What Does Health Care Reform Mean to Me?

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Clear & Simple Answers to "What does health insurance reform actually mean for me?"

Let's start with how health care reform will extend and strengthen coverage:

• Starting 2010, children with pre-existing medical conditions can no longer be denied health insurance. Once the new health insurance exchanges begin in the coming years, pre-existing condition discrimination will become a thing of the past for everyone.

• Starting 2010, health insurance plans will allow young adults to remain on their parents' insurance coverage up until their 26th birthday.

• Starting 2010, insurance companies will be banned from canceling coverage when they get sick, and they will be banned from implementing lifetime caps on health insurance . This year, restrictive annual limits on coverage will be banned for certain plans. Under health insurance reform, Americans will be ensured access to the care they need.

• Starting 2010, adults who are uninsured because of pre-existing medical conditions will have access to affordable insurance through a temporary subsidized high-risk pool.

• At the end of 2010, the bill increases funding for community health centers, so they can treat nearly double the number of patients over the next five years.

• Starting 2010, also will be establish an independent commission to advise on how best to build the health care workforce and increase the number of nurses, doctors and other professionals to meet our country's needs. Going forward, we will provide $1.5 billion in funding to support the next generation of doctors, nurses and other primary care practitioners -- on top of a $500 million investment from the American Recovery and Reinvestment Act.

Health insurance reform will also curb some of the worst insurance industry practices and strengthen consumer protections:

• Starting 2010, this bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.

• Starting 2010, discrimination based on salary will be outlawed. New group health plans will be prohibited from establishing any eligibility rules for health insurance coverage that discriminate in favor of higher-wage employees.

• At the end of 2010, this bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance companies.

• Starting January 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services. Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services. Any insurers who don't meet those thresholds will be required to provide rebates to their policyholders.

• Starting in 2011, this bill helps states require insurance companies to submit explanation for requested premium raise. Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance coverage exchanges.

Reform immediately begins to lower health care costs for American families and small businesses:

• Starting 2010, small businesses that choose to offer coverage will begin to receive tax credits of up to 35 percent of premiums to help make employee coverage more affordable.

• Starting 2010, new private plans will be required to provide free preventive care: no co-payments and no deductibles for preventive services. And beginning January 1, 2011, Medicare will do the same.

• Starting 2010, this bill will provide help for early retirees by creating a temporary re-insurance program to help offset the costs of expensive premiums for employers and retirees age 55-64.

• Starting 2010, this bill starts to close the Medicare Part D 'donut hole' by providing a $250 rebate to Medicare beneficiaries who hit the gap in prescription drug coverage. And beginning in 2011, the bill institutes a 50% discount on prescription drugs in the 'donut hole.'