Tuesday, March 23, 2010

What is in health care reform?

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The good things the new health care reform will do is pretty incredible. And a lot of them start right away, or at least sometime this year.


  • Ban on denial of children because of pre-existing conditions

  • Tax credits for small businesses to assist with employee's insurance premiums, up to 50% of the premium cost.

  • Rebates for seniors to help cover the medication coverage expenditure limitation in Medicare

  • Cutoff for young adults being on their parents' insurance policy is reset to age 27.

  • Lifetime caps on individual insurance are banned.

  • High-risk insurance pool created for adults with pre-existing conditions

  • New insurance plans must include preventative care without co-pays

  • Insurance companies are banned from cutting someone's insurance once they get sick

  • Insurance companies must reveal how much money they output on administrative costs and profits

  • There will finally be an appeals process for coverage and claims for the patient

  • New screening processes to tackle health insurance fraud

  • Medicare payment protections will be extended to small and rural hospitals.

  • Nutritional content will have to be disclosed by chain restaurants


  • Annual wellness visits and prevention care for Medicare recipients

  • Medicaid plans that would allow states to offer home and community care for the disabled

  • Payments to insurers offering Medicare Advantage frozen at 2010 level to bring costs in line with Medicare.

  • Employers must disclose the value of employees' health benefits on their W-2

  • Insurance companies required to spend 80-85 of premiums on actual health care, or they will be required to issue a rebate to the patient for the difference


  • Move in Medicare and Medicaid to track admissions to prevent readmissions because of preventable issues.


  • Medicare payroll tax increased for individuals earning > $200,000 per year, or couples earning > $250,000 per year.


  • Ban on discrimination for adults with pre-existing conditions

  • Insurance exchanges for small businesses and individuals

  • Annual limits for insurance will be banned


  • All plans must include preventative care without co-pays

There are still a number of fixes that will need to be put into law, like a lot of earmarks and fluff removed...as well as the affirmation that federal dollars will not be spent on abortion services.  I hope the Republicans will be kind in their treatment of these fixes.

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