organizations” to improve quality and efficiency of care.
  • An incentive program will be established in Medicare for acute care hospitals to improve quality outcomes.
  • The Centers for Medicare and Medicaid Services, which oversees the government programs, will begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.

Healthcare reform in 2013

  • A national pilot program will be established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.
  • The threshold for claiming medical expenses on itemized tax returns will be raised to 10% from 7.5% of income. The threshold will remain at 7.5% for the elderly through 2016.
  • The Medicare payroll tax will be raised to 2.35% from 1.45% for individuals earning more than $200,000 and married couples with incomes over $250,000. This tax will also be imposed on some investment income for that income group.
  • A 2.9% excise tax will be imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.

Healthcare reform in 2014

  • State health insurance exchanges for small businesses and individuals will open.
  • Most people will be required to obtain health insurance coverage or pay a fine if they don’t.
  • Healthcare tax credits will become available to certain income groups to purchase coverage on the exchange.
  • Health plans will no longer be able to exclude people from coverage due to pre-existing conditions.
  • Employers with 50 or more workers who do not offer coverage will face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren’t counted for the fine.
  • Health insurance companies will begin paying a fee based on their market share.

Healthcare reform in 2015

  • Medicare will create a physician payment program aimed at rewarding quality of care rather than volume of services.

Healthcare reform in 2016

  • An excise tax on high cost employer-provided plans will be imposed. The first $27,500 of a family plan and $10,200 for individual coverage will be exempt from the tax. Higher levels will be set for plans covering retirees and people in high risk professions.

What do you think about this bill? Leave a comment so we can discuss…