What Does the New Health Care Law Mean for Me?


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Six months after passage, Louise Kertesz reviews how the law has and will change health care.
by Louise Kertesz

September 23 marked the 6-month anniversary of the Affordable Care Act, signed into law by President Obama on March 23.

All the provisions in the law won’t take effect until 2014, when people without employer coverage and small businesses will be able to purchase affordable insurance in a competitive marketplace, or exchange. Also, in 2014, everyone will be required to have health insurance or pay a fee; those who can’t find affordable coverage will be exempt. Large employers who do not provide minimal essential coverage will have to pay a penalty.

But parts of the law in effect now already begin to extend and improve coverage. Whether you are without insurance, or employed and receiving health insurance through your job, or are a small-business owner, or buy your own individual health insurance, or are on Medicare or Medicaid, provisions in the law are now in force that may benefit you.

Trusted news and information outlets marked the 6-month anniversary of the new law with special reports explaining the changes. Check their websites below for the details and the finer points of the changes.

Here’s a list of some–and by no means all—of those changes in effect now. The websites below give details of the sweeping changes that will occur over the next several years.

  • It is now illegal for an insurance company to deny payment for treatment or cancel your coverage after you get sick because of an error or technical mistake on your application. Policies can be canceled only on the basis of fraud. 
  • Rules prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition.
  • Insurance companies are prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays.
  • Preventive care: All new health plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, copay, or coinsurance.
  • Young adults can stay on their parent’s plan until they turn 26 years old. Check with your insurance company or employer to see if you qualify. 
  • Small business owners (with up to 25 employees and average annual wages of less than $50,000) can get a tax credit of up to 35% of the employer cost of providing employee insurance; this goes up to 50% in 2014 if purchased through an insurance exchange.
  • States can receive federal matching funds to provide Medicaid coverage for low-income childless adults. States will be required to provide this coverage in 2014.
  • Seniors who reach the coverage gap (donut hole) in their Medicare Part D prescription drug plan this year will receive $250. Beginning Jan. 1, 2011, they get a 50 percent discount when buying Part D-approved brand-name drugs. Additional savings will kick in until the coverage gap is closed in 2020. Seniors on Medicare will also receive certain free preventive services beginning in January. 
  • A temporary reinsurance program has been created to help employers continue to provide health insurance coverage to early retirees over age 55 who are not eligible for Medicare as well as their spouses and families.
  • Individuals who have been uninsured for at least six months because of a pre-existing condition have new insurance options through a Pre-Existing Condition Insurance Plan. In 2014, all discrimination against pre-existing conditions will be prohibited.

For more details, here are a few respected information sources:

A Consumer’s Guide to the Health Law, Six Months In” by the Kaiser Family Foundation, an independent nonprofit research and communication foundation focusing on U.S. health care policy and issues. It is not affiliated with Kaiser Permanente, the health care organization. 

Because nothing as sweeping as health reform can be simple, check out this report by a Kaiser Health News reporter of the “yes, but” parts of the changes at six months: “Health Law's 8 New Changes To Insurance—With 7 Caveats.”

Consumers Union, publishers of Consumers Report, issued “Health Reform: The First Six Months. Discover What the New Law Means for You and Your Family.”

For a broader view of what the health reform law provides and what it means to you–and some very cool interactive tools—check out the Kaiser Family Foundation’s Implementation Guideline, described as “an interactive tool designed to explain how and when the provisions of the health reform law will be implemented over the next several years.”

Interactive tools like this one and the next, at healthcare.gov, make it almost fun to learn about health insurance and health care. (I mean, if you’re at all interested. Really.) As the site explains, “You can show or hide all the changes occurring in a year by clicking on that year. Click on a provision to get more information about it. Customize the timeline by checking and unchecking specific topics.”

The government site explaining the provisions of the law is comprehensive, interactive, and easy to navigate, with a timeline toolbar that takes you to a year or a specific change by clicking on it.   

In addition to information about the new law, healthcare.gov offers three interactive tools to 1) help you find the best insurance to suit your needs, 2) learn about preventive care and healthy living for yourself or someone else, and 3) compare the quality of hospitals, nursing homes, and dialysis facilities.

The government says healthcare.gov will grow over time to include more tools and information.

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